|
PR CATHETERIZE FOR URINE SPEC
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS P9612
|
| Min. Negotiated Rate |
$1.26 |
| Max. Negotiated Rate |
$23.25 |
| Rate for Payer: Aetna Commercial |
$12.52
|
| Rate for Payer: Aetna Medicare |
$9.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.45
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$9.34
|
| Rate for Payer: BCN Commercial |
$6.38
|
| Rate for Payer: BCN Medicare Advantage |
$9.34
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$12.52
|
| Rate for Payer: Cofinity Commercial |
$13.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.27
|
| Rate for Payer: Nomi Health Commercial |
$11.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.25
|
| Rate for Payer: PACE SWMI |
$9.34
|
| Rate for Payer: PHP Commercial |
$13.08
|
| Rate for Payer: PHP Medicare Advantage |
$9.34
|
| Rate for Payer: Priority Health Medicare |
$9.34
|
| Rate for Payer: Railroad Medicare Medicare |
$9.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.26
|
| Rate for Payer: UHC Core |
$1.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.34
|
| Rate for Payer: UHC Exchange |
$1.26
|
| Rate for Payer: UMR Bronson Commercial |
$14.26
|
|
|
PR CATHJ UMBILICAL VEIN DX/THER NB
|
Professional
|
Both
|
$298.00
|
|
|
Service Code
|
HCPCS 36510
|
| Min. Negotiated Rate |
$28.76 |
| Max. Negotiated Rate |
$223.50 |
| Rate for Payer: Aetna Commercial |
$59.97
|
| Rate for Payer: Aetna Medicare |
$46.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.97
|
| Rate for Payer: BCBS Complete |
$30.20
|
| Rate for Payer: BCBS MAPPO |
$44.75
|
| Rate for Payer: BCN Commercial |
$77.18
|
| Rate for Payer: BCN Medicare Advantage |
$44.75
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cofinity Commercial |
$64.44
|
| Rate for Payer: Cofinity Commercial |
$59.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.99
|
| Rate for Payer: Meridian Medicaid |
$30.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.23
|
| Rate for Payer: Nomi Health Commercial |
$53.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.50
|
| Rate for Payer: PACE SWMI |
$44.75
|
| Rate for Payer: PHP Commercial |
$62.65
|
| Rate for Payer: PHP Medicare Advantage |
$44.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$83.01
|
| Rate for Payer: Priority Health Medicare |
$44.75
|
| Rate for Payer: Priority Health SBD |
$83.01
|
| Rate for Payer: Priority Health Tiered Network |
$83.01
|
| Rate for Payer: Railroad Medicare Medicare |
$44.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.30
|
| Rate for Payer: UHC Core |
$95.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.75
|
| Rate for Payer: UHC Exchange |
$95.30
|
| Rate for Payer: UHC Medicaid |
$28.76
|
| Rate for Payer: UHCCP Medicaid |
$28.76
|
| Rate for Payer: UMR Bronson Commercial |
$137.08
|
|
|
PR CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I
|
Professional
|
Both
|
$805.00
|
|
|
Service Code
|
HCPCS 93454
|
| Min. Negotiated Rate |
$370.30 |
| Max. Negotiated Rate |
$1,407.38 |
| Rate for Payer: Aetna Commercial |
$1,100.03
|
| Rate for Payer: Aetna Commercial |
$1,100.03
|
| Rate for Payer: Aetna Medicare |
$853.76
|
| Rate for Payer: Aetna Medicare |
$853.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,100.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,182.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,182.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,100.03
|
| Rate for Payer: BCBS MAPPO |
$820.92
|
| Rate for Payer: BCBS MAPPO |
$820.92
|
| Rate for Payer: BCN Commercial |
$1,286.78
|
| Rate for Payer: BCN Commercial |
$1,286.78
|
| Rate for Payer: BCN Medicare Advantage |
$820.92
|
| Rate for Payer: BCN Medicare Advantage |
$820.92
|
| Rate for Payer: Cash Price |
$1,411.20
|
| Rate for Payer: Cash Price |
$1,411.20
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Cofinity Commercial |
$1,182.12
|
| Rate for Payer: Cofinity Commercial |
$1,182.12
|
| Rate for Payer: Cofinity Commercial |
$1,100.03
|
| Rate for Payer: Cofinity Commercial |
$1,100.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$820.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$820.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$861.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$861.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$903.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$903.01
|
| Rate for Payer: Nomi Health Commercial |
$985.10
|
| Rate for Payer: Nomi Health Commercial |
$985.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$603.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,323.00
|
| Rate for Payer: PACE SWMI |
$820.92
|
| Rate for Payer: PACE SWMI |
$820.92
|
| Rate for Payer: PHP Commercial |
$1,149.29
|
| Rate for Payer: PHP Commercial |
$1,149.29
|
| Rate for Payer: PHP Medicare Advantage |
$820.92
|
| Rate for Payer: PHP Medicare Advantage |
$820.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,223.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,223.02
|
| Rate for Payer: Priority Health Medicare |
$820.92
|
| Rate for Payer: Priority Health Medicare |
$820.92
|
| Rate for Payer: Priority Health SBD |
$1,223.02
|
| Rate for Payer: Priority Health SBD |
$1,223.02
|
| Rate for Payer: Priority Health Tiered Network |
$1,223.02
|
| Rate for Payer: Priority Health Tiered Network |
$1,223.02
|
| Rate for Payer: Railroad Medicare Medicare |
$820.92
|
| Rate for Payer: Railroad Medicare Medicare |
$820.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,407.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,407.38
|
| Rate for Payer: UHC Core |
$1,407.38
|
| Rate for Payer: UHC Core |
$1,407.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$820.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$820.92
|
| Rate for Payer: UHC Exchange |
$1,407.38
|
| Rate for Payer: UHC Exchange |
$1,407.38
|
| Rate for Payer: UMR Bronson Commercial |
$811.44
|
| Rate for Payer: UMR Bronson Commercial |
$370.30
|
|
|
PR CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I
|
Professional
|
Both
|
$2,266.00
|
|
|
Service Code
|
HCPCS 93459
|
| Min. Negotiated Rate |
$1,020.21 |
| Max. Negotiated Rate |
$1,797.10 |
| Rate for Payer: Aetna Commercial |
$1,367.08
|
| Rate for Payer: Aetna Commercial |
$1,367.08
|
| Rate for Payer: Aetna Medicare |
$1,061.02
|
| Rate for Payer: Aetna Medicare |
$1,061.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,469.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,469.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.08
|
| Rate for Payer: BCBS MAPPO |
$1,020.21
|
| Rate for Payer: BCBS MAPPO |
$1,020.21
|
| Rate for Payer: BCN Commercial |
$1,596.03
|
| Rate for Payer: BCN Commercial |
$1,596.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,020.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,020.21
|
| Rate for Payer: Cash Price |
$915.20
|
| Rate for Payer: Cash Price |
$915.20
|
| Rate for Payer: Cash Price |
$1,812.80
|
| Rate for Payer: Cash Price |
$1,812.80
|
| Rate for Payer: Cofinity Commercial |
$1,469.10
|
| Rate for Payer: Cofinity Commercial |
$1,469.10
|
| Rate for Payer: Cofinity Commercial |
$1,367.08
|
| Rate for Payer: Cofinity Commercial |
$1,367.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,020.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,020.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,071.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,071.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,122.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,122.23
|
| Rate for Payer: Nomi Health Commercial |
$1,224.25
|
| Rate for Payer: Nomi Health Commercial |
$1,224.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,699.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.00
|
| Rate for Payer: PACE SWMI |
$1,020.21
|
| Rate for Payer: PACE SWMI |
$1,020.21
|
| Rate for Payer: PHP Commercial |
$1,428.29
|
| Rate for Payer: PHP Commercial |
$1,428.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,020.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,020.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,516.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,516.95
|
| Rate for Payer: Priority Health Medicare |
$1,020.21
|
| Rate for Payer: Priority Health Medicare |
$1,020.21
|
| Rate for Payer: Priority Health SBD |
$1,516.95
|
| Rate for Payer: Priority Health SBD |
$1,516.95
|
| Rate for Payer: Priority Health Tiered Network |
$1,516.95
|
| Rate for Payer: Priority Health Tiered Network |
$1,516.95
|
| Rate for Payer: Railroad Medicare Medicare |
$1,020.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,020.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,797.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,797.10
|
| Rate for Payer: UHC Core |
$1,797.10
|
| Rate for Payer: UHC Core |
$1,797.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,020.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,020.21
|
| Rate for Payer: UHC Exchange |
$1,797.10
|
| Rate for Payer: UHC Exchange |
$1,797.10
|
| Rate for Payer: UMR Bronson Commercial |
$526.24
|
| Rate for Payer: UMR Bronson Commercial |
$1,042.36
|
|
|
PR CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I
|
Professional
|
Both
|
$999.00
|
|
|
Service Code
|
HCPCS 93458
|
| Min. Negotiated Rate |
$459.54 |
| Max. Negotiated Rate |
$1,649.69 |
| Rate for Payer: Aetna Commercial |
$1,267.89
|
| Rate for Payer: Aetna Commercial |
$1,267.89
|
| Rate for Payer: Aetna Medicare |
$984.04
|
| Rate for Payer: Aetna Medicare |
$984.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,267.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,362.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,362.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,267.89
|
| Rate for Payer: BCBS MAPPO |
$946.19
|
| Rate for Payer: BCBS MAPPO |
$946.19
|
| Rate for Payer: BCN Commercial |
$1,482.49
|
| Rate for Payer: BCN Commercial |
$1,482.49
|
| Rate for Payer: BCN Medicare Advantage |
$946.19
|
| Rate for Payer: BCN Medicare Advantage |
$946.19
|
| Rate for Payer: Cash Price |
$1,635.20
|
| Rate for Payer: Cash Price |
$1,635.20
|
| Rate for Payer: Cash Price |
$799.20
|
| Rate for Payer: Cash Price |
$799.20
|
| Rate for Payer: Cofinity Commercial |
$1,362.51
|
| Rate for Payer: Cofinity Commercial |
$1,362.51
|
| Rate for Payer: Cofinity Commercial |
$1,267.89
|
| Rate for Payer: Cofinity Commercial |
$1,267.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$946.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$946.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$993.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$993.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,040.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,040.81
|
| Rate for Payer: Nomi Health Commercial |
$1,135.43
|
| Rate for Payer: Nomi Health Commercial |
$1,135.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$749.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,533.00
|
| Rate for Payer: PACE SWMI |
$946.19
|
| Rate for Payer: PACE SWMI |
$946.19
|
| Rate for Payer: PHP Commercial |
$1,324.67
|
| Rate for Payer: PHP Commercial |
$1,324.67
|
| Rate for Payer: PHP Medicare Advantage |
$946.19
|
| Rate for Payer: PHP Medicare Advantage |
$946.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,409.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,409.04
|
| Rate for Payer: Priority Health Medicare |
$946.19
|
| Rate for Payer: Priority Health Medicare |
$946.19
|
| Rate for Payer: Priority Health SBD |
$1,409.04
|
| Rate for Payer: Priority Health SBD |
$1,409.04
|
| Rate for Payer: Priority Health Tiered Network |
$1,409.04
|
| Rate for Payer: Priority Health Tiered Network |
$1,409.04
|
| Rate for Payer: Railroad Medicare Medicare |
$946.19
|
| Rate for Payer: Railroad Medicare Medicare |
$946.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,649.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,649.69
|
| Rate for Payer: UHC Core |
$1,649.69
|
| Rate for Payer: UHC Core |
$1,649.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$946.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$946.19
|
| Rate for Payer: UHC Exchange |
$1,649.69
|
| Rate for Payer: UHC Exchange |
$1,649.69
|
| Rate for Payer: UMR Bronson Commercial |
$940.24
|
| Rate for Payer: UMR Bronson Commercial |
$459.54
|
|
|
PR CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I
|
Professional
|
Both
|
$599.00
|
|
|
Service Code
|
HCPCS 93455
|
| Min. Negotiated Rate |
$275.54 |
| Max. Negotiated Rate |
$1,599.97 |
| Rate for Payer: Aetna Commercial |
$1,228.65
|
| Rate for Payer: Aetna Medicare |
$953.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,228.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,320.34
|
| Rate for Payer: BCBS MAPPO |
$916.90
|
| Rate for Payer: BCN Commercial |
$1,436.67
|
| Rate for Payer: BCN Medicare Advantage |
$916.90
|
| Rate for Payer: Cash Price |
$479.20
|
| Rate for Payer: Cash Price |
$479.20
|
| Rate for Payer: Cofinity Commercial |
$1,228.65
|
| Rate for Payer: Cofinity Commercial |
$1,320.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$916.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$962.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,008.59
|
| Rate for Payer: Nomi Health Commercial |
$1,100.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$449.25
|
| Rate for Payer: PACE SWMI |
$916.90
|
| Rate for Payer: PHP Commercial |
$1,283.66
|
| Rate for Payer: PHP Medicare Advantage |
$916.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,365.49
|
| Rate for Payer: Priority Health Medicare |
$916.90
|
| Rate for Payer: Priority Health SBD |
$1,365.49
|
| Rate for Payer: Priority Health Tiered Network |
$1,365.49
|
| Rate for Payer: Railroad Medicare Medicare |
$916.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,599.97
|
| Rate for Payer: UHC Core |
$1,599.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$916.90
|
| Rate for Payer: UHC Exchange |
$1,599.97
|
| Rate for Payer: UMR Bronson Commercial |
$275.54
|
|
|
PR CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I
|
Professional
|
Both
|
$2,500.00
|
|
|
Service Code
|
HCPCS 93457
|
| Min. Negotiated Rate |
$1,117.98 |
| Max. Negotiated Rate |
$1,974.31 |
| Rate for Payer: Aetna Commercial |
$1,498.09
|
| Rate for Payer: Aetna Medicare |
$1,162.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,498.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,609.89
|
| Rate for Payer: BCBS MAPPO |
$1,117.98
|
| Rate for Payer: BCN Commercial |
$1,748.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,117.98
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cofinity Commercial |
$1,609.89
|
| Rate for Payer: Cofinity Commercial |
$1,498.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,117.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,173.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,229.78
|
| Rate for Payer: Nomi Health Commercial |
$1,341.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,875.00
|
| Rate for Payer: PACE SWMI |
$1,117.98
|
| Rate for Payer: PHP Commercial |
$1,565.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,117.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,661.78
|
| Rate for Payer: Priority Health Medicare |
$1,117.98
|
| Rate for Payer: Priority Health SBD |
$1,661.78
|
| Rate for Payer: Priority Health Tiered Network |
$1,661.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,117.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,974.31
|
| Rate for Payer: UHC Core |
$1,974.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,117.98
|
| Rate for Payer: UHC Exchange |
$1,974.31
|
| Rate for Payer: UMR Bronson Commercial |
$1,150.00
|
|
|
PR CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I
|
Professional
|
Both
|
$2,236.00
|
|
|
Service Code
|
HCPCS 93456
|
| Min. Negotiated Rate |
$1,023.48 |
| Max. Negotiated Rate |
$1,782.16 |
| Rate for Payer: Aetna Commercial |
$1,371.46
|
| Rate for Payer: Aetna Medicare |
$1,064.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,371.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,473.81
|
| Rate for Payer: BCBS MAPPO |
$1,023.48
|
| Rate for Payer: BCN Commercial |
$1,602.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,023.48
|
| Rate for Payer: Cash Price |
$1,788.80
|
| Rate for Payer: Cash Price |
$1,788.80
|
| Rate for Payer: Cofinity Commercial |
$1,371.46
|
| Rate for Payer: Cofinity Commercial |
$1,473.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,023.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,074.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,125.83
|
| Rate for Payer: Nomi Health Commercial |
$1,228.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,677.00
|
| Rate for Payer: PACE SWMI |
$1,023.48
|
| Rate for Payer: PHP Commercial |
$1,432.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,023.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,522.63
|
| Rate for Payer: Priority Health Medicare |
$1,023.48
|
| Rate for Payer: Priority Health SBD |
$1,522.63
|
| Rate for Payer: Priority Health Tiered Network |
$1,522.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,023.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,782.16
|
| Rate for Payer: UHC Core |
$1,782.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,023.48
|
| Rate for Payer: UHC Exchange |
$1,782.16
|
| Rate for Payer: UMR Bronson Commercial |
$1,028.56
|
|
|
PR CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI
|
Professional
|
Both
|
$663.00
|
|
|
Service Code
|
HCPCS 58340
|
| Min. Negotiated Rate |
$33.23 |
| Max. Negotiated Rate |
$497.25 |
| Rate for Payer: Aetna Commercial |
$68.45
|
| Rate for Payer: Aetna Medicare |
$53.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.56
|
| Rate for Payer: BCBS Complete |
$34.89
|
| Rate for Payer: BCBS MAPPO |
$51.08
|
| Rate for Payer: BCN Commercial |
$87.15
|
| Rate for Payer: BCN Medicare Advantage |
$51.08
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cofinity Commercial |
$73.56
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.63
|
| Rate for Payer: Meridian Medicaid |
$34.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.19
|
| Rate for Payer: Nomi Health Commercial |
$61.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$497.25
|
| Rate for Payer: PACE SWMI |
$51.08
|
| Rate for Payer: PHP Commercial |
$71.51
|
| Rate for Payer: PHP Medicare Advantage |
$51.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$88.27
|
| Rate for Payer: Priority Health Medicare |
$51.08
|
| Rate for Payer: Priority Health SBD |
$88.27
|
| Rate for Payer: Priority Health Tiered Network |
$88.27
|
| Rate for Payer: Railroad Medicare Medicare |
$51.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.14
|
| Rate for Payer: UHC Core |
$100.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.08
|
| Rate for Payer: UHC Exchange |
$100.14
|
| Rate for Payer: UHC Medicaid |
$33.23
|
| Rate for Payer: UHCCP Medicaid |
$33.23
|
| Rate for Payer: UMR Bronson Commercial |
$304.98
|
|
|
PR CAUTERY CERVIX CRYOCAUTERY INITIAL/REPEAT
|
Professional
|
Both
|
$474.00
|
|
|
Service Code
|
HCPCS 57511
|
| Min. Negotiated Rate |
$83.92 |
| Max. Negotiated Rate |
$355.50 |
| Rate for Payer: Aetna Commercial |
$171.68
|
| Rate for Payer: Aetna Medicare |
$133.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.49
|
| Rate for Payer: BCBS Complete |
$88.12
|
| Rate for Payer: BCBS MAPPO |
$128.12
|
| Rate for Payer: BCN Commercial |
$174.75
|
| Rate for Payer: BCN Medicare Advantage |
$128.12
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cofinity Commercial |
$171.68
|
| Rate for Payer: Cofinity Commercial |
$184.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.53
|
| Rate for Payer: Meridian Medicaid |
$88.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$140.93
|
| Rate for Payer: Nomi Health Commercial |
$153.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$355.50
|
| Rate for Payer: PACE SWMI |
$128.12
|
| Rate for Payer: PHP Commercial |
$179.37
|
| Rate for Payer: PHP Medicare Advantage |
$128.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$224.43
|
| Rate for Payer: Priority Health Medicare |
$128.12
|
| Rate for Payer: Priority Health SBD |
$224.43
|
| Rate for Payer: Priority Health Tiered Network |
$224.43
|
| Rate for Payer: Railroad Medicare Medicare |
$128.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.32
|
| Rate for Payer: UHC Core |
$245.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.12
|
| Rate for Payer: UHC Exchange |
$245.32
|
| Rate for Payer: UHC Medicaid |
$83.92
|
| Rate for Payer: UHCCP Medicaid |
$83.92
|
| Rate for Payer: UMR Bronson Commercial |
$218.04
|
|
|
PR CAUTERY CERVIX ELECTRO/THERMAL
|
Professional
|
Both
|
$494.00
|
|
|
Service Code
|
HCPCS 57510
|
| Min. Negotiated Rate |
$65.18 |
| Max. Negotiated Rate |
$370.50 |
| Rate for Payer: Aetna Commercial |
$135.53
|
| Rate for Payer: Aetna Medicare |
$105.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.64
|
| Rate for Payer: BCBS Complete |
$68.44
|
| Rate for Payer: BCBS MAPPO |
$101.14
|
| Rate for Payer: BCN Commercial |
$169.31
|
| Rate for Payer: BCN Medicare Advantage |
$101.14
|
| Rate for Payer: Cash Price |
$395.20
|
| Rate for Payer: Cash Price |
$395.20
|
| Rate for Payer: Cofinity Commercial |
$135.53
|
| Rate for Payer: Cofinity Commercial |
$145.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.20
|
| Rate for Payer: Meridian Medicaid |
$68.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.25
|
| Rate for Payer: Nomi Health Commercial |
$121.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$370.50
|
| Rate for Payer: PACE SWMI |
$101.14
|
| Rate for Payer: PHP Commercial |
$141.60
|
| Rate for Payer: PHP Medicare Advantage |
$101.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$171.48
|
| Rate for Payer: Priority Health Medicare |
$101.14
|
| Rate for Payer: Priority Health SBD |
$171.48
|
| Rate for Payer: Priority Health Tiered Network |
$171.48
|
| Rate for Payer: Railroad Medicare Medicare |
$101.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$200.76
|
| Rate for Payer: UHC Core |
$200.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$101.14
|
| Rate for Payer: UHC Exchange |
$200.76
|
| Rate for Payer: UHC Medicaid |
$65.18
|
| Rate for Payer: UHCCP Medicaid |
$65.18
|
| Rate for Payer: UMR Bronson Commercial |
$227.24
|
|
|
PR CAUTERY CERVIX LASER ABLATION
|
Professional
|
Both
|
$571.00
|
|
|
Service Code
|
HCPCS 57513
|
| Min. Negotiated Rate |
$83.50 |
| Max. Negotiated Rate |
$428.25 |
| Rate for Payer: Aetna Commercial |
$170.86
|
| Rate for Payer: Aetna Medicare |
$132.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.61
|
| Rate for Payer: BCBS Complete |
$87.67
|
| Rate for Payer: BCBS MAPPO |
$127.51
|
| Rate for Payer: BCN Commercial |
$220.60
|
| Rate for Payer: BCN Medicare Advantage |
$127.51
|
| Rate for Payer: Cash Price |
$456.80
|
| Rate for Payer: Cash Price |
$456.80
|
| Rate for Payer: Cofinity Commercial |
$170.86
|
| Rate for Payer: Cofinity Commercial |
$183.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.89
|
| Rate for Payer: Meridian Medicaid |
$87.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$140.26
|
| Rate for Payer: Nomi Health Commercial |
$153.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$428.25
|
| Rate for Payer: PACE SWMI |
$127.51
|
| Rate for Payer: PHP Commercial |
$178.51
|
| Rate for Payer: PHP Medicare Advantage |
$127.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$223.42
|
| Rate for Payer: Priority Health Medicare |
$127.51
|
| Rate for Payer: Priority Health SBD |
$223.42
|
| Rate for Payer: Priority Health Tiered Network |
$223.42
|
| Rate for Payer: Railroad Medicare Medicare |
$127.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.75
|
| Rate for Payer: UHC Core |
$244.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$127.51
|
| Rate for Payer: UHC Exchange |
$244.75
|
| Rate for Payer: UHC Medicaid |
$83.50
|
| Rate for Payer: UHCCP Medicaid |
$83.50
|
| Rate for Payer: UMR Bronson Commercial |
$262.66
|
|
|
PR CBHC CONSULT FEE $150
|
Professional
|
Both
|
$158.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$63.20 |
| Max. Negotiated Rate |
$118.50 |
| Rate for Payer: Aetna Medicare |
$79.00
|
| Rate for Payer: BCBS Complete |
$63.20
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.50
|
| Rate for Payer: UMR Bronson Commercial |
$72.68
|
|
|
PR CBHC CONSULT FEE $300
|
Professional
|
Both
|
$315.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$236.25 |
| Rate for Payer: Aetna Medicare |
$157.50
|
| Rate for Payer: BCBS Complete |
$126.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.25
|
| Rate for Payer: UMR Bronson Commercial |
$144.90
|
|
|
PR CBHC IN HOUSE REPAIR
|
Professional
|
Both
|
$37.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$27.75 |
| Rate for Payer: Aetna Medicare |
$18.50
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.75
|
| Rate for Payer: UMR Bronson Commercial |
$17.02
|
|
|
PR CBHC IN-HOUSE REPAIR
|
Professional
|
Both
|
$28.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: Aetna Medicare |
$14.00
|
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.00
|
| Rate for Payer: UMR Bronson Commercial |
$12.88
|
|
|
PR CBHC LOSS AND DAMAGE FEE
|
Professional
|
Both
|
$289.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$115.60 |
| Max. Negotiated Rate |
$216.75 |
| Rate for Payer: Aetna Medicare |
$144.50
|
| Rate for Payer: BCBS Complete |
$115.60
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$216.75
|
| Rate for Payer: UMR Bronson Commercial |
$132.94
|
|
|
PR CBHC MAILING CHARGE
|
Professional
|
Both
|
$47.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$35.25 |
| Rate for Payer: Aetna Medicare |
$23.50
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.25
|
| Rate for Payer: UMR Bronson Commercial |
$21.62
|
|
|
PR CBHC RECASE BTE
|
Professional
|
Both
|
$63.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$47.25 |
| Rate for Payer: Aetna Medicare |
$31.50
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
| Rate for Payer: UMR Bronson Commercial |
$28.98
|
|
|
PR CBHC RECASE ITE
|
Professional
|
Both
|
$184.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$73.60 |
| Max. Negotiated Rate |
$138.00 |
| Rate for Payer: Aetna Medicare |
$92.00
|
| Rate for Payer: BCBS Complete |
$73.60
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.00
|
| Rate for Payer: UMR Bronson Commercial |
$84.64
|
|
|
PR CBHC REPAIR 5 YRS AND OLDER
|
Professional
|
Both
|
$447.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$178.80 |
| Max. Negotiated Rate |
$335.25 |
| Rate for Payer: Aetna Medicare |
$223.50
|
| Rate for Payer: BCBS Complete |
$178.80
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.25
|
| Rate for Payer: UMR Bronson Commercial |
$205.62
|
|
|
PR CBHC REPAIR DIGITAL/CIC
|
Professional
|
Both
|
$315.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$236.25 |
| Rate for Payer: Aetna Medicare |
$157.50
|
| Rate for Payer: BCBS Complete |
$126.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.25
|
| Rate for Payer: UMR Bronson Commercial |
$144.90
|
|
|
PR CBHC REPAIR RECEIVER
|
Professional
|
Both
|
$132.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$52.80 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Medicare |
$66.00
|
| Rate for Payer: BCBS Complete |
$52.80
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.00
|
| Rate for Payer: UMR Bronson Commercial |
$60.72
|
|
|
PR CCIIV3 VACCINE ABX FREE 0.5 ML FOR IM USE
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 90661
|
| Min. Negotiated Rate |
$20.24 |
| Max. Negotiated Rate |
$71.28 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$51.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.33
|
| Rate for Payer: BCBS MAPPO |
$49.50
|
| Rate for Payer: BCBS Trust/PPO |
$43.54
|
| Rate for Payer: BCN Commercial |
$31.80
|
| Rate for Payer: BCN Medicare Advantage |
$49.50
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$71.28
|
| Rate for Payer: Cofinity Commercial |
$66.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.45
|
| Rate for Payer: Nomi Health Commercial |
$59.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE SWMI |
$49.50
|
| Rate for Payer: PHP Commercial |
$69.30
|
| Rate for Payer: PHP Medicare Advantage |
$49.50
|
| Rate for Payer: Priority Health Medicare |
$49.50
|
| Rate for Payer: Railroad Medicare Medicare |
$49.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.54
|
| Rate for Payer: UHC Core |
$43.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.50
|
| Rate for Payer: UHC Exchange |
$43.54
|
| Rate for Payer: UMR Bronson Commercial |
$20.24
|
|
|
PR CCIIV4 VACCINE ANTIBIOTIC FREE 0.5 ML DOS IM USE
|
Professional
|
Both
|
$70.00
|
|
|
Service Code
|
HCPCS 90756
|
| Min. Negotiated Rate |
$28.52 |
| Max. Negotiated Rate |
$52.50 |
| Rate for Payer: Aetna Commercial |
$32.37
|
| Rate for Payer: Aetna Medicare |
$35.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.37
|
| Rate for Payer: BCBS Trust/PPO |
$28.52
|
| Rate for Payer: BCN Commercial |
$33.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.38
|
| Rate for Payer: UHC Core |
$32.38
|
| Rate for Payer: UHC Exchange |
$32.38
|
| Rate for Payer: UMR Bronson Commercial |
$32.20
|
|
