|
PRAZOSIN 1 MG CAPSULE
|
Facility
|
OP
|
$462.72
|
|
|
Service Code
|
NDC 00904702061
|
| Hospital Charge Code |
6468
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$171.21 |
| Max. Negotiated Rate |
$416.45 |
| Rate for Payer: Aetna American Axle |
$300.77
|
| Rate for Payer: Aetna Commercial |
$393.31
|
| Rate for Payer: Aetna Medicare |
$231.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.77
|
| Rate for Payer: BCBS Complete |
$185.09
|
| Rate for Payer: Cash Price |
$370.18
|
| Rate for Payer: Cofinity Commercial |
$323.90
|
| Rate for Payer: Cofinity Commercial |
$397.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$323.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.18
|
| Rate for Payer: Healthscope Commercial |
$416.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$323.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.31
|
| Rate for Payer: PHP Commercial |
$393.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.77
|
| Rate for Payer: Priority Health SBD |
$291.51
|
| Rate for Payer: UMR Bronson Commercial |
$171.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.04
|
|
|
PRAZOSIN 1 MG CAPSULE
|
Facility
|
IP
|
$462.72
|
|
|
Service Code
|
NDC 00904702061
|
| Hospital Charge Code |
6468
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$203.60 |
| Max. Negotiated Rate |
$416.45 |
| Rate for Payer: Aetna American Axle |
$300.77
|
| Rate for Payer: Aetna Commercial |
$393.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.77
|
| Rate for Payer: Cash Price |
$370.18
|
| Rate for Payer: Cofinity Commercial |
$323.90
|
| Rate for Payer: Cofinity Commercial |
$397.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$323.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.18
|
| Rate for Payer: Healthscope Commercial |
$416.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$323.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.31
|
| Rate for Payer: PHP Commercial |
$393.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.77
|
| Rate for Payer: Priority Health SBD |
$291.51
|
| Rate for Payer: UMR Bronson Commercial |
$203.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.04
|
|
|
PRAZOSIN 5 MG CAPSULE
|
Facility
|
OP
|
$584.64
|
|
|
Service Code
|
NDC 00378320501
|
| Hospital Charge Code |
6470
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$216.32 |
| Max. Negotiated Rate |
$526.18 |
| Rate for Payer: Aetna American Axle |
$380.02
|
| Rate for Payer: Aetna Commercial |
$496.94
|
| Rate for Payer: Aetna Medicare |
$292.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$380.02
|
| Rate for Payer: BCBS Complete |
$233.86
|
| Rate for Payer: Cash Price |
$467.71
|
| Rate for Payer: Cofinity Commercial |
$409.25
|
| Rate for Payer: Cofinity Commercial |
$502.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$409.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.71
|
| Rate for Payer: Healthscope Commercial |
$526.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$409.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$438.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$496.94
|
| Rate for Payer: PHP Commercial |
$496.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$380.02
|
| Rate for Payer: Priority Health SBD |
$368.32
|
| Rate for Payer: UMR Bronson Commercial |
$216.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$438.48
|
|
|
PRAZOSIN 5 MG CAPSULE
|
Facility
|
IP
|
$584.64
|
|
|
Service Code
|
NDC 00378320501
|
| Hospital Charge Code |
6470
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$257.24 |
| Max. Negotiated Rate |
$526.18 |
| Rate for Payer: Aetna American Axle |
$380.02
|
| Rate for Payer: Aetna Commercial |
$496.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$380.02
|
| Rate for Payer: Cash Price |
$467.71
|
| Rate for Payer: Cofinity Commercial |
$409.25
|
| Rate for Payer: Cofinity Commercial |
$502.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$409.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.71
|
| Rate for Payer: Healthscope Commercial |
$526.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$409.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$438.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$496.94
|
| Rate for Payer: PHP Commercial |
$496.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$380.02
|
| Rate for Payer: Priority Health SBD |
$368.32
|
| Rate for Payer: UMR Bronson Commercial |
$257.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$438.48
|
|
|
PRAZOSIN 5 MG CAPSULE
|
Facility
|
OP
|
$1,199.54
|
|
|
Service Code
|
NDC 00904702261
|
| Hospital Charge Code |
6470
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$443.83 |
| Max. Negotiated Rate |
$1,079.59 |
| Rate for Payer: Aetna American Axle |
$779.70
|
| Rate for Payer: Aetna Commercial |
$1,019.61
|
| Rate for Payer: Aetna Medicare |
$599.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.70
|
| Rate for Payer: BCBS Complete |
$479.82
|
| Rate for Payer: Cash Price |
$959.63
|
| Rate for Payer: Cofinity Commercial |
$1,031.60
|
| Rate for Payer: Cofinity Commercial |
$839.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$839.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.63
|
| Rate for Payer: Healthscope Commercial |
$1,079.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$839.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$899.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.61
|
| Rate for Payer: PHP Commercial |
$1,019.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$779.70
|
| Rate for Payer: Priority Health SBD |
$755.71
|
| Rate for Payer: UMR Bronson Commercial |
$443.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.65
|
|
|
PRAZOSIN 5 MG CAPSULE
|
Facility
|
IP
|
$1,199.54
|
|
|
Service Code
|
NDC 00904702261
|
| Hospital Charge Code |
6470
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$527.80 |
| Max. Negotiated Rate |
$1,079.59 |
| Rate for Payer: Aetna American Axle |
$779.70
|
| Rate for Payer: Aetna Commercial |
$1,019.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.70
|
| Rate for Payer: Cash Price |
$959.63
|
| Rate for Payer: Cofinity Commercial |
$1,031.60
|
| Rate for Payer: Cofinity Commercial |
$839.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$839.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.63
|
| Rate for Payer: Healthscope Commercial |
$1,079.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$839.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$899.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.61
|
| Rate for Payer: PHP Commercial |
$1,019.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$779.70
|
| Rate for Payer: Priority Health SBD |
$755.71
|
| Rate for Payer: UMR Bronson Commercial |
$527.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.65
|
|
|
PR B1 GRF FEM H/N INTERTRCHNTRIC/SUBTRCHNTRIC AREA
|
Professional
|
Both
|
$2,174.00
|
|
|
Service Code
|
HCPCS 27170
|
| Min. Negotiated Rate |
$869.60 |
| Max. Negotiated Rate |
$1,625.44 |
| Rate for Payer: Aetna Commercial |
$1,512.57
|
| Rate for Payer: Aetna Medicare |
$1,173.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,625.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,512.57
|
| Rate for Payer: BCBS Complete |
$869.60
|
| Rate for Payer: BCBS MAPPO |
$1,128.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,128.78
|
| Rate for Payer: Cash Price |
$1,739.20
|
| Rate for Payer: Cash Price |
$1,739.20
|
| Rate for Payer: Cofinity Commercial |
$1,625.44
|
| Rate for Payer: Cofinity Commercial |
$1,512.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,128.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,185.22
|
| Rate for Payer: Nomi Health Commercial |
$1,354.54
|
| Rate for Payer: PACE SWMI |
$1,128.78
|
| Rate for Payer: PHP Commercial |
$1,580.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,128.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,413.10
|
| Rate for Payer: Priority Health Medicare |
$1,128.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,128.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,128.78
|
| Rate for Payer: UMR Bronson Commercial |
$1,000.04
|
|
|
PR BACILLUS CALMETTE-GUERIN VACCINE INTRAVESICAL
|
Professional
|
Both
|
$273.00
|
|
|
Service Code
|
HCPCS 90586
|
| Min. Negotiated Rate |
$109.20 |
| Max. Negotiated Rate |
$234.69 |
| Rate for Payer: Aetna Commercial |
$218.39
|
| Rate for Payer: Aetna Medicare |
$169.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.39
|
| Rate for Payer: BCBS Complete |
$109.20
|
| Rate for Payer: BCBS MAPPO |
$162.98
|
| Rate for Payer: BCN Medicare Advantage |
$162.98
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cofinity Commercial |
$234.69
|
| Rate for Payer: Cofinity Commercial |
$218.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$171.13
|
| Rate for Payer: Nomi Health Commercial |
$195.58
|
| Rate for Payer: PACE SWMI |
$162.98
|
| Rate for Payer: PHP Commercial |
$228.17
|
| Rate for Payer: PHP Medicare Advantage |
$162.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.45
|
| Rate for Payer: Priority Health Medicare |
$162.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.98
|
| Rate for Payer: UHC Medicare Advantage |
$162.98
|
| Rate for Payer: UMR Bronson Commercial |
$125.58
|
|
|
PR BALLN ANGIOPLASTY OPEN,BRACHCEPH
|
Professional
|
Both
|
$958.00
|
|
|
Service Code
|
HCPCS 35458
|
| Min. Negotiated Rate |
$383.20 |
| Max. Negotiated Rate |
$622.70 |
| Rate for Payer: Aetna Medicare |
$479.00
|
| Rate for Payer: BCBS Complete |
$383.20
|
| Rate for Payer: Cash Price |
$766.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$622.70
|
| Rate for Payer: UMR Bronson Commercial |
$440.68
|
|
|
PR BALLN ANGIOPLASTY PERC,AORTIC
|
Professional
|
Both
|
$689.00
|
|
|
Service Code
|
HCPCS 35472
|
| Min. Negotiated Rate |
$275.60 |
| Max. Negotiated Rate |
$447.85 |
| Rate for Payer: Aetna Medicare |
$344.50
|
| Rate for Payer: BCBS Complete |
$275.60
|
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.85
|
| Rate for Payer: UMR Bronson Commercial |
$316.94
|
|
|
PR BALLN ANGIOPLASTY PERC,BRACHIOCEPH
|
Professional
|
Both
|
$2,039.00
|
|
|
Service Code
|
HCPCS 35475
|
| Min. Negotiated Rate |
$815.60 |
| Max. Negotiated Rate |
$1,325.35 |
| Rate for Payer: Aetna Medicare |
$1,019.50
|
| Rate for Payer: BCBS Complete |
$815.60
|
| Rate for Payer: Cash Price |
$1,631.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,325.35
|
| Rate for Payer: UMR Bronson Commercial |
$937.94
|
|
|
PR BALLN ANGIOPLASTY,PERC VENOUS
|
Professional
|
Both
|
$3,441.00
|
|
|
Service Code
|
HCPCS 35476
|
| Min. Negotiated Rate |
$1,376.40 |
| Max. Negotiated Rate |
$2,236.65 |
| Rate for Payer: Aetna Medicare |
$1,720.50
|
| Rate for Payer: BCBS Complete |
$1,376.40
|
| Rate for Payer: Cash Price |
$2,752.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,236.65
|
| Rate for Payer: UMR Bronson Commercial |
$1,582.86
|
|
|
PR BALLN ANGIOPLASTY PERC,VISCERAL
|
Professional
|
Both
|
$2,857.00
|
|
|
Service Code
|
HCPCS 35471
|
| Min. Negotiated Rate |
$1,142.80 |
| Max. Negotiated Rate |
$1,857.05 |
| Rate for Payer: Aetna Medicare |
$1,428.50
|
| Rate for Payer: BCBS Complete |
$1,142.80
|
| Rate for Payer: Cash Price |
$2,285.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,857.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,314.22
|
|
|
PR BALLOON ANGIOPLASTY INTRACRANIAL PERCUTANEOUS
|
Professional
|
Both
|
$4,922.00
|
|
|
Service Code
|
HCPCS 61630
|
| Min. Negotiated Rate |
$1,331.64 |
| Max. Negotiated Rate |
$3,199.30 |
| Rate for Payer: Aetna Commercial |
$1,784.40
|
| Rate for Payer: Aetna Medicare |
$1,384.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,784.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,917.56
|
| Rate for Payer: BCBS Complete |
$1,968.80
|
| Rate for Payer: BCBS MAPPO |
$1,331.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,331.64
|
| Rate for Payer: Cash Price |
$3,937.60
|
| Rate for Payer: Cash Price |
$3,937.60
|
| Rate for Payer: Cofinity Commercial |
$1,784.40
|
| Rate for Payer: Cofinity Commercial |
$1,917.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,331.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,398.22
|
| Rate for Payer: Nomi Health Commercial |
$1,597.97
|
| Rate for Payer: PACE SWMI |
$1,331.64
|
| Rate for Payer: PHP Commercial |
$1,864.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,331.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,199.30
|
| Rate for Payer: Priority Health Medicare |
$1,331.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,331.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,331.64
|
| Rate for Payer: UMR Bronson Commercial |
$2,264.12
|
|
|
PR BALLOON DILAT BILIARY DUCT/AMPULLA PRQ EACH DUCT
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 47542
|
| Min. Negotiated Rate |
$127.35 |
| Max. Negotiated Rate |
$763.75 |
| Rate for Payer: Aetna Commercial |
$170.65
|
| Rate for Payer: Aetna Medicare |
$132.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.65
|
| Rate for Payer: BCBS Complete |
$470.00
|
| Rate for Payer: BCBS MAPPO |
$127.35
|
| Rate for Payer: BCN Medicare Advantage |
$127.35
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$183.38
|
| Rate for Payer: Cofinity Commercial |
$170.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.72
|
| Rate for Payer: Nomi Health Commercial |
$152.82
|
| Rate for Payer: PACE SWMI |
$127.35
|
| Rate for Payer: PHP Commercial |
$178.29
|
| Rate for Payer: PHP Medicare Advantage |
$127.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health Medicare |
$127.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.35
|
| Rate for Payer: UHC Medicare Advantage |
$127.35
|
| Rate for Payer: UMR Bronson Commercial |
$540.50
|
|
|
PR BALLOON DILAT INTRACRANIAL VASOSPASM PRQ INITIAL
|
Professional
|
Both
|
$986.00
|
|
|
Service Code
|
HCPCS 61640
|
| Min. Negotiated Rate |
$394.40 |
| Max. Negotiated Rate |
$640.90 |
| Rate for Payer: Aetna Medicare |
$493.00
|
| Rate for Payer: BCBS Complete |
$394.40
|
| Rate for Payer: Cash Price |
$788.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.90
|
| Rate for Payer: UMR Bronson Commercial |
$453.56
|
|
|
PR BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I
|
Professional
|
Both
|
$1,921.00
|
|
|
Service Code
|
HCPCS 50706
|
| Min. Negotiated Rate |
$170.13 |
| Max. Negotiated Rate |
$1,248.65 |
| Rate for Payer: Aetna Commercial |
$227.97
|
| Rate for Payer: Aetna Medicare |
$176.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.99
|
| Rate for Payer: BCBS Complete |
$768.40
|
| Rate for Payer: BCBS MAPPO |
$170.13
|
| Rate for Payer: BCN Medicare Advantage |
$170.13
|
| Rate for Payer: Cash Price |
$1,536.80
|
| Rate for Payer: Cash Price |
$1,536.80
|
| Rate for Payer: Cofinity Commercial |
$227.97
|
| Rate for Payer: Cofinity Commercial |
$244.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.64
|
| Rate for Payer: Nomi Health Commercial |
$204.16
|
| Rate for Payer: PACE SWMI |
$170.13
|
| Rate for Payer: PHP Commercial |
$238.18
|
| Rate for Payer: PHP Medicare Advantage |
$170.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,248.65
|
| Rate for Payer: Priority Health Medicare |
$170.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.13
|
| Rate for Payer: UHC Medicare Advantage |
$170.13
|
| Rate for Payer: UMR Bronson Commercial |
$883.66
|
|
|
PR BCG LIVE INTRAVESICAL VAC
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS J9031
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$117.00 |
| Rate for Payer: Aetna Medicare |
$90.00
|
| Rate for Payer: BCBS Complete |
$72.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.00
|
| Rate for Payer: UMR Bronson Commercial |
$82.80
|
|
|
PR BCN APNEALINK PLUS
|
Professional
|
Both
|
$753.00
|
|
|
Service Code
|
HCPCS 00119
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$301.20 |
| Max. Negotiated Rate |
$489.45 |
| Rate for Payer: Aetna Medicare |
$376.50
|
| Rate for Payer: BCBS Complete |
$301.20
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$489.45
|
| Rate for Payer: UMR Bronson Commercial |
$346.38
|
|
|
PR BCN WATCHPAT
|
Professional
|
Both
|
$559.00
|
|
|
Service Code
|
HCPCS 00120
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$223.60 |
| Max. Negotiated Rate |
$363.35 |
| Rate for Payer: Aetna Medicare |
$279.50
|
| Rate for Payer: BCBS Complete |
$223.60
|
| Rate for Payer: Cash Price |
$447.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$363.35
|
| Rate for Payer: UMR Bronson Commercial |
$257.14
|
|
|
PR BEDSIDE DRAINAGE BAG
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS A4357
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$19.54 |
| Rate for Payer: Aetna Commercial |
$18.18
|
| Rate for Payer: Aetna Medicare |
$14.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.18
|
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: BCBS MAPPO |
$13.57
|
| Rate for Payer: BCN Medicare Advantage |
$13.57
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$19.54
|
| Rate for Payer: Cofinity Commercial |
$18.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.25
|
| Rate for Payer: Nomi Health Commercial |
$16.28
|
| Rate for Payer: PACE SWMI |
$13.57
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Medicare Advantage |
$13.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.75
|
| Rate for Payer: Priority Health Medicare |
$13.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.57
|
| Rate for Payer: UHC Medicare Advantage |
$13.57
|
| Rate for Payer: UMR Bronson Commercial |
$6.90
|
|
|
PR BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS 96127
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$7.15 |
| Rate for Payer: Aetna Commercial |
$5.64
|
| Rate for Payer: Aetna Medicare |
$4.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.64
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS MAPPO |
$4.21
|
| Rate for Payer: BCN Medicare Advantage |
$4.21
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$6.06
|
| Rate for Payer: Cofinity Commercial |
$5.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.42
|
| Rate for Payer: Nomi Health Commercial |
$5.05
|
| Rate for Payer: PACE SWMI |
$4.21
|
| Rate for Payer: PHP Commercial |
$5.89
|
| Rate for Payer: PHP Medicare Advantage |
$4.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.15
|
| Rate for Payer: Priority Health Medicare |
$4.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.21
|
| Rate for Payer: UHC Medicare Advantage |
$4.21
|
| Rate for Payer: UMR Bronson Commercial |
$5.06
|
|
|
PR BEHAV HLTH DAY TREAT, PER HR
|
Professional
|
Both
|
$550.00
|
|
|
Service Code
|
HCPCS H2012
|
| Min. Negotiated Rate |
$220.00 |
| Max. Negotiated Rate |
$357.50 |
| Rate for Payer: Aetna Medicare |
$275.00
|
| Rate for Payer: BCBS Complete |
$220.00
|
| Rate for Payer: Cash Price |
$440.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.50
|
| Rate for Payer: UMR Bronson Commercial |
$253.00
|
|
|
PR BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 92524
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$148.59 |
| Rate for Payer: Aetna Commercial |
$138.27
|
| Rate for Payer: Aetna Medicare |
$107.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.59
|
| Rate for Payer: BCBS Complete |
$72.00
|
| Rate for Payer: BCBS MAPPO |
$103.19
|
| Rate for Payer: BCN Medicare Advantage |
$103.19
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$138.27
|
| Rate for Payer: Cofinity Commercial |
$148.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.35
|
| Rate for Payer: Nomi Health Commercial |
$123.83
|
| Rate for Payer: PACE SWMI |
$103.19
|
| Rate for Payer: PHP Commercial |
$144.47
|
| Rate for Payer: PHP Medicare Advantage |
$103.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.00
|
| Rate for Payer: Priority Health Medicare |
$103.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.19
|
| Rate for Payer: UHC Medicare Advantage |
$103.19
|
| Rate for Payer: UMR Bronson Commercial |
$82.80
|
|
|
PR BEHAVIOR COUNSEL OBESITY 15M
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS G0447
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$41.17 |
| Rate for Payer: Aetna Commercial |
$38.31
|
| Rate for Payer: Aetna Medicare |
$29.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.31
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS MAPPO |
$28.59
|
| Rate for Payer: BCN Medicare Advantage |
$28.59
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$41.17
|
| Rate for Payer: Cofinity Commercial |
$38.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.02
|
| Rate for Payer: Nomi Health Commercial |
$34.31
|
| Rate for Payer: PACE SWMI |
$28.59
|
| Rate for Payer: PHP Commercial |
$40.03
|
| Rate for Payer: PHP Medicare Advantage |
$28.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health Medicare |
$28.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.59
|
| Rate for Payer: UHC Medicare Advantage |
$28.59
|
| Rate for Payer: UMR Bronson Commercial |
$20.70
|
|
