|
PR ARYTENOIDECTOMY/ARYTENOIDOPEXY XTRNL APPROACH
|
Professional
|
Both
|
$2,150.00
|
|
|
Service Code
|
HCPCS 31400
|
| Min. Negotiated Rate |
$595.55 |
| Max. Negotiated Rate |
$1,680.28 |
| Rate for Payer: Aetna Commercial |
$1,202.53
|
| Rate for Payer: Aetna Medicare |
$933.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,202.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,292.27
|
| Rate for Payer: BCBS Complete |
$625.33
|
| Rate for Payer: BCBS MAPPO |
$897.41
|
| Rate for Payer: BCN Commercial |
$1,524.82
|
| Rate for Payer: BCN Medicare Advantage |
$897.41
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cofinity Commercial |
$1,202.53
|
| Rate for Payer: Cofinity Commercial |
$1,292.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$897.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$942.28
|
| Rate for Payer: Meridian Medicaid |
$625.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$987.15
|
| Rate for Payer: Nomi Health Commercial |
$1,076.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,612.50
|
| Rate for Payer: PACE SWMI |
$897.41
|
| Rate for Payer: PHP Commercial |
$1,256.37
|
| Rate for Payer: PHP Medicare Advantage |
$897.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$595.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,435.93
|
| Rate for Payer: Priority Health Medicare |
$897.41
|
| Rate for Payer: Priority Health SBD |
$1,435.93
|
| Rate for Payer: Priority Health Tiered Network |
$1,435.93
|
| Rate for Payer: Railroad Medicare Medicare |
$897.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,680.28
|
| Rate for Payer: UHC Core |
$1,680.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$897.41
|
| Rate for Payer: UHC Exchange |
$1,680.28
|
| Rate for Payer: UHC Medicaid |
$595.55
|
| Rate for Payer: UHCCP Medicaid |
$595.55
|
| Rate for Payer: UMR Bronson Commercial |
$989.00
|
|
|
PR AS-AORT GRF W/CARD BYP & AORTIC ROOT RPLCMT
|
Professional
|
Both
|
$6,821.00
|
|
|
Service Code
|
HCPCS 33863
|
| Min. Negotiated Rate |
$1,853.10 |
| Max. Negotiated Rate |
$5,636.85 |
| Rate for Payer: Aetna Commercial |
$3,915.01
|
| Rate for Payer: Aetna Medicare |
$3,038.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,915.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,207.18
|
| Rate for Payer: BCBS Complete |
$1,945.76
|
| Rate for Payer: BCBS MAPPO |
$2,921.65
|
| Rate for Payer: BCN Commercial |
$4,604.83
|
| Rate for Payer: BCN Medicare Advantage |
$2,921.65
|
| Rate for Payer: Cash Price |
$5,456.80
|
| Rate for Payer: Cash Price |
$5,456.80
|
| Rate for Payer: Cofinity Commercial |
$3,915.01
|
| Rate for Payer: Cofinity Commercial |
$4,207.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,921.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,067.73
|
| Rate for Payer: Meridian Medicaid |
$1,945.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,213.82
|
| Rate for Payer: Nomi Health Commercial |
$3,505.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,115.75
|
| Rate for Payer: PACE SWMI |
$2,921.65
|
| Rate for Payer: PHP Commercial |
$4,090.31
|
| Rate for Payer: PHP Medicare Advantage |
$2,921.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,951.91
|
| Rate for Payer: Priority Health Medicare |
$2,921.65
|
| Rate for Payer: Priority Health SBD |
$4,951.91
|
| Rate for Payer: Priority Health Tiered Network |
$4,951.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,921.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,636.85
|
| Rate for Payer: UHC Core |
$5,636.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,921.65
|
| Rate for Payer: UHC Exchange |
$5,636.85
|
| Rate for Payer: UHC Medicaid |
$1,853.10
|
| Rate for Payer: UHCCP Medicaid |
$1,853.10
|
| Rate for Payer: UMR Bronson Commercial |
$3,137.66
|
|
|
PR AS-AORT GRF W/CARD BYP F/AORTIC DISSECTION
|
Professional
|
Both
|
$7,339.00
|
|
|
Service Code
|
HCPCS 33858
|
| Min. Negotiated Rate |
$1,998.37 |
| Max. Negotiated Rate |
$6,076.72 |
| Rate for Payer: Aetna Commercial |
$4,222.53
|
| Rate for Payer: Aetna Medicare |
$3,277.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,222.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,537.64
|
| Rate for Payer: BCBS Complete |
$2,098.29
|
| Rate for Payer: BCBS MAPPO |
$3,151.14
|
| Rate for Payer: BCN Commercial |
$4,969.36
|
| Rate for Payer: BCN Medicare Advantage |
$3,151.14
|
| Rate for Payer: Cash Price |
$5,871.20
|
| Rate for Payer: Cash Price |
$5,871.20
|
| Rate for Payer: Cofinity Commercial |
$4,222.53
|
| Rate for Payer: Cofinity Commercial |
$4,537.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,151.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,308.70
|
| Rate for Payer: Meridian Medicaid |
$2,098.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,466.25
|
| Rate for Payer: Nomi Health Commercial |
$3,781.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,504.25
|
| Rate for Payer: PACE SWMI |
$3,151.14
|
| Rate for Payer: PHP Commercial |
$4,411.60
|
| Rate for Payer: PHP Medicare Advantage |
$3,151.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,998.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,343.91
|
| Rate for Payer: Priority Health Medicare |
$3,151.14
|
| Rate for Payer: Priority Health SBD |
$5,343.91
|
| Rate for Payer: Priority Health Tiered Network |
$5,343.91
|
| Rate for Payer: Railroad Medicare Medicare |
$3,151.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,076.72
|
| Rate for Payer: UHC Core |
$6,076.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,151.14
|
| Rate for Payer: UHC Exchange |
$6,076.72
|
| Rate for Payer: UHC Medicaid |
$1,998.37
|
| Rate for Payer: UHCCP Medicaid |
$1,998.37
|
| Rate for Payer: UMR Bronson Commercial |
$3,375.94
|
|
|
PR AS-AORT GRF W/CARD BYP F/AORTIC DS OTH/THN DSJ
|
Professional
|
Both
|
$5,264.00
|
|
|
Service Code
|
HCPCS 33859
|
| Min. Negotiated Rate |
$1,442.44 |
| Max. Negotiated Rate |
$4,359.60 |
| Rate for Payer: Aetna Commercial |
$3,043.58
|
| Rate for Payer: Aetna Medicare |
$2,362.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,043.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,270.72
|
| Rate for Payer: BCBS Complete |
$1,514.56
|
| Rate for Payer: BCBS MAPPO |
$2,271.33
|
| Rate for Payer: BCN Commercial |
$3,573.02
|
| Rate for Payer: BCN Medicare Advantage |
$2,271.33
|
| Rate for Payer: Cash Price |
$4,211.20
|
| Rate for Payer: Cash Price |
$4,211.20
|
| Rate for Payer: Cofinity Commercial |
$3,043.58
|
| Rate for Payer: Cofinity Commercial |
$3,270.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,271.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,384.90
|
| Rate for Payer: Meridian Medicaid |
$1,514.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,498.46
|
| Rate for Payer: Nomi Health Commercial |
$2,725.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,948.00
|
| Rate for Payer: PACE SWMI |
$2,271.33
|
| Rate for Payer: PHP Commercial |
$3,179.86
|
| Rate for Payer: PHP Medicare Advantage |
$2,271.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,442.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,842.32
|
| Rate for Payer: Priority Health Medicare |
$2,271.33
|
| Rate for Payer: Priority Health SBD |
$3,842.32
|
| Rate for Payer: Priority Health Tiered Network |
$3,842.32
|
| Rate for Payer: Railroad Medicare Medicare |
$2,271.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,359.60
|
| Rate for Payer: UHC Core |
$4,359.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,271.33
|
| Rate for Payer: UHC Exchange |
$4,359.60
|
| Rate for Payer: UHC Medicaid |
$1,442.44
|
| Rate for Payer: UHCCP Medicaid |
$1,442.44
|
| Rate for Payer: UMR Bronson Commercial |
$2,421.44
|
|
|
PR ASCEND AORTA GRAFT INCL VAVLE SUSPENSION
|
Professional
|
Both
|
$10,357.00
|
|
|
Service Code
|
HCPCS 33860
|
| Min. Negotiated Rate |
$4,142.80 |
| Max. Negotiated Rate |
$7,767.75 |
| Rate for Payer: Aetna Medicare |
$5,178.50
|
| Rate for Payer: BCBS Complete |
$4,142.80
|
| Rate for Payer: Cash Price |
$8,285.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,767.75
|
| Rate for Payer: UMR Bronson Commercial |
$4,764.22
|
|
|
PR ASCENDING AORTA GRF VALVE SPARE ROOT REMODEL
|
Professional
|
Both
|
$5,385.00
|
|
|
Service Code
|
HCPCS 33864
|
| Min. Negotiated Rate |
$1,891.65 |
| Max. Negotiated Rate |
$5,759.09 |
| Rate for Payer: Aetna Commercial |
$3,996.58
|
| Rate for Payer: Aetna Medicare |
$3,101.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,996.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,294.83
|
| Rate for Payer: BCBS Complete |
$1,986.23
|
| Rate for Payer: BCBS MAPPO |
$2,982.52
|
| Rate for Payer: BCN Commercial |
$4,706.92
|
| Rate for Payer: BCN Medicare Advantage |
$2,982.52
|
| Rate for Payer: Cash Price |
$4,308.00
|
| Rate for Payer: Cash Price |
$4,308.00
|
| Rate for Payer: Cofinity Commercial |
$4,294.83
|
| Rate for Payer: Cofinity Commercial |
$3,996.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,982.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,131.65
|
| Rate for Payer: Meridian Medicaid |
$1,986.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,280.77
|
| Rate for Payer: Nomi Health Commercial |
$3,579.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,038.75
|
| Rate for Payer: PACE SWMI |
$2,982.52
|
| Rate for Payer: PHP Commercial |
$4,175.53
|
| Rate for Payer: PHP Medicare Advantage |
$2,982.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,891.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,061.69
|
| Rate for Payer: Priority Health Medicare |
$2,982.52
|
| Rate for Payer: Priority Health SBD |
$5,061.69
|
| Rate for Payer: Priority Health Tiered Network |
$5,061.69
|
| Rate for Payer: Railroad Medicare Medicare |
$2,982.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,759.09
|
| Rate for Payer: UHC Core |
$5,759.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,982.52
|
| Rate for Payer: UHC Exchange |
$5,759.09
|
| Rate for Payer: UHC Medicaid |
$1,891.65
|
| Rate for Payer: UHCCP Medicaid |
$1,891.65
|
| Rate for Payer: UMR Bronson Commercial |
$2,477.10
|
|
|
PR ASPIRATION AND/OR INJECTION THYROID CYST
|
Professional
|
Both
|
$167.00
|
|
|
Service Code
|
HCPCS 60300
|
| Min. Negotiated Rate |
$26.63 |
| Max. Negotiated Rate |
$125.25 |
| Rate for Payer: Aetna Commercial |
$55.84
|
| Rate for Payer: Aetna Medicare |
$43.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.00
|
| Rate for Payer: BCBS Complete |
$27.96
|
| Rate for Payer: BCBS MAPPO |
$41.67
|
| Rate for Payer: BCN Commercial |
$71.71
|
| Rate for Payer: BCN Medicare Advantage |
$41.67
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cofinity Commercial |
$55.84
|
| Rate for Payer: Cofinity Commercial |
$60.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.75
|
| Rate for Payer: Meridian Medicaid |
$27.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.84
|
| Rate for Payer: Nomi Health Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.25
|
| Rate for Payer: PACE SWMI |
$41.67
|
| Rate for Payer: PHP Commercial |
$58.34
|
| Rate for Payer: PHP Medicare Advantage |
$41.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$77.76
|
| Rate for Payer: Priority Health Medicare |
$41.67
|
| Rate for Payer: Priority Health SBD |
$77.76
|
| Rate for Payer: Priority Health Tiered Network |
$77.76
|
| Rate for Payer: Railroad Medicare Medicare |
$41.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.24
|
| Rate for Payer: UHC Core |
$87.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.67
|
| Rate for Payer: UHC Exchange |
$87.24
|
| Rate for Payer: UHC Medicaid |
$26.63
|
| Rate for Payer: UHCCP Medicaid |
$26.63
|
| Rate for Payer: UMR Bronson Commercial |
$76.82
|
|
|
PR ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS 51102
|
| Min. Negotiated Rate |
$80.30 |
| Max. Negotiated Rate |
$257.31 |
| Rate for Payer: Aetna Commercial |
$167.49
|
| Rate for Payer: Aetna Medicare |
$129.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.99
|
| Rate for Payer: BCBS Complete |
$84.31
|
| Rate for Payer: BCBS MAPPO |
$124.99
|
| Rate for Payer: BCN Commercial |
$209.65
|
| Rate for Payer: BCN Medicare Advantage |
$124.99
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$167.49
|
| Rate for Payer: Cofinity Commercial |
$179.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.24
|
| Rate for Payer: Meridian Medicaid |
$84.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$137.49
|
| Rate for Payer: Nomi Health Commercial |
$149.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.50
|
| Rate for Payer: PACE SWMI |
$124.99
|
| Rate for Payer: PHP Commercial |
$174.99
|
| Rate for Payer: PHP Medicare Advantage |
$124.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$228.38
|
| Rate for Payer: Priority Health Medicare |
$124.99
|
| Rate for Payer: Priority Health SBD |
$228.38
|
| Rate for Payer: Priority Health Tiered Network |
$228.38
|
| Rate for Payer: Railroad Medicare Medicare |
$124.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.31
|
| Rate for Payer: UHC Core |
$257.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.99
|
| Rate for Payer: UHC Exchange |
$257.31
|
| Rate for Payer: UHC Medicaid |
$80.30
|
| Rate for Payer: UHCCP Medicaid |
$80.30
|
| Rate for Payer: UMR Bronson Commercial |
$116.84
|
|
|
PR ASPIRATION BLADDER NEEDLE
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 51100
|
| Min. Negotiated Rate |
$21.51 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$35.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.47
|
| Rate for Payer: BCBS Complete |
$22.59
|
| Rate for Payer: BCBS MAPPO |
$33.66
|
| Rate for Payer: BCN Commercial |
$57.76
|
| Rate for Payer: BCN Medicare Advantage |
$33.66
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$45.10
|
| Rate for Payer: Cofinity Commercial |
$48.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.34
|
| Rate for Payer: Meridian Medicaid |
$22.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.03
|
| Rate for Payer: Nomi Health Commercial |
$40.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.00
|
| Rate for Payer: PACE SWMI |
$33.66
|
| Rate for Payer: PHP Commercial |
$47.12
|
| Rate for Payer: PHP Medicare Advantage |
$33.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$62.92
|
| Rate for Payer: Priority Health Medicare |
$33.66
|
| Rate for Payer: Priority Health SBD |
$62.92
|
| Rate for Payer: Priority Health Tiered Network |
$62.92
|
| Rate for Payer: Railroad Medicare Medicare |
$33.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.99
|
| Rate for Payer: UHC Core |
$68.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$33.66
|
| Rate for Payer: UHC Exchange |
$68.99
|
| Rate for Payer: UHC Medicaid |
$21.51
|
| Rate for Payer: UHCCP Medicaid |
$21.51
|
| Rate for Payer: UMR Bronson Commercial |
$58.88
|
|
|
PR ASPIRATION BLADDER TROCAR/INTRACATHETER
|
Professional
|
Both
|
$399.00
|
|
|
Service Code
|
HCPCS 51101
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$299.25 |
| Rate for Payer: Aetna Commercial |
$59.46
|
| Rate for Payer: Aetna Medicare |
$46.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.89
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCBS MAPPO |
$44.37
|
| Rate for Payer: BCN Commercial |
$75.70
|
| Rate for Payer: BCN Medicare Advantage |
$44.37
|
| Rate for Payer: Cash Price |
$319.20
|
| Rate for Payer: Cash Price |
$319.20
|
| Rate for Payer: Cofinity Commercial |
$59.46
|
| Rate for Payer: Cofinity Commercial |
$63.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.59
|
| Rate for Payer: Meridian Medicaid |
$29.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.81
|
| Rate for Payer: Nomi Health Commercial |
$53.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$299.25
|
| Rate for Payer: PACE SWMI |
$44.37
|
| Rate for Payer: PHP Commercial |
$62.12
|
| Rate for Payer: PHP Medicare Advantage |
$44.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$82.46
|
| Rate for Payer: Priority Health Medicare |
$44.37
|
| Rate for Payer: Priority Health SBD |
$82.46
|
| Rate for Payer: Priority Health Tiered Network |
$82.46
|
| Rate for Payer: Railroad Medicare Medicare |
$44.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.70
|
| Rate for Payer: UHC Core |
$91.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.37
|
| Rate for Payer: UHC Exchange |
$91.70
|
| Rate for Payer: UHC Medicaid |
$28.33
|
| Rate for Payer: UHCCP Medicaid |
$28.33
|
| Rate for Payer: UMR Bronson Commercial |
$183.54
|
|
|
PR ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ
|
Professional
|
Both
|
$139.00
|
|
|
Service Code
|
HCPCS 20612
|
| Min. Negotiated Rate |
$23.43 |
| Max. Negotiated Rate |
$104.25 |
| Rate for Payer: Aetna Commercial |
$48.47
|
| Rate for Payer: Aetna Medicare |
$37.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.08
|
| Rate for Payer: BCBS Complete |
$24.60
|
| Rate for Payer: BCBS MAPPO |
$36.17
|
| Rate for Payer: BCN Commercial |
$61.75
|
| Rate for Payer: BCN Medicare Advantage |
$36.17
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cofinity Commercial |
$48.47
|
| Rate for Payer: Cofinity Commercial |
$52.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.98
|
| Rate for Payer: Meridian Medicaid |
$24.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.79
|
| Rate for Payer: Nomi Health Commercial |
$43.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.25
|
| Rate for Payer: PACE SWMI |
$36.17
|
| Rate for Payer: PHP Commercial |
$50.64
|
| Rate for Payer: PHP Medicare Advantage |
$36.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$66.01
|
| Rate for Payer: Priority Health Medicare |
$36.17
|
| Rate for Payer: Priority Health SBD |
$66.01
|
| Rate for Payer: Priority Health Tiered Network |
$66.01
|
| Rate for Payer: Railroad Medicare Medicare |
$36.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.59
|
| Rate for Payer: UHC Core |
$72.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.17
|
| Rate for Payer: UHC Exchange |
$72.59
|
| Rate for Payer: UHC Medicaid |
$23.43
|
| Rate for Payer: UHCCP Medicaid |
$23.43
|
| Rate for Payer: UMR Bronson Commercial |
$63.94
|
|
|
PR ASSESSMENT APHASIA W/INTERP & REPORT PER HOUR
|
Professional
|
Both
|
$209.00
|
|
|
Service Code
|
HCPCS 96105
|
| Min. Negotiated Rate |
$83.60 |
| Max. Negotiated Rate |
$164.86 |
| Rate for Payer: Aetna Commercial |
$126.21
|
| Rate for Payer: Aetna Medicare |
$97.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.63
|
| Rate for Payer: BCBS Complete |
$83.60
|
| Rate for Payer: BCBS MAPPO |
$94.19
|
| Rate for Payer: BCN Commercial |
$144.41
|
| Rate for Payer: BCN Medicare Advantage |
$94.19
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cofinity Commercial |
$135.63
|
| Rate for Payer: Cofinity Commercial |
$126.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$103.61
|
| Rate for Payer: Nomi Health Commercial |
$113.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.75
|
| Rate for Payer: PACE SWMI |
$94.19
|
| Rate for Payer: PHP Commercial |
$131.87
|
| Rate for Payer: PHP Medicare Advantage |
$94.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$133.17
|
| Rate for Payer: Priority Health Medicare |
$94.19
|
| Rate for Payer: Priority Health SBD |
$133.17
|
| Rate for Payer: Priority Health Tiered Network |
$133.17
|
| Rate for Payer: Railroad Medicare Medicare |
$94.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.86
|
| Rate for Payer: UHC Core |
$164.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$94.19
|
| Rate for Payer: UHC Exchange |
$164.86
|
| Rate for Payer: UMR Bronson Commercial |
$96.14
|
|
|
PR ASSESSMENT FOR HEARING AID
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS V5010
|
| Min. Negotiated Rate |
$47.05 |
| Max. Negotiated Rate |
$110.25 |
| Rate for Payer: Aetna Commercial |
$47.05
|
| Rate for Payer: Aetna Medicare |
$73.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.05
|
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$110.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.68
|
| Rate for Payer: UHC Core |
$78.68
|
| Rate for Payer: UHC Exchange |
$78.68
|
| Rate for Payer: UMR Bronson Commercial |
$67.62
|
|
|
PR ASSMT & CARE PLANNING PT W/COGNITIVE IMPAIRMENT
|
Professional
|
Both
|
$368.00
|
|
|
Service Code
|
HCPCS 99483
|
| Min. Negotiated Rate |
$108.20 |
| Max. Negotiated Rate |
$276.00 |
| Rate for Payer: Aetna Commercial |
$225.15
|
| Rate for Payer: Aetna Medicare |
$174.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.95
|
| Rate for Payer: BCBS Complete |
$113.61
|
| Rate for Payer: BCBS MAPPO |
$168.02
|
| Rate for Payer: BCN Commercial |
$208.87
|
| Rate for Payer: BCN Medicare Advantage |
$168.02
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cofinity Commercial |
$225.15
|
| Rate for Payer: Cofinity Commercial |
$241.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.42
|
| Rate for Payer: Meridian Medicaid |
$113.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$184.82
|
| Rate for Payer: Nomi Health Commercial |
$201.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.00
|
| Rate for Payer: PACE SWMI |
$168.02
|
| Rate for Payer: PHP Commercial |
$235.23
|
| Rate for Payer: PHP Medicare Advantage |
$168.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$257.55
|
| Rate for Payer: Priority Health Medicare |
$168.02
|
| Rate for Payer: Priority Health SBD |
$257.55
|
| Rate for Payer: Priority Health Tiered Network |
$257.55
|
| Rate for Payer: Railroad Medicare Medicare |
$168.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.10
|
| Rate for Payer: UHC Core |
$256.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$168.02
|
| Rate for Payer: UHC Exchange |
$256.10
|
| Rate for Payer: UHC Medicaid |
$108.20
|
| Rate for Payer: UHCCP Medicaid |
$108.20
|
| Rate for Payer: UMR Bronson Commercial |
$169.28
|
|
|
PRASUGREL HCL 10 MG TABLET
|
Facility
|
IP
|
$86.26
|
|
|
Service Code
|
NDC 67877060530
|
| Hospital Charge Code |
98373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$37.95 |
| Max. Negotiated Rate |
$77.63 |
| Rate for Payer: Aetna American Axle |
$56.07
|
| Rate for Payer: Aetna Commercial |
$73.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.07
|
| Rate for Payer: Cash Price |
$69.01
|
| Rate for Payer: Cofinity Advantage |
$60.38
|
| Rate for Payer: Cofinity Commercial |
$74.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.01
|
| Rate for Payer: Healthscope Commercial |
$77.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.69
|
| Rate for Payer: PHP Commercial |
$73.32
|
| Rate for Payer: Priority Health SBD |
$54.34
|
| Rate for Payer: UMR Bronson Commercial |
$37.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.69
|
|
|
PRASUGREL HCL 10 MG TABLET
|
Facility
|
IP
|
$2,417.47
|
|
|
Service Code
|
NDC 00713088230
|
| Hospital Charge Code |
98373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,063.69 |
| Max. Negotiated Rate |
$2,175.72 |
| Rate for Payer: Aetna American Axle |
$1,571.36
|
| Rate for Payer: Aetna Commercial |
$2,054.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,571.36
|
| Rate for Payer: Cash Price |
$1,933.98
|
| Rate for Payer: Cofinity Advantage |
$1,692.23
|
| Rate for Payer: Cofinity Commercial |
$2,079.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,933.98
|
| Rate for Payer: Healthscope Commercial |
$2,175.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,692.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,813.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,054.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,813.10
|
| Rate for Payer: PHP Commercial |
$2,054.85
|
| Rate for Payer: Priority Health SBD |
$1,523.01
|
| Rate for Payer: UMR Bronson Commercial |
$1,063.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,813.10
|
|
|
PRASUGREL HCL 10 MG TABLET
|
Facility
|
IP
|
$133.92
|
|
|
Service Code
|
NDC 00378518693
|
| Hospital Charge Code |
98373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$58.92 |
| Max. Negotiated Rate |
$120.53 |
| Rate for Payer: Aetna American Axle |
$87.05
|
| Rate for Payer: Aetna Commercial |
$113.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.05
|
| Rate for Payer: Cash Price |
$107.14
|
| Rate for Payer: Cofinity Advantage |
$93.74
|
| Rate for Payer: Cofinity Commercial |
$115.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.14
|
| Rate for Payer: Healthscope Commercial |
$120.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$93.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.44
|
| Rate for Payer: PHP Commercial |
$113.83
|
| Rate for Payer: Priority Health SBD |
$84.37
|
| Rate for Payer: UMR Bronson Commercial |
$58.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.44
|
|
|
PRASUGREL HCL 10 MG TABLET
|
Facility
|
OP
|
$86.26
|
|
|
Service Code
|
NDC 67877060530
|
| Hospital Charge Code |
98373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$31.92 |
| Max. Negotiated Rate |
$77.63 |
| Rate for Payer: Aetna American Axle |
$56.07
|
| Rate for Payer: Aetna Commercial |
$73.32
|
| Rate for Payer: Aetna Medicare |
$43.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.07
|
| Rate for Payer: BCBS Complete |
$34.50
|
| Rate for Payer: Cash Price |
$69.01
|
| Rate for Payer: Cofinity Advantage |
$60.38
|
| Rate for Payer: Cofinity Commercial |
$74.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.01
|
| Rate for Payer: Healthscope Commercial |
$77.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.69
|
| Rate for Payer: PHP Commercial |
$73.32
|
| Rate for Payer: Priority Health SBD |
$54.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.07
|
| Rate for Payer: UHC Core |
$44.94
|
| Rate for Payer: UHC Exchange |
$33.90
|
| Rate for Payer: UMR Bronson Commercial |
$31.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.69
|
|
|
PRASUGREL HCL 10 MG TABLET
|
Facility
|
OP
|
$133.92
|
|
|
Service Code
|
NDC 00378518693
|
| Hospital Charge Code |
98373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$49.55 |
| Max. Negotiated Rate |
$120.53 |
| Rate for Payer: Aetna American Axle |
$87.05
|
| Rate for Payer: Aetna Commercial |
$113.83
|
| Rate for Payer: Aetna Medicare |
$66.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.05
|
| Rate for Payer: BCBS Complete |
$53.57
|
| Rate for Payer: Cash Price |
$107.14
|
| Rate for Payer: Cofinity Advantage |
$93.74
|
| Rate for Payer: Cofinity Commercial |
$115.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.14
|
| Rate for Payer: Healthscope Commercial |
$120.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$93.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.44
|
| Rate for Payer: PHP Commercial |
$113.83
|
| Rate for Payer: Priority Health SBD |
$84.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.05
|
| Rate for Payer: UHC Core |
$69.77
|
| Rate for Payer: UHC Exchange |
$52.63
|
| Rate for Payer: UMR Bronson Commercial |
$49.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.44
|
|
|
PRASUGREL HCL 10 MG TABLET
|
Facility
|
OP
|
$2,417.47
|
|
|
Service Code
|
NDC 00713088230
|
| Hospital Charge Code |
98373
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$894.46 |
| Max. Negotiated Rate |
$2,175.72 |
| Rate for Payer: Aetna American Axle |
$1,571.36
|
| Rate for Payer: Aetna Commercial |
$2,054.85
|
| Rate for Payer: Aetna Medicare |
$1,208.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,571.36
|
| Rate for Payer: BCBS Complete |
$966.99
|
| Rate for Payer: Cash Price |
$1,933.98
|
| Rate for Payer: Cofinity Advantage |
$1,692.23
|
| Rate for Payer: Cofinity Commercial |
$2,079.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,933.98
|
| Rate for Payer: Healthscope Commercial |
$2,175.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,692.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,813.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,933.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,054.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,813.10
|
| Rate for Payer: PHP Commercial |
$2,054.85
|
| Rate for Payer: Priority Health SBD |
$1,523.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,571.36
|
| Rate for Payer: UHC Core |
$1,259.50
|
| Rate for Payer: UHC Exchange |
$950.07
|
| Rate for Payer: UMR Bronson Commercial |
$894.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,813.10
|
|
|
PR ATRIA ABLATE & RCNSTJ W/OTHER PROCEDURE LIMITE
|
Professional
|
Both
|
$1,571.00
|
|
|
Service Code
|
HCPCS 33257
|
| Min. Negotiated Rate |
$362.95 |
| Max. Negotiated Rate |
$1,178.25 |
| Rate for Payer: Aetna Commercial |
$755.40
|
| Rate for Payer: Aetna Medicare |
$586.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$755.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$811.77
|
| Rate for Payer: BCBS Complete |
$381.10
|
| Rate for Payer: BCBS MAPPO |
$563.73
|
| Rate for Payer: BCN Commercial |
$864.49
|
| Rate for Payer: BCN Medicare Advantage |
$563.73
|
| Rate for Payer: Cash Price |
$1,256.80
|
| Rate for Payer: Cash Price |
$1,256.80
|
| Rate for Payer: Cofinity Commercial |
$755.40
|
| Rate for Payer: Cofinity Commercial |
$811.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$563.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.92
|
| Rate for Payer: Meridian Medicaid |
$381.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$620.10
|
| Rate for Payer: Nomi Health Commercial |
$676.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,178.25
|
| Rate for Payer: PACE SWMI |
$563.73
|
| Rate for Payer: PHP Commercial |
$789.22
|
| Rate for Payer: PHP Medicare Advantage |
$563.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$929.66
|
| Rate for Payer: Priority Health Medicare |
$563.73
|
| Rate for Payer: Priority Health SBD |
$929.66
|
| Rate for Payer: Priority Health Tiered Network |
$929.66
|
| Rate for Payer: Railroad Medicare Medicare |
$563.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,028.15
|
| Rate for Payer: UHC Core |
$1,028.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$563.73
|
| Rate for Payer: UHC Exchange |
$1,028.15
|
| Rate for Payer: UHC Medicaid |
$362.95
|
| Rate for Payer: UHCCP Medicaid |
$362.95
|
| Rate for Payer: UMR Bronson Commercial |
$722.66
|
|
|
PR ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTEN W/BYPASS
|
Professional
|
Both
|
$2,372.00
|
|
|
Service Code
|
HCPCS 33259
|
| Min. Negotiated Rate |
$523.55 |
| Max. Negotiated Rate |
$1,779.00 |
| Rate for Payer: Aetna Commercial |
$1,090.60
|
| Rate for Payer: Aetna Medicare |
$846.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,090.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,171.99
|
| Rate for Payer: BCBS Complete |
$549.73
|
| Rate for Payer: BCBS MAPPO |
$813.88
|
| Rate for Payer: BCN Commercial |
$1,254.91
|
| Rate for Payer: BCN Medicare Advantage |
$813.88
|
| Rate for Payer: Cash Price |
$1,897.60
|
| Rate for Payer: Cash Price |
$1,897.60
|
| Rate for Payer: Cofinity Commercial |
$1,090.60
|
| Rate for Payer: Cofinity Commercial |
$1,171.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$813.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$854.57
|
| Rate for Payer: Meridian Medicaid |
$549.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$895.27
|
| Rate for Payer: Nomi Health Commercial |
$976.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,779.00
|
| Rate for Payer: PACE SWMI |
$813.88
|
| Rate for Payer: PHP Commercial |
$1,139.43
|
| Rate for Payer: PHP Medicare Advantage |
$813.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$523.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,349.50
|
| Rate for Payer: Priority Health Medicare |
$813.88
|
| Rate for Payer: Priority Health SBD |
$1,349.50
|
| Rate for Payer: Priority Health Tiered Network |
$1,349.50
|
| Rate for Payer: Railroad Medicare Medicare |
$813.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,492.97
|
| Rate for Payer: UHC Core |
$1,492.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$813.88
|
| Rate for Payer: UHC Exchange |
$1,492.97
|
| Rate for Payer: UHC Medicaid |
$523.55
|
| Rate for Payer: UHCCP Medicaid |
$523.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,091.12
|
|
|
PR ATTN AT DELIVERY 1ST STABILIZATION OF NEWBORN
|
Professional
|
Both
|
$422.00
|
|
|
Service Code
|
HCPCS 99464
|
| Min. Negotiated Rate |
$40.26 |
| Max. Negotiated Rate |
$316.50 |
| Rate for Payer: Aetna Commercial |
$83.84
|
| Rate for Payer: Aetna Medicare |
$65.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.10
|
| Rate for Payer: BCBS Complete |
$42.27
|
| Rate for Payer: BCBS MAPPO |
$62.57
|
| Rate for Payer: BCN Commercial |
$106.57
|
| Rate for Payer: BCN Medicare Advantage |
$62.57
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cofinity Commercial |
$83.84
|
| Rate for Payer: Cofinity Commercial |
$90.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.70
|
| Rate for Payer: Meridian Medicaid |
$42.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.83
|
| Rate for Payer: Nomi Health Commercial |
$75.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$316.50
|
| Rate for Payer: PACE SWMI |
$62.57
|
| Rate for Payer: PHP Commercial |
$87.60
|
| Rate for Payer: PHP Medicare Advantage |
$62.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$95.85
|
| Rate for Payer: Priority Health Medicare |
$62.57
|
| Rate for Payer: Priority Health SBD |
$95.85
|
| Rate for Payer: Priority Health Tiered Network |
$95.85
|
| Rate for Payer: Railroad Medicare Medicare |
$62.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.86
|
| Rate for Payer: UHC Core |
$105.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.57
|
| Rate for Payer: UHC Exchange |
$105.86
|
| Rate for Payer: UHC Medicaid |
$40.26
|
| Rate for Payer: UHCCP Medicaid |
$40.26
|
| Rate for Payer: UMR Bronson Commercial |
$194.12
|
|
|
PR AUDIOMETRY FOR HEARING AID
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS S0618
|
| Min. Negotiated Rate |
$32.40 |
| Max. Negotiated Rate |
$60.75 |
| Rate for Payer: Aetna Commercial |
$43.02
|
| Rate for Payer: Aetna Medicare |
$40.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.02
|
| Rate for Payer: BCBS Complete |
$32.40
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
| Rate for Payer: UMR Bronson Commercial |
$37.26
|
|
|
PR AUDITORY EVOKED POTENTIAL
|
Professional
|
Both
|
$351.00
|
|
|
Service Code
|
HCPCS 92585
|
| Min. Negotiated Rate |
$140.40 |
| Max. Negotiated Rate |
$263.25 |
| Rate for Payer: Aetna Medicare |
$175.50
|
| Rate for Payer: BCBS Complete |
$140.40
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$263.25
|
| Rate for Payer: UMR Bronson Commercial |
$161.46
|
|
