|
PR BIOPSY INTRANASAL
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 30100
|
| Min. Negotiated Rate |
$65.10 |
| Max. Negotiated Rate |
$148.20 |
| Rate for Payer: Aetna Commercial |
$87.23
|
| Rate for Payer: Aetna Medicare |
$67.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.74
|
| Rate for Payer: BCBS Complete |
$91.20
|
| Rate for Payer: BCBS MAPPO |
$65.10
|
| Rate for Payer: BCN Medicare Advantage |
$65.10
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$87.23
|
| Rate for Payer: Cofinity Commercial |
$93.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.36
|
| Rate for Payer: Nomi Health Commercial |
$78.12
|
| Rate for Payer: PACE SWMI |
$65.10
|
| Rate for Payer: PHP Commercial |
$91.14
|
| Rate for Payer: PHP Medicare Advantage |
$65.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.20
|
| Rate for Payer: Priority Health Medicare |
$65.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.10
|
| Rate for Payer: UHC Medicare Advantage |
$65.10
|
| Rate for Payer: UMR Bronson Commercial |
$104.88
|
|
|
PR BIOPSY LIVER NEEDLE PERCUTANEOUS
|
Professional
|
Both
|
$593.00
|
|
|
Service Code
|
HCPCS 47000
|
| Min. Negotiated Rate |
$82.43 |
| Max. Negotiated Rate |
$385.45 |
| Rate for Payer: Aetna Commercial |
$110.46
|
| Rate for Payer: Aetna Medicare |
$85.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.46
|
| Rate for Payer: BCBS Complete |
$237.20
|
| Rate for Payer: BCBS MAPPO |
$82.43
|
| Rate for Payer: BCN Medicare Advantage |
$82.43
|
| Rate for Payer: Cash Price |
$474.40
|
| Rate for Payer: Cash Price |
$474.40
|
| Rate for Payer: Cofinity Commercial |
$118.70
|
| Rate for Payer: Cofinity Commercial |
$110.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.55
|
| Rate for Payer: Nomi Health Commercial |
$98.92
|
| Rate for Payer: PACE SWMI |
$82.43
|
| Rate for Payer: PHP Commercial |
$115.40
|
| Rate for Payer: PHP Medicare Advantage |
$82.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$385.45
|
| Rate for Payer: Priority Health Medicare |
$82.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.43
|
| Rate for Payer: UHC Medicare Advantage |
$82.43
|
| Rate for Payer: UMR Bronson Commercial |
$272.78
|
|
|
PR BIOPSY LIVER WEDGE
|
Professional
|
Both
|
$1,789.00
|
|
|
Service Code
|
HCPCS 47100
|
| Min. Negotiated Rate |
$715.60 |
| Max. Negotiated Rate |
$1,182.08 |
| Rate for Payer: Aetna Commercial |
$1,099.99
|
| Rate for Payer: Aetna Medicare |
$853.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,182.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,099.99
|
| Rate for Payer: BCBS Complete |
$715.60
|
| Rate for Payer: BCBS MAPPO |
$820.89
|
| Rate for Payer: BCN Medicare Advantage |
$820.89
|
| Rate for Payer: Cash Price |
$1,431.20
|
| Rate for Payer: Cash Price |
$1,431.20
|
| Rate for Payer: Cofinity Commercial |
$1,182.08
|
| Rate for Payer: Cofinity Commercial |
$1,099.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$820.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$861.93
|
| Rate for Payer: Nomi Health Commercial |
$985.07
|
| Rate for Payer: PACE SWMI |
$820.89
|
| Rate for Payer: PHP Commercial |
$1,149.25
|
| Rate for Payer: PHP Medicare Advantage |
$820.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.85
|
| Rate for Payer: Priority Health Medicare |
$820.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$820.89
|
| Rate for Payer: UHC Medicare Advantage |
$820.89
|
| Rate for Payer: UMR Bronson Commercial |
$822.94
|
|
|
PR BIOPSY LUNG/MEDIASTINUM PERCUTANEOUS NEEDLE
|
Professional
|
Both
|
$762.00
|
|
|
Service Code
|
HCPCS 32405
|
| Min. Negotiated Rate |
$304.80 |
| Max. Negotiated Rate |
$495.30 |
| Rate for Payer: Aetna Medicare |
$381.00
|
| Rate for Payer: BCBS Complete |
$304.80
|
| Rate for Payer: Cash Price |
$609.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$495.30
|
| Rate for Payer: UMR Bronson Commercial |
$350.52
|
|
|
PR BIOPSY MUSCLE DEEP
|
Professional
|
Both
|
$591.00
|
|
|
Service Code
|
HCPCS 20205
|
| Min. Negotiated Rate |
$150.10 |
| Max. Negotiated Rate |
$384.15 |
| Rate for Payer: Aetna Commercial |
$201.13
|
| Rate for Payer: Aetna Medicare |
$156.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.14
|
| Rate for Payer: BCBS Complete |
$236.40
|
| Rate for Payer: BCBS MAPPO |
$150.10
|
| Rate for Payer: BCN Medicare Advantage |
$150.10
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cofinity Commercial |
$201.13
|
| Rate for Payer: Cofinity Commercial |
$216.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.60
|
| Rate for Payer: Nomi Health Commercial |
$180.12
|
| Rate for Payer: PACE SWMI |
$150.10
|
| Rate for Payer: PHP Commercial |
$210.14
|
| Rate for Payer: PHP Medicare Advantage |
$150.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.15
|
| Rate for Payer: Priority Health Medicare |
$150.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.10
|
| Rate for Payer: UHC Medicare Advantage |
$150.10
|
| Rate for Payer: UMR Bronson Commercial |
$271.86
|
|
|
PR BIOPSY MUSCLE PERCUTANEOUS NEEDLE
|
Professional
|
Both
|
$414.00
|
|
|
Service Code
|
HCPCS 20206
|
| Min. Negotiated Rate |
$54.09 |
| Max. Negotiated Rate |
$269.10 |
| Rate for Payer: Aetna Commercial |
$72.48
|
| Rate for Payer: Aetna Medicare |
$56.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.48
|
| Rate for Payer: BCBS Complete |
$165.60
|
| Rate for Payer: BCBS MAPPO |
$54.09
|
| Rate for Payer: BCN Medicare Advantage |
$54.09
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cofinity Commercial |
$77.89
|
| Rate for Payer: Cofinity Commercial |
$72.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.79
|
| Rate for Payer: Nomi Health Commercial |
$64.91
|
| Rate for Payer: PACE SWMI |
$54.09
|
| Rate for Payer: PHP Commercial |
$75.73
|
| Rate for Payer: PHP Medicare Advantage |
$54.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.10
|
| Rate for Payer: Priority Health Medicare |
$54.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.09
|
| Rate for Payer: UHC Medicare Advantage |
$54.09
|
| Rate for Payer: UMR Bronson Commercial |
$190.44
|
|
|
PR BIOPSY MUSCLE SUPERFICIAL
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
HCPCS 20200
|
| Min. Negotiated Rate |
$92.88 |
| Max. Negotiated Rate |
$233.35 |
| Rate for Payer: Aetna Commercial |
$124.46
|
| Rate for Payer: Aetna Medicare |
$96.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.46
|
| Rate for Payer: BCBS Complete |
$143.60
|
| Rate for Payer: BCBS MAPPO |
$92.88
|
| Rate for Payer: BCN Medicare Advantage |
$92.88
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$133.75
|
| Rate for Payer: Cofinity Commercial |
$124.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.52
|
| Rate for Payer: Nomi Health Commercial |
$111.46
|
| Rate for Payer: PACE SWMI |
$92.88
|
| Rate for Payer: PHP Commercial |
$130.03
|
| Rate for Payer: PHP Medicare Advantage |
$92.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
| Rate for Payer: Priority Health Medicare |
$92.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.88
|
| Rate for Payer: UHC Medicare Advantage |
$92.88
|
| Rate for Payer: UMR Bronson Commercial |
$165.14
|
|
|
PR BIOPSY MUSCLE SUPERFICIAL
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
HCPCS 20200
|
| Hospital Charge Code |
20200
|
| Min. Negotiated Rate |
$92.88 |
| Max. Negotiated Rate |
$233.35 |
| Rate for Payer: Aetna Commercial |
$124.46
|
| Rate for Payer: Aetna Medicare |
$96.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.46
|
| Rate for Payer: BCBS Complete |
$143.60
|
| Rate for Payer: BCBS MAPPO |
$92.88
|
| Rate for Payer: BCN Medicare Advantage |
$92.88
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$133.75
|
| Rate for Payer: Cofinity Commercial |
$124.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.52
|
| Rate for Payer: Nomi Health Commercial |
$111.46
|
| Rate for Payer: PACE SWMI |
$92.88
|
| Rate for Payer: PHP Commercial |
$130.03
|
| Rate for Payer: PHP Medicare Advantage |
$92.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
| Rate for Payer: Priority Health Medicare |
$92.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.88
|
| Rate for Payer: UHC Medicare Advantage |
$92.88
|
| Rate for Payer: UMR Bronson Commercial |
$165.14
|
|
|
PR BIOPSY MUSCLE SUPERFICIAL
|
Facility
|
OP
|
$359.00
|
|
|
Service Code
|
CPT 20200
|
| Hospital Charge Code |
20200
|
| Min. Negotiated Rate |
$132.83 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna American Axle |
$233.35
|
| Rate for Payer: Aetna Commercial |
$305.15
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$308.74
|
| Rate for Payer: Cofinity Commercial |
$251.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$251.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$323.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.25
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.15
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$305.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$226.17
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$3,019.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: UMR Bronson Commercial |
$132.83
|
| Rate for Payer: VA VA |
$1,580.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.25
|
|
|
PR BIOPSY MUSCLE SUPERFICIAL
|
Facility
|
IP
|
$359.00
|
|
|
Service Code
|
CPT 20200
|
| Hospital Charge Code |
20200
|
| Min. Negotiated Rate |
$157.96 |
| Max. Negotiated Rate |
$323.10 |
| Rate for Payer: Aetna American Axle |
$233.35
|
| Rate for Payer: Aetna Commercial |
$305.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.35
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$251.30
|
| Rate for Payer: Cofinity Commercial |
$308.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$251.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.20
|
| Rate for Payer: Healthscope Commercial |
$323.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.15
|
| Rate for Payer: PHP Commercial |
$305.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
| Rate for Payer: Priority Health SBD |
$226.17
|
| Rate for Payer: UMR Bronson Commercial |
$157.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.25
|
|
|
PR BIOPSY NAIL UNIT SEPARATE PROCEDURE
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 11755
|
| Min. Negotiated Rate |
$57.78 |
| Max. Negotiated Rate |
$143.65 |
| Rate for Payer: Aetna Commercial |
$77.43
|
| Rate for Payer: Aetna Medicare |
$60.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.43
|
| Rate for Payer: BCBS Complete |
$88.40
|
| Rate for Payer: BCBS MAPPO |
$57.78
|
| Rate for Payer: BCN Medicare Advantage |
$57.78
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$83.20
|
| Rate for Payer: Cofinity Commercial |
$77.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.67
|
| Rate for Payer: Nomi Health Commercial |
$69.34
|
| Rate for Payer: PACE SWMI |
$57.78
|
| Rate for Payer: PHP Commercial |
$80.89
|
| Rate for Payer: PHP Medicare Advantage |
$57.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.65
|
| Rate for Payer: Priority Health Medicare |
$57.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.78
|
| Rate for Payer: UHC Medicare Advantage |
$57.78
|
| Rate for Payer: UMR Bronson Commercial |
$101.66
|
|
|
PR BIOPSY NASOPHARYNX VISIBLE LESION SIMPLE
|
Professional
|
Both
|
$838.00
|
|
|
Service Code
|
HCPCS 42804
|
| Min. Negotiated Rate |
$115.15 |
| Max. Negotiated Rate |
$544.70 |
| Rate for Payer: Aetna Commercial |
$154.30
|
| Rate for Payer: Aetna Medicare |
$119.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.30
|
| Rate for Payer: BCBS Complete |
$335.20
|
| Rate for Payer: BCBS MAPPO |
$115.15
|
| Rate for Payer: BCN Medicare Advantage |
$115.15
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cofinity Commercial |
$165.82
|
| Rate for Payer: Cofinity Commercial |
$154.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.91
|
| Rate for Payer: Nomi Health Commercial |
$138.18
|
| Rate for Payer: PACE SWMI |
$115.15
|
| Rate for Payer: PHP Commercial |
$161.21
|
| Rate for Payer: PHP Medicare Advantage |
$115.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.70
|
| Rate for Payer: Priority Health Medicare |
$115.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.15
|
| Rate for Payer: UHC Medicare Advantage |
$115.15
|
| Rate for Payer: UMR Bronson Commercial |
$385.48
|
|
|
PR BIOPSY NERVE
|
Professional
|
Both
|
$722.00
|
|
|
Service Code
|
HCPCS 64795
|
| Min. Negotiated Rate |
$192.25 |
| Max. Negotiated Rate |
$469.30 |
| Rate for Payer: Aetna Commercial |
$257.62
|
| Rate for Payer: Aetna Medicare |
$199.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.62
|
| Rate for Payer: BCBS Complete |
$288.80
|
| Rate for Payer: BCBS MAPPO |
$192.25
|
| Rate for Payer: BCN Medicare Advantage |
$192.25
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cofinity Commercial |
$276.84
|
| Rate for Payer: Cofinity Commercial |
$257.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.86
|
| Rate for Payer: Nomi Health Commercial |
$230.70
|
| Rate for Payer: PACE SWMI |
$192.25
|
| Rate for Payer: PHP Commercial |
$269.15
|
| Rate for Payer: PHP Medicare Advantage |
$192.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.30
|
| Rate for Payer: Priority Health Medicare |
$192.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.25
|
| Rate for Payer: UHC Medicare Advantage |
$192.25
|
| Rate for Payer: UMR Bronson Commercial |
$332.12
|
|
|
PR BIOPSY OF LIP
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 40490
|
| Min. Negotiated Rate |
$65.91 |
| Max. Negotiated Rate |
$148.20 |
| Rate for Payer: Aetna Commercial |
$88.32
|
| Rate for Payer: Aetna Medicare |
$68.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.32
|
| Rate for Payer: BCBS Complete |
$91.20
|
| Rate for Payer: BCBS MAPPO |
$65.91
|
| Rate for Payer: BCN Medicare Advantage |
$65.91
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$94.91
|
| Rate for Payer: Cofinity Commercial |
$88.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.21
|
| Rate for Payer: Nomi Health Commercial |
$79.09
|
| Rate for Payer: PACE SWMI |
$65.91
|
| Rate for Payer: PHP Commercial |
$92.27
|
| Rate for Payer: PHP Medicare Advantage |
$65.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.20
|
| Rate for Payer: Priority Health Medicare |
$65.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.91
|
| Rate for Payer: UHC Medicare Advantage |
$65.91
|
| Rate for Payer: UMR Bronson Commercial |
$104.88
|
|
|
PR BIOPSY OF SKIN LESION
|
Professional
|
Both
|
$171.00
|
|
|
Service Code
|
HCPCS 11100
|
| Min. Negotiated Rate |
$68.40 |
| Max. Negotiated Rate |
$111.15 |
| Rate for Payer: Aetna Medicare |
$85.50
|
| Rate for Payer: BCBS Complete |
$68.40
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.15
|
| Rate for Payer: UMR Bronson Commercial |
$78.66
|
|
|
PR BIOPSY OROPHARYNX
|
Professional
|
Both
|
$258.00
|
|
|
Service Code
|
HCPCS 42800
|
| Min. Negotiated Rate |
$103.20 |
| Max. Negotiated Rate |
$167.70 |
| Rate for Payer: Aetna Commercial |
$149.30
|
| Rate for Payer: Aetna Medicare |
$115.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.44
|
| Rate for Payer: BCBS Complete |
$103.20
|
| Rate for Payer: BCBS MAPPO |
$111.42
|
| Rate for Payer: BCN Medicare Advantage |
$111.42
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cofinity Commercial |
$149.30
|
| Rate for Payer: Cofinity Commercial |
$160.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$116.99
|
| Rate for Payer: Nomi Health Commercial |
$133.70
|
| Rate for Payer: PACE SWMI |
$111.42
|
| Rate for Payer: PHP Commercial |
$155.99
|
| Rate for Payer: PHP Medicare Advantage |
$111.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.70
|
| Rate for Payer: Priority Health Medicare |
$111.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$111.42
|
| Rate for Payer: UHC Medicare Advantage |
$111.42
|
| Rate for Payer: UMR Bronson Commercial |
$118.68
|
|
|
PR BIOPSY OVARY UNI/BI SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,617.00
|
|
|
Service Code
|
HCPCS 58900
|
| Min. Negotiated Rate |
$416.76 |
| Max. Negotiated Rate |
$1,051.05 |
| Rate for Payer: Aetna Commercial |
$558.46
|
| Rate for Payer: Aetna Medicare |
$433.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$600.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$558.46
|
| Rate for Payer: BCBS Complete |
$646.80
|
| Rate for Payer: BCBS MAPPO |
$416.76
|
| Rate for Payer: BCN Medicare Advantage |
$416.76
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cofinity Commercial |
$600.13
|
| Rate for Payer: Cofinity Commercial |
$558.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.60
|
| Rate for Payer: Nomi Health Commercial |
$500.11
|
| Rate for Payer: PACE SWMI |
$416.76
|
| Rate for Payer: PHP Commercial |
$583.46
|
| Rate for Payer: PHP Medicare Advantage |
$416.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.05
|
| Rate for Payer: Priority Health Medicare |
$416.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$416.76
|
| Rate for Payer: UHC Medicare Advantage |
$416.76
|
| Rate for Payer: UMR Bronson Commercial |
$743.82
|
|
|
PR BIOPSY PALATE UVULA
|
Professional
|
Both
|
$268.00
|
|
|
Service Code
|
HCPCS 42100
|
| Min. Negotiated Rate |
$103.99 |
| Max. Negotiated Rate |
$174.20 |
| Rate for Payer: Aetna Commercial |
$139.35
|
| Rate for Payer: Aetna Medicare |
$108.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.35
|
| Rate for Payer: BCBS Complete |
$107.20
|
| Rate for Payer: BCBS MAPPO |
$103.99
|
| Rate for Payer: BCN Medicare Advantage |
$103.99
|
| Rate for Payer: Cash Price |
$214.40
|
| Rate for Payer: Cash Price |
$214.40
|
| Rate for Payer: Cofinity Commercial |
$149.75
|
| Rate for Payer: Cofinity Commercial |
$139.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.19
|
| Rate for Payer: Nomi Health Commercial |
$124.79
|
| Rate for Payer: PACE SWMI |
$103.99
|
| Rate for Payer: PHP Commercial |
$145.59
|
| Rate for Payer: PHP Medicare Advantage |
$103.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.20
|
| Rate for Payer: Priority Health Medicare |
$103.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.99
|
| Rate for Payer: UHC Medicare Advantage |
$103.99
|
| Rate for Payer: UMR Bronson Commercial |
$123.28
|
|
|
PR BIOPSY PANCREAS OPEN
|
Professional
|
Both
|
$1,588.00
|
|
|
Service Code
|
HCPCS 48100
|
| Min. Negotiated Rate |
$635.20 |
| Max. Negotiated Rate |
$1,241.57 |
| Rate for Payer: Aetna Commercial |
$1,155.35
|
| Rate for Payer: Aetna Medicare |
$896.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,241.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,155.35
|
| Rate for Payer: BCBS Complete |
$635.20
|
| Rate for Payer: BCBS MAPPO |
$862.20
|
| Rate for Payer: BCN Medicare Advantage |
$862.20
|
| Rate for Payer: Cash Price |
$1,270.40
|
| Rate for Payer: Cash Price |
$1,270.40
|
| Rate for Payer: Cofinity Commercial |
$1,241.57
|
| Rate for Payer: Cofinity Commercial |
$1,155.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$862.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$905.31
|
| Rate for Payer: Nomi Health Commercial |
$1,034.64
|
| Rate for Payer: PACE SWMI |
$862.20
|
| Rate for Payer: PHP Commercial |
$1,207.08
|
| Rate for Payer: PHP Medicare Advantage |
$862.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.20
|
| Rate for Payer: Priority Health Medicare |
$862.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$862.20
|
| Rate for Payer: UHC Medicare Advantage |
$862.20
|
| Rate for Payer: UMR Bronson Commercial |
$730.48
|
|
|
PR BIOPSY PENIS DEEP STRUCTURES
|
Professional
|
Both
|
$563.00
|
|
|
Service Code
|
HCPCS 54105
|
| Min. Negotiated Rate |
$203.40 |
| Max. Negotiated Rate |
$365.95 |
| Rate for Payer: Aetna Commercial |
$272.56
|
| Rate for Payer: Aetna Medicare |
$211.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.56
|
| Rate for Payer: BCBS Complete |
$225.20
|
| Rate for Payer: BCBS MAPPO |
$203.40
|
| Rate for Payer: BCN Medicare Advantage |
$203.40
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cofinity Commercial |
$292.90
|
| Rate for Payer: Cofinity Commercial |
$272.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$213.57
|
| Rate for Payer: Nomi Health Commercial |
$244.08
|
| Rate for Payer: PACE SWMI |
$203.40
|
| Rate for Payer: PHP Commercial |
$284.76
|
| Rate for Payer: PHP Medicare Advantage |
$203.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.95
|
| Rate for Payer: Priority Health Medicare |
$203.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$203.40
|
| Rate for Payer: UHC Medicare Advantage |
$203.40
|
| Rate for Payer: UMR Bronson Commercial |
$258.98
|
|
|
PR BIOPSY PENIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$307.00
|
|
|
Service Code
|
HCPCS 54100
|
| Min. Negotiated Rate |
$115.40 |
| Max. Negotiated Rate |
$199.55 |
| Rate for Payer: Aetna Commercial |
$154.64
|
| Rate for Payer: Aetna Medicare |
$120.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.64
|
| Rate for Payer: BCBS Complete |
$122.80
|
| Rate for Payer: BCBS MAPPO |
$115.40
|
| Rate for Payer: BCN Medicare Advantage |
$115.40
|
| Rate for Payer: Cash Price |
$245.60
|
| Rate for Payer: Cash Price |
$245.60
|
| Rate for Payer: Cofinity Commercial |
$166.18
|
| Rate for Payer: Cofinity Commercial |
$154.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.17
|
| Rate for Payer: Nomi Health Commercial |
$138.48
|
| Rate for Payer: PACE SWMI |
$115.40
|
| Rate for Payer: PHP Commercial |
$161.56
|
| Rate for Payer: PHP Medicare Advantage |
$115.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.55
|
| Rate for Payer: Priority Health Medicare |
$115.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.40
|
| Rate for Payer: UHC Medicare Advantage |
$115.40
|
| Rate for Payer: UMR Bronson Commercial |
$141.22
|
|
|
PR BIOPSY PROSTATE INCISIONAL ANY APPROACH
|
Professional
|
Both
|
$477.00
|
|
|
Service Code
|
HCPCS 55705
|
| Min. Negotiated Rate |
$190.80 |
| Max. Negotiated Rate |
$364.56 |
| Rate for Payer: Aetna Commercial |
$339.25
|
| Rate for Payer: Aetna Medicare |
$263.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$364.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$339.25
|
| Rate for Payer: BCBS Complete |
$190.80
|
| Rate for Payer: BCBS MAPPO |
$253.17
|
| Rate for Payer: BCN Medicare Advantage |
$253.17
|
| Rate for Payer: Cash Price |
$381.60
|
| Rate for Payer: Cash Price |
$381.60
|
| Rate for Payer: Cofinity Commercial |
$364.56
|
| Rate for Payer: Cofinity Commercial |
$339.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$253.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$265.83
|
| Rate for Payer: Nomi Health Commercial |
$303.80
|
| Rate for Payer: PACE SWMI |
$253.17
|
| Rate for Payer: PHP Commercial |
$354.44
|
| Rate for Payer: PHP Medicare Advantage |
$253.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$310.05
|
| Rate for Payer: Priority Health Medicare |
$253.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$253.17
|
| Rate for Payer: UHC Medicare Advantage |
$253.17
|
| Rate for Payer: UMR Bronson Commercial |
$219.42
|
|
|
PR BIOPSY SALIVARY GLAND INCISIONAL
|
Professional
|
Both
|
$533.00
|
|
|
Service Code
|
HCPCS 42405
|
| Min. Negotiated Rate |
$213.20 |
| Max. Negotiated Rate |
$346.45 |
| Rate for Payer: Aetna Commercial |
$290.51
|
| Rate for Payer: Aetna Medicare |
$225.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.51
|
| Rate for Payer: BCBS Complete |
$213.20
|
| Rate for Payer: BCBS MAPPO |
$216.80
|
| Rate for Payer: BCN Medicare Advantage |
$216.80
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cofinity Commercial |
$312.19
|
| Rate for Payer: Cofinity Commercial |
$290.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.64
|
| Rate for Payer: Nomi Health Commercial |
$260.16
|
| Rate for Payer: PACE SWMI |
$216.80
|
| Rate for Payer: PHP Commercial |
$303.52
|
| Rate for Payer: PHP Medicare Advantage |
$216.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$346.45
|
| Rate for Payer: Priority Health Medicare |
$216.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.80
|
| Rate for Payer: UHC Medicare Advantage |
$216.80
|
| Rate for Payer: UMR Bronson Commercial |
$245.18
|
|
|
PR BIOPSY SOFT TISSUE BACK/FLANK DEEP
|
Professional
|
Both
|
$920.00
|
|
|
Service Code
|
HCPCS 21925
|
| Min. Negotiated Rate |
$363.92 |
| Max. Negotiated Rate |
$598.00 |
| Rate for Payer: Aetna Commercial |
$487.65
|
| Rate for Payer: Aetna Medicare |
$378.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$524.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.65
|
| Rate for Payer: BCBS Complete |
$368.00
|
| Rate for Payer: BCBS MAPPO |
$363.92
|
| Rate for Payer: BCN Medicare Advantage |
$363.92
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cofinity Commercial |
$524.04
|
| Rate for Payer: Cofinity Commercial |
$487.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$382.12
|
| Rate for Payer: Nomi Health Commercial |
$436.70
|
| Rate for Payer: PACE SWMI |
$363.92
|
| Rate for Payer: PHP Commercial |
$509.49
|
| Rate for Payer: PHP Medicare Advantage |
$363.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$598.00
|
| Rate for Payer: Priority Health Medicare |
$363.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.92
|
| Rate for Payer: UHC Medicare Advantage |
$363.92
|
| Rate for Payer: UMR Bronson Commercial |
$423.20
|
|
|
PR BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL
|
Professional
|
Both
|
$508.00
|
|
|
Service Code
|
HCPCS 21920
|
| Min. Negotiated Rate |
$147.45 |
| Max. Negotiated Rate |
$330.20 |
| Rate for Payer: Aetna Commercial |
$197.58
|
| Rate for Payer: Aetna Medicare |
$153.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.58
|
| Rate for Payer: BCBS Complete |
$203.20
|
| Rate for Payer: BCBS MAPPO |
$147.45
|
| Rate for Payer: BCN Medicare Advantage |
$147.45
|
| Rate for Payer: Cash Price |
$406.40
|
| Rate for Payer: Cash Price |
$406.40
|
| Rate for Payer: Cofinity Commercial |
$212.33
|
| Rate for Payer: Cofinity Commercial |
$197.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.82
|
| Rate for Payer: Nomi Health Commercial |
$176.94
|
| Rate for Payer: PACE SWMI |
$147.45
|
| Rate for Payer: PHP Commercial |
$206.43
|
| Rate for Payer: PHP Medicare Advantage |
$147.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.20
|
| Rate for Payer: Priority Health Medicare |
$147.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.45
|
| Rate for Payer: UHC Medicare Advantage |
$147.45
|
| Rate for Payer: UMR Bronson Commercial |
$233.68
|
|
