|
PR CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE
|
Professional
|
Both
|
$190.00
|
|
|
Service Code
|
HCPCS 64643
|
| Min. Negotiated Rate |
$38.13 |
| Max. Negotiated Rate |
$142.50 |
| Rate for Payer: Aetna Commercial |
$80.00
|
| Rate for Payer: Aetna Medicare |
$62.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.97
|
| Rate for Payer: BCBS Complete |
$40.04
|
| Rate for Payer: BCBS MAPPO |
$59.70
|
| Rate for Payer: BCN Commercial |
$103.58
|
| Rate for Payer: BCN Medicare Advantage |
$59.70
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$85.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.69
|
| Rate for Payer: Meridian Medicaid |
$40.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.67
|
| Rate for Payer: Nomi Health Commercial |
$71.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.50
|
| Rate for Payer: PACE SWMI |
$59.70
|
| Rate for Payer: PHP Commercial |
$83.58
|
| Rate for Payer: PHP Medicare Advantage |
$59.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$120.30
|
| Rate for Payer: Priority Health Medicare |
$59.70
|
| Rate for Payer: Priority Health SBD |
$120.30
|
| Rate for Payer: Priority Health Tiered Network |
$120.30
|
| Rate for Payer: Railroad Medicare Medicare |
$59.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.03
|
| Rate for Payer: UHC Core |
$126.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$59.70
|
| Rate for Payer: UHC Exchange |
$126.03
|
| Rate for Payer: UHC Medicaid |
$38.13
|
| Rate for Payer: UHCCP Medicaid |
$38.13
|
| Rate for Payer: UMR Bronson Commercial |
$87.40
|
|
|
PR CHEMODENERVATION 1 EXTREMITY EA ADDL 5/> MUSCLES
|
Professional
|
Both
|
$327.00
|
|
|
Service Code
|
HCPCS 64645
|
| Min. Negotiated Rate |
$44.94 |
| Max. Negotiated Rate |
$245.25 |
| Rate for Payer: Aetna Commercial |
$94.81
|
| Rate for Payer: Aetna Medicare |
$73.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.81
|
| Rate for Payer: BCBS Complete |
$47.19
|
| Rate for Payer: BCBS MAPPO |
$70.75
|
| Rate for Payer: BCN Commercial |
$121.50
|
| Rate for Payer: BCN Medicare Advantage |
$70.75
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cofinity Commercial |
$101.88
|
| Rate for Payer: Cofinity Commercial |
$94.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.29
|
| Rate for Payer: Meridian Medicaid |
$47.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.83
|
| Rate for Payer: Nomi Health Commercial |
$84.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.25
|
| Rate for Payer: PACE SWMI |
$70.75
|
| Rate for Payer: PHP Commercial |
$99.05
|
| Rate for Payer: PHP Medicare Advantage |
$70.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$141.14
|
| Rate for Payer: Priority Health Medicare |
$70.75
|
| Rate for Payer: Priority Health SBD |
$141.14
|
| Rate for Payer: Priority Health Tiered Network |
$141.14
|
| Rate for Payer: Railroad Medicare Medicare |
$70.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.06
|
| Rate for Payer: UHC Core |
$145.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$70.75
|
| Rate for Payer: UHC Exchange |
$145.06
|
| Rate for Payer: UHC Medicaid |
$44.94
|
| Rate for Payer: UHCCP Medicaid |
$44.94
|
| Rate for Payer: UMR Bronson Commercial |
$150.42
|
|
|
PR CHEMODENERVATION EXTREMITY&/TRUNK MUSCLE
|
Professional
|
Both
|
$483.00
|
|
|
Service Code
|
HCPCS 64614
|
| Min. Negotiated Rate |
$193.20 |
| Max. Negotiated Rate |
$362.25 |
| Rate for Payer: Aetna Medicare |
$241.50
|
| Rate for Payer: BCBS Complete |
$193.20
|
| Rate for Payer: Cash Price |
$386.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$362.25
|
| Rate for Payer: UMR Bronson Commercial |
$222.18
|
|
|
PR CHEMODENERVATION INTERNAL ANAL SPHINCTER
|
Professional
|
Both
|
$767.00
|
|
|
Service Code
|
HCPCS 46505
|
| Min. Negotiated Rate |
$157.19 |
| Max. Negotiated Rate |
$575.25 |
| Rate for Payer: Aetna Commercial |
$318.96
|
| Rate for Payer: Aetna Medicare |
$247.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$342.76
|
| Rate for Payer: BCBS Complete |
$165.05
|
| Rate for Payer: BCBS MAPPO |
$238.03
|
| Rate for Payer: BCN Commercial |
$375.48
|
| Rate for Payer: BCN Medicare Advantage |
$238.03
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cofinity Commercial |
$342.76
|
| Rate for Payer: Cofinity Commercial |
$318.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.93
|
| Rate for Payer: Meridian Medicaid |
$165.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.83
|
| Rate for Payer: Nomi Health Commercial |
$285.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$575.25
|
| Rate for Payer: PACE SWMI |
$238.03
|
| Rate for Payer: PHP Commercial |
$333.24
|
| Rate for Payer: PHP Medicare Advantage |
$238.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$457.49
|
| Rate for Payer: Priority Health Medicare |
$238.03
|
| Rate for Payer: Priority Health SBD |
$457.49
|
| Rate for Payer: Priority Health Tiered Network |
$457.49
|
| Rate for Payer: Railroad Medicare Medicare |
$238.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.98
|
| Rate for Payer: UHC Core |
$421.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$238.03
|
| Rate for Payer: UHC Exchange |
$421.98
|
| Rate for Payer: UHC Medicaid |
$157.19
|
| Rate for Payer: UHCCP Medicaid |
$157.19
|
| Rate for Payer: UMR Bronson Commercial |
$352.82
|
|
|
PR CHEMODENERVATION MUSCLE LARYNX UNILAT W/EMG
|
Professional
|
Both
|
$332.00
|
|
|
Service Code
|
HCPCS 64617
|
| Min. Negotiated Rate |
$58.58 |
| Max. Negotiated Rate |
$249.00 |
| Rate for Payer: Aetna Commercial |
$122.09
|
| Rate for Payer: Aetna Medicare |
$94.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.20
|
| Rate for Payer: BCBS Complete |
$61.51
|
| Rate for Payer: BCBS MAPPO |
$91.11
|
| Rate for Payer: BCN Commercial |
$162.34
|
| Rate for Payer: BCN Medicare Advantage |
$91.11
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cofinity Commercial |
$122.09
|
| Rate for Payer: Cofinity Commercial |
$131.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.67
|
| Rate for Payer: Meridian Medicaid |
$61.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.22
|
| Rate for Payer: Nomi Health Commercial |
$109.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$249.00
|
| Rate for Payer: PACE SWMI |
$91.11
|
| Rate for Payer: PHP Commercial |
$127.55
|
| Rate for Payer: PHP Medicare Advantage |
$91.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$188.56
|
| Rate for Payer: Priority Health Medicare |
$91.11
|
| Rate for Payer: Priority Health SBD |
$188.56
|
| Rate for Payer: Priority Health Tiered Network |
$188.56
|
| Rate for Payer: Railroad Medicare Medicare |
$91.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.42
|
| Rate for Payer: UHC Core |
$191.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$91.11
|
| Rate for Payer: UHC Exchange |
$191.42
|
| Rate for Payer: UHC Medicaid |
$58.58
|
| Rate for Payer: UHCCP Medicaid |
$58.58
|
| Rate for Payer: UMR Bronson Commercial |
$152.72
|
|
|
PR CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA
|
Professional
|
Both
|
$372.00
|
|
|
Service Code
|
HCPCS 64616
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$279.00 |
| Rate for Payer: Aetna Commercial |
$132.41
|
| Rate for Payer: Aetna Medicare |
$102.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.29
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCBS MAPPO |
$98.81
|
| Rate for Payer: BCN Commercial |
$165.83
|
| Rate for Payer: BCN Medicare Advantage |
$98.81
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cofinity Commercial |
$132.41
|
| Rate for Payer: Cofinity Commercial |
$142.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.75
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.69
|
| Rate for Payer: Nomi Health Commercial |
$118.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.00
|
| Rate for Payer: PACE SWMI |
$98.81
|
| Rate for Payer: PHP Commercial |
$138.33
|
| Rate for Payer: PHP Medicare Advantage |
$98.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$192.60
|
| Rate for Payer: Priority Health Medicare |
$98.81
|
| Rate for Payer: Priority Health SBD |
$192.60
|
| Rate for Payer: Priority Health Tiered Network |
$192.60
|
| Rate for Payer: Railroad Medicare Medicare |
$98.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.12
|
| Rate for Payer: UHC Core |
$191.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.81
|
| Rate for Payer: UHC Exchange |
$191.12
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
| Rate for Payer: UMR Bronson Commercial |
$171.12
|
|
|
PR CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES
|
Professional
|
Both
|
$318.00
|
|
|
Service Code
|
HCPCS 64646
|
| Min. Negotiated Rate |
$66.24 |
| Max. Negotiated Rate |
$238.50 |
| Rate for Payer: Aetna Commercial |
$138.58
|
| Rate for Payer: Aetna Medicare |
$107.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.92
|
| Rate for Payer: BCBS Complete |
$69.55
|
| Rate for Payer: BCBS MAPPO |
$103.42
|
| Rate for Payer: BCN Commercial |
$175.29
|
| Rate for Payer: BCN Medicare Advantage |
$103.42
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cofinity Commercial |
$138.58
|
| Rate for Payer: Cofinity Commercial |
$148.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.59
|
| Rate for Payer: Meridian Medicaid |
$69.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$113.76
|
| Rate for Payer: Nomi Health Commercial |
$124.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$238.50
|
| Rate for Payer: PACE SWMI |
$103.42
|
| Rate for Payer: PHP Commercial |
$144.79
|
| Rate for Payer: PHP Medicare Advantage |
$103.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$203.60
|
| Rate for Payer: Priority Health Medicare |
$103.42
|
| Rate for Payer: Priority Health SBD |
$203.60
|
| Rate for Payer: Priority Health Tiered Network |
$203.60
|
| Rate for Payer: Railroad Medicare Medicare |
$103.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.54
|
| Rate for Payer: UHC Core |
$202.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$103.42
|
| Rate for Payer: UHC Exchange |
$202.54
|
| Rate for Payer: UHC Medicaid |
$66.24
|
| Rate for Payer: UHCCP Medicaid |
$66.24
|
| Rate for Payer: UMR Bronson Commercial |
$146.28
|
|
|
PR CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
HCPCS 64642
|
| Min. Negotiated Rate |
$61.34 |
| Max. Negotiated Rate |
$307.50 |
| Rate for Payer: Aetna Commercial |
$127.73
|
| Rate for Payer: Aetna Medicare |
$99.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.26
|
| Rate for Payer: BCBS Complete |
$64.41
|
| Rate for Payer: BCBS MAPPO |
$95.32
|
| Rate for Payer: BCN Commercial |
$160.85
|
| Rate for Payer: BCN Medicare Advantage |
$95.32
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$127.73
|
| Rate for Payer: Cofinity Commercial |
$137.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.09
|
| Rate for Payer: Meridian Medicaid |
$64.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.85
|
| Rate for Payer: Nomi Health Commercial |
$114.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.50
|
| Rate for Payer: PACE SWMI |
$95.32
|
| Rate for Payer: PHP Commercial |
$133.45
|
| Rate for Payer: PHP Medicare Advantage |
$95.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$186.82
|
| Rate for Payer: Priority Health Medicare |
$95.32
|
| Rate for Payer: Priority Health SBD |
$186.82
|
| Rate for Payer: Priority Health Tiered Network |
$186.82
|
| Rate for Payer: Railroad Medicare Medicare |
$95.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.20
|
| Rate for Payer: UHC Core |
$188.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$95.32
|
| Rate for Payer: UHC Exchange |
$188.20
|
| Rate for Payer: UHC Medicaid |
$61.34
|
| Rate for Payer: UHCCP Medicaid |
$61.34
|
| Rate for Payer: UMR Bronson Commercial |
$188.60
|
|
|
PR CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
HCPCS 64611
|
| Min. Negotiated Rate |
$69.01 |
| Max. Negotiated Rate |
$198.39 |
| Rate for Payer: Aetna Commercial |
$140.06
|
| Rate for Payer: Aetna Medicare |
$108.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.51
|
| Rate for Payer: BCBS Complete |
$72.46
|
| Rate for Payer: BCBS MAPPO |
$104.52
|
| Rate for Payer: BCN Commercial |
$170.81
|
| Rate for Payer: BCN Medicare Advantage |
$104.52
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cofinity Commercial |
$140.06
|
| Rate for Payer: Cofinity Commercial |
$150.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.75
|
| Rate for Payer: Meridian Medicaid |
$72.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.97
|
| Rate for Payer: Nomi Health Commercial |
$125.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.00
|
| Rate for Payer: PACE SWMI |
$104.52
|
| Rate for Payer: PHP Commercial |
$146.33
|
| Rate for Payer: PHP Medicare Advantage |
$104.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$198.39
|
| Rate for Payer: Priority Health Medicare |
$104.52
|
| Rate for Payer: Priority Health SBD |
$198.39
|
| Rate for Payer: Priority Health Tiered Network |
$198.39
|
| Rate for Payer: Railroad Medicare Medicare |
$104.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.87
|
| Rate for Payer: UHC Core |
$180.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.52
|
| Rate for Payer: UHC Exchange |
$180.87
|
| Rate for Payer: UHC Medicaid |
$69.01
|
| Rate for Payer: UHCCP Medicaid |
$69.01
|
| Rate for Payer: UMR Bronson Commercial |
$101.20
|
|
|
PR CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE
|
Professional
|
Both
|
$431.00
|
|
|
Service Code
|
HCPCS 64615
|
| Min. Negotiated Rate |
$69.65 |
| Max. Negotiated Rate |
$323.25 |
| Rate for Payer: Aetna Commercial |
$146.62
|
| Rate for Payer: Aetna Medicare |
$113.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.56
|
| Rate for Payer: BCBS Complete |
$73.13
|
| Rate for Payer: BCBS MAPPO |
$109.42
|
| Rate for Payer: BCN Commercial |
$184.75
|
| Rate for Payer: BCN Medicare Advantage |
$109.42
|
| Rate for Payer: Cash Price |
$344.80
|
| Rate for Payer: Cash Price |
$344.80
|
| Rate for Payer: Cofinity Commercial |
$146.62
|
| Rate for Payer: Cofinity Commercial |
$157.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.89
|
| Rate for Payer: Meridian Medicaid |
$73.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.36
|
| Rate for Payer: Nomi Health Commercial |
$131.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$323.25
|
| Rate for Payer: PACE SWMI |
$109.42
|
| Rate for Payer: PHP Commercial |
$153.19
|
| Rate for Payer: PHP Medicare Advantage |
$109.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$214.59
|
| Rate for Payer: Priority Health Medicare |
$109.42
|
| Rate for Payer: Priority Health SBD |
$214.59
|
| Rate for Payer: Priority Health Tiered Network |
$214.59
|
| Rate for Payer: Railroad Medicare Medicare |
$109.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.91
|
| Rate for Payer: UHC Core |
$216.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$109.42
|
| Rate for Payer: UHC Exchange |
$216.91
|
| Rate for Payer: UHC Medicaid |
$69.65
|
| Rate for Payer: UHCCP Medicaid |
$69.65
|
| Rate for Payer: UMR Bronson Commercial |
$198.26
|
|
|
PR CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL
|
Professional
|
Both
|
$335.00
|
|
|
Service Code
|
HCPCS 64612
|
| Min. Negotiated Rate |
$69.01 |
| Max. Negotiated Rate |
$251.25 |
| Rate for Payer: Aetna Commercial |
$140.54
|
| Rate for Payer: Aetna Medicare |
$109.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.03
|
| Rate for Payer: BCBS Complete |
$72.46
|
| Rate for Payer: BCBS MAPPO |
$104.88
|
| Rate for Payer: BCN Commercial |
$141.37
|
| Rate for Payer: BCN Medicare Advantage |
$104.88
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cofinity Commercial |
$140.54
|
| Rate for Payer: Cofinity Commercial |
$151.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.12
|
| Rate for Payer: Meridian Medicaid |
$72.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$115.37
|
| Rate for Payer: Nomi Health Commercial |
$125.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.25
|
| Rate for Payer: PACE SWMI |
$104.88
|
| Rate for Payer: PHP Commercial |
$146.83
|
| Rate for Payer: PHP Medicare Advantage |
$104.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$208.23
|
| Rate for Payer: Priority Health Medicare |
$104.88
|
| Rate for Payer: Priority Health SBD |
$208.23
|
| Rate for Payer: Priority Health Tiered Network |
$208.23
|
| Rate for Payer: Railroad Medicare Medicare |
$104.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.44
|
| Rate for Payer: UHC Core |
$201.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.88
|
| Rate for Payer: UHC Exchange |
$201.44
|
| Rate for Payer: UHC Medicaid |
$69.01
|
| Rate for Payer: UHCCP Medicaid |
$69.01
|
| Rate for Payer: UMR Bronson Commercial |
$154.10
|
|
|
PR CHEMOTHERAPY ADMN IV INFUSION TQ EA HR
|
Professional
|
Both
|
$137.00
|
|
|
Service Code
|
HCPCS 96415
|
| Min. Negotiated Rate |
$26.62 |
| Max. Negotiated Rate |
$102.75 |
| Rate for Payer: Aetna Commercial |
$35.67
|
| Rate for Payer: Aetna Medicare |
$27.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.33
|
| Rate for Payer: BCBS MAPPO |
$26.62
|
| Rate for Payer: BCN Commercial |
$39.34
|
| Rate for Payer: BCN Medicare Advantage |
$26.62
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cofinity Commercial |
$35.67
|
| Rate for Payer: Cofinity Commercial |
$38.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.28
|
| Rate for Payer: Nomi Health Commercial |
$31.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.75
|
| Rate for Payer: PACE SWMI |
$26.62
|
| Rate for Payer: PHP Commercial |
$37.27
|
| Rate for Payer: PHP Medicare Advantage |
$26.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$36.27
|
| Rate for Payer: Priority Health Medicare |
$26.62
|
| Rate for Payer: Priority Health SBD |
$36.27
|
| Rate for Payer: Priority Health Tiered Network |
$36.27
|
| Rate for Payer: Railroad Medicare Medicare |
$26.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.71
|
| Rate for Payer: UHC Core |
$28.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.62
|
| Rate for Payer: UHC Exchange |
$28.71
|
| Rate for Payer: UMR Bronson Commercial |
$63.02
|
|
|
PR CHEMOTX ADMN CNS REQ SPINAL PUNCTURE
|
Professional
|
Both
|
$755.00
|
|
|
Service Code
|
HCPCS 96450
|
| Min. Negotiated Rate |
$42.39 |
| Max. Negotiated Rate |
$566.25 |
| Rate for Payer: Aetna Commercial |
$88.63
|
| Rate for Payer: Aetna Medicare |
$68.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.24
|
| Rate for Payer: BCBS Complete |
$44.51
|
| Rate for Payer: BCBS MAPPO |
$66.14
|
| Rate for Payer: BCN Commercial |
$114.04
|
| Rate for Payer: BCN Medicare Advantage |
$66.14
|
| Rate for Payer: Cash Price |
$604.00
|
| Rate for Payer: Cash Price |
$604.00
|
| Rate for Payer: Cofinity Commercial |
$95.24
|
| Rate for Payer: Cofinity Commercial |
$88.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.45
|
| Rate for Payer: Meridian Medicaid |
$44.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.75
|
| Rate for Payer: Nomi Health Commercial |
$79.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$566.25
|
| Rate for Payer: PACE SWMI |
$66.14
|
| Rate for Payer: PHP Commercial |
$92.60
|
| Rate for Payer: PHP Medicare Advantage |
$66.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$105.16
|
| Rate for Payer: Priority Health Medicare |
$66.14
|
| Rate for Payer: Priority Health SBD |
$105.16
|
| Rate for Payer: Priority Health Tiered Network |
$105.16
|
| Rate for Payer: Railroad Medicare Medicare |
$66.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.69
|
| Rate for Payer: UHC Core |
$79.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$66.14
|
| Rate for Payer: UHC Exchange |
$79.69
|
| Rate for Payer: UHC Medicaid |
$42.39
|
| Rate for Payer: UHCCP Medicaid |
$42.39
|
| Rate for Payer: UMR Bronson Commercial |
$347.30
|
|
|
PR CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR
|
Professional
|
Both
|
$136.00
|
|
|
Service Code
|
HCPCS 96417
|
| Min. Negotiated Rate |
$61.51 |
| Max. Negotiated Rate |
$102.00 |
| Rate for Payer: Aetna Commercial |
$82.42
|
| Rate for Payer: Aetna Medicare |
$63.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.57
|
| Rate for Payer: BCBS MAPPO |
$61.51
|
| Rate for Payer: BCN Commercial |
$90.63
|
| Rate for Payer: BCN Medicare Advantage |
$61.51
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cofinity Commercial |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$88.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.66
|
| Rate for Payer: Nomi Health Commercial |
$73.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.00
|
| Rate for Payer: PACE SWMI |
$61.51
|
| Rate for Payer: PHP Commercial |
$86.11
|
| Rate for Payer: PHP Medicare Advantage |
$61.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$83.58
|
| Rate for Payer: Priority Health Medicare |
$61.51
|
| Rate for Payer: Priority Health SBD |
$83.58
|
| Rate for Payer: Priority Health Tiered Network |
$83.58
|
| Rate for Payer: Railroad Medicare Medicare |
$61.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.20
|
| Rate for Payer: UHC Core |
$64.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$61.51
|
| Rate for Payer: UHC Exchange |
$64.20
|
| Rate for Payer: UMR Bronson Commercial |
$62.56
|
|
|
PR CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 96413
|
| Min. Negotiated Rate |
$117.30 |
| Max. Negotiated Rate |
$191.25 |
| Rate for Payer: Aetna Commercial |
$164.81
|
| Rate for Payer: Aetna Medicare |
$127.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.11
|
| Rate for Payer: BCBS MAPPO |
$122.99
|
| Rate for Payer: BCN Commercial |
$183.76
|
| Rate for Payer: BCN Medicare Advantage |
$122.99
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$177.11
|
| Rate for Payer: Cofinity Commercial |
$164.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$135.29
|
| Rate for Payer: Nomi Health Commercial |
$147.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.25
|
| Rate for Payer: PACE SWMI |
$122.99
|
| Rate for Payer: PHP Commercial |
$172.19
|
| Rate for Payer: PHP Medicare Advantage |
$122.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$169.46
|
| Rate for Payer: Priority Health Medicare |
$122.99
|
| Rate for Payer: Priority Health SBD |
$169.46
|
| Rate for Payer: Priority Health Tiered Network |
$169.46
|
| Rate for Payer: Railroad Medicare Medicare |
$122.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.57
|
| Rate for Payer: UHC Core |
$131.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$122.99
|
| Rate for Payer: UHC Exchange |
$131.57
|
| Rate for Payer: UMR Bronson Commercial |
$117.30
|
|
|
PR CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG
|
Professional
|
Both
|
$213.00
|
|
|
Service Code
|
HCPCS 96409
|
| Min. Negotiated Rate |
$96.58 |
| Max. Negotiated Rate |
$159.75 |
| Rate for Payer: Aetna Commercial |
$129.42
|
| Rate for Payer: Aetna Medicare |
$100.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.08
|
| Rate for Payer: BCBS MAPPO |
$96.58
|
| Rate for Payer: BCN Commercial |
$142.42
|
| Rate for Payer: BCN Medicare Advantage |
$96.58
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$129.42
|
| Rate for Payer: Cofinity Commercial |
$139.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$106.24
|
| Rate for Payer: Nomi Health Commercial |
$115.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.75
|
| Rate for Payer: PACE SWMI |
$96.58
|
| Rate for Payer: PHP Commercial |
$135.21
|
| Rate for Payer: PHP Medicare Advantage |
$96.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$131.34
|
| Rate for Payer: Priority Health Medicare |
$96.58
|
| Rate for Payer: Priority Health SBD |
$131.34
|
| Rate for Payer: Priority Health Tiered Network |
$131.34
|
| Rate for Payer: Railroad Medicare Medicare |
$96.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.70
|
| Rate for Payer: UHC Core |
$101.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$96.58
|
| Rate for Payer: UHC Exchange |
$101.70
|
| Rate for Payer: UMR Bronson Commercial |
$97.98
|
|
|
PR CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 96411
|
| Min. Negotiated Rate |
$52.94 |
| Max. Negotiated Rate |
$90.75 |
| Rate for Payer: Aetna Commercial |
$70.94
|
| Rate for Payer: Aetna Medicare |
$55.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.23
|
| Rate for Payer: BCBS MAPPO |
$52.94
|
| Rate for Payer: BCN Commercial |
$78.18
|
| Rate for Payer: BCN Medicare Advantage |
$52.94
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cofinity Commercial |
$76.23
|
| Rate for Payer: Cofinity Commercial |
$70.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.23
|
| Rate for Payer: Nomi Health Commercial |
$63.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.75
|
| Rate for Payer: PACE SWMI |
$52.94
|
| Rate for Payer: PHP Commercial |
$74.12
|
| Rate for Payer: PHP Medicare Advantage |
$52.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$72.10
|
| Rate for Payer: Priority Health Medicare |
$52.94
|
| Rate for Payer: Priority Health SBD |
$72.10
|
| Rate for Payer: Priority Health Tiered Network |
$72.10
|
| Rate for Payer: Railroad Medicare Medicare |
$52.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.58
|
| Rate for Payer: UHC Core |
$55.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.94
|
| Rate for Payer: UHC Exchange |
$55.58
|
| Rate for Payer: UMR Bronson Commercial |
$55.66
|
|
|
PR CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO
|
Professional
|
Both
|
$85.00
|
|
|
Service Code
|
HCPCS 96402
|
| Min. Negotiated Rate |
$30.03 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Aetna Commercial |
$48.33
|
| Rate for Payer: Aetna Medicare |
$37.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.94
|
| Rate for Payer: BCBS MAPPO |
$36.07
|
| Rate for Payer: BCN Commercial |
$53.78
|
| Rate for Payer: BCN Medicare Advantage |
$36.07
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cofinity Commercial |
$48.33
|
| Rate for Payer: Cofinity Commercial |
$51.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.68
|
| Rate for Payer: Nomi Health Commercial |
$43.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.75
|
| Rate for Payer: PACE SWMI |
$36.07
|
| Rate for Payer: PHP Commercial |
$50.50
|
| Rate for Payer: PHP Medicare Advantage |
$36.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$49.59
|
| Rate for Payer: Priority Health Medicare |
$36.07
|
| Rate for Payer: Priority Health SBD |
$49.59
|
| Rate for Payer: Priority Health Tiered Network |
$49.59
|
| Rate for Payer: Railroad Medicare Medicare |
$36.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.03
|
| Rate for Payer: UHC Core |
$30.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.07
|
| Rate for Payer: UHC Exchange |
$30.03
|
| Rate for Payer: UMR Bronson Commercial |
$39.10
|
|
|
PR CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 96401
|
| Min. Negotiated Rate |
$54.74 |
| Max. Negotiated Rate |
$102.08 |
| Rate for Payer: Aetna Commercial |
$89.06
|
| Rate for Payer: Aetna Medicare |
$69.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.70
|
| Rate for Payer: BCBS MAPPO |
$66.46
|
| Rate for Payer: BCN Commercial |
$102.08
|
| Rate for Payer: BCN Medicare Advantage |
$66.46
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cofinity Commercial |
$95.70
|
| Rate for Payer: Cofinity Commercial |
$89.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$73.11
|
| Rate for Payer: Nomi Health Commercial |
$79.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.25
|
| Rate for Payer: PACE SWMI |
$66.46
|
| Rate for Payer: PHP Commercial |
$93.04
|
| Rate for Payer: PHP Medicare Advantage |
$66.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$94.14
|
| Rate for Payer: Priority Health Medicare |
$66.46
|
| Rate for Payer: Priority Health SBD |
$94.14
|
| Rate for Payer: Priority Health Tiered Network |
$94.14
|
| Rate for Payer: Railroad Medicare Medicare |
$66.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.10
|
| Rate for Payer: UHC Core |
$74.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$66.46
|
| Rate for Payer: UHC Exchange |
$74.10
|
| Rate for Payer: UMR Bronson Commercial |
$54.74
|
|
|
PR CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1/MULT
|
Professional
|
Both
|
$293.00
|
|
|
Service Code
|
HCPCS 96542
|
| Min. Negotiated Rate |
$22.79 |
| Max. Negotiated Rate |
$219.75 |
| Rate for Payer: Aetna Commercial |
$47.22
|
| Rate for Payer: Aetna Medicare |
$36.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.75
|
| Rate for Payer: BCBS Complete |
$23.93
|
| Rate for Payer: BCBS MAPPO |
$35.24
|
| Rate for Payer: BCN Commercial |
$61.25
|
| Rate for Payer: BCN Medicare Advantage |
$35.24
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cofinity Commercial |
$47.22
|
| Rate for Payer: Cofinity Commercial |
$50.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.00
|
| Rate for Payer: Meridian Medicaid |
$23.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.76
|
| Rate for Payer: Nomi Health Commercial |
$42.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.75
|
| Rate for Payer: PACE SWMI |
$35.24
|
| Rate for Payer: PHP Commercial |
$49.34
|
| Rate for Payer: PHP Medicare Advantage |
$35.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$56.49
|
| Rate for Payer: Priority Health Medicare |
$35.24
|
| Rate for Payer: Priority Health SBD |
$56.49
|
| Rate for Payer: Priority Health Tiered Network |
$56.49
|
| Rate for Payer: Railroad Medicare Medicare |
$35.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.50
|
| Rate for Payer: UHC Core |
$42.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.24
|
| Rate for Payer: UHC Exchange |
$42.50
|
| Rate for Payer: UHC Medicaid |
$22.79
|
| Rate for Payer: UHCCP Medicaid |
$22.79
|
| Rate for Payer: UMR Bronson Commercial |
$134.78
|
|
|
PR CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 98941
|
| Min. Negotiated Rate |
$25.60 |
| Max. Negotiated Rate |
$48.00 |
| Rate for Payer: Aetna Commercial |
$37.10
|
| Rate for Payer: Aetna Medicare |
$28.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.87
|
| Rate for Payer: BCBS Complete |
$25.60
|
| Rate for Payer: BCBS MAPPO |
$27.69
|
| Rate for Payer: BCN Commercial |
$33.72
|
| Rate for Payer: BCN Medicare Advantage |
$27.69
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$39.87
|
| Rate for Payer: Cofinity Commercial |
$37.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.46
|
| Rate for Payer: Nomi Health Commercial |
$33.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.00
|
| Rate for Payer: PACE SWMI |
$27.69
|
| Rate for Payer: PHP Commercial |
$38.77
|
| Rate for Payer: PHP Medicare Advantage |
$27.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$46.38
|
| Rate for Payer: Priority Health Medicare |
$27.69
|
| Rate for Payer: Priority Health SBD |
$46.38
|
| Rate for Payer: Priority Health Tiered Network |
$46.38
|
| Rate for Payer: Railroad Medicare Medicare |
$27.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.11
|
| Rate for Payer: UHC Core |
$31.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27.69
|
| Rate for Payer: UHC Exchange |
$31.11
|
| Rate for Payer: UMR Bronson Commercial |
$29.44
|
|
|
PR CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL
|
Professional
|
Both
|
$155.00
|
|
|
Service Code
|
HCPCS 50688
|
| Min. Negotiated Rate |
$45.37 |
| Max. Negotiated Rate |
$135.69 |
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna Medicare |
$72.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.78
|
| Rate for Payer: BCBS Complete |
$47.64
|
| Rate for Payer: BCBS MAPPO |
$69.29
|
| Rate for Payer: BCN Commercial |
$117.02
|
| Rate for Payer: BCN Medicare Advantage |
$69.29
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cofinity Commercial |
$99.78
|
| Rate for Payer: Cofinity Commercial |
$92.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.75
|
| Rate for Payer: Meridian Medicaid |
$47.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$76.22
|
| Rate for Payer: Nomi Health Commercial |
$83.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$116.25
|
| Rate for Payer: PACE SWMI |
$69.29
|
| Rate for Payer: PHP Commercial |
$97.01
|
| Rate for Payer: PHP Medicare Advantage |
$69.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$127.47
|
| Rate for Payer: Priority Health Medicare |
$69.29
|
| Rate for Payer: Priority Health SBD |
$127.47
|
| Rate for Payer: Priority Health Tiered Network |
$127.47
|
| Rate for Payer: Railroad Medicare Medicare |
$69.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.69
|
| Rate for Payer: UHC Core |
$135.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$69.29
|
| Rate for Payer: UHC Exchange |
$135.69
|
| Rate for Payer: UHC Medicaid |
$45.37
|
| Rate for Payer: UHCCP Medicaid |
$45.37
|
| Rate for Payer: UMR Bronson Commercial |
$71.30
|
|
|
PR CHOLECSTC EXPL DUX SPHNCTROTOMY/SPHNCTROP
|
Professional
|
Both
|
$2,184.00
|
|
|
Service Code
|
HCPCS 47620
|
| Min. Negotiated Rate |
$818.13 |
| Max. Negotiated Rate |
$2,512.59 |
| Rate for Payer: Aetna Commercial |
$1,715.33
|
| Rate for Payer: Aetna Medicare |
$1,331.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,715.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,843.34
|
| Rate for Payer: BCBS Complete |
$859.04
|
| Rate for Payer: BCBS MAPPO |
$1,280.10
|
| Rate for Payer: BCN Commercial |
$2,062.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,280.10
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cofinity Commercial |
$1,715.33
|
| Rate for Payer: Cofinity Commercial |
$1,843.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,280.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,344.11
|
| Rate for Payer: Meridian Medicaid |
$859.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,408.11
|
| Rate for Payer: Nomi Health Commercial |
$1,536.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.00
|
| Rate for Payer: PACE SWMI |
$1,280.10
|
| Rate for Payer: PHP Commercial |
$1,792.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,280.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$818.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,512.59
|
| Rate for Payer: Priority Health Medicare |
$1,280.10
|
| Rate for Payer: Priority Health SBD |
$2,512.59
|
| Rate for Payer: Priority Health Tiered Network |
$2,512.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,280.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,462.40
|
| Rate for Payer: UHC Core |
$2,462.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,280.10
|
| Rate for Payer: UHC Exchange |
$2,462.40
|
| Rate for Payer: UHC Medicaid |
$818.13
|
| Rate for Payer: UHCCP Medicaid |
$818.13
|
| Rate for Payer: UMR Bronson Commercial |
$1,004.64
|
|
|
PR CHOLECSTONTRSTM ROUX-EN-Y W/GASTRONTRSTM
|
Professional
|
Both
|
$2,723.00
|
|
|
Service Code
|
HCPCS 47741
|
| Min. Negotiated Rate |
$883.10 |
| Max. Negotiated Rate |
$2,698.85 |
| Rate for Payer: Aetna Commercial |
$1,847.10
|
| Rate for Payer: Aetna Medicare |
$1,433.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,847.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,984.94
|
| Rate for Payer: BCBS Complete |
$927.25
|
| Rate for Payer: BCBS MAPPO |
$1,378.43
|
| Rate for Payer: BCN Commercial |
$2,215.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,378.43
|
| Rate for Payer: Cash Price |
$2,178.40
|
| Rate for Payer: Cash Price |
$2,178.40
|
| Rate for Payer: Cofinity Commercial |
$1,847.10
|
| Rate for Payer: Cofinity Commercial |
$1,984.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,378.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,447.35
|
| Rate for Payer: Meridian Medicaid |
$927.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,516.27
|
| Rate for Payer: Nomi Health Commercial |
$1,654.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,042.25
|
| Rate for Payer: PACE SWMI |
$1,378.43
|
| Rate for Payer: PHP Commercial |
$1,929.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,378.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$883.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,698.85
|
| Rate for Payer: Priority Health Medicare |
$1,378.43
|
| Rate for Payer: Priority Health SBD |
$2,698.85
|
| Rate for Payer: Priority Health Tiered Network |
$2,698.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,378.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,636.64
|
| Rate for Payer: UHC Core |
$2,636.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,378.43
|
| Rate for Payer: UHC Exchange |
$2,636.64
|
| Rate for Payer: UHC Medicaid |
$883.10
|
| Rate for Payer: UHCCP Medicaid |
$883.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,252.58
|
|
|
PR CHOLECSTOT/CHOLECSTOST W/EXPL DRG/RMVL ST1 SPX
|
Professional
|
Both
|
$2,702.00
|
|
|
Service Code
|
HCPCS 47480
|
| Min. Negotiated Rate |
$534.20 |
| Max. Negotiated Rate |
$2,026.50 |
| Rate for Payer: Aetna Commercial |
$1,105.90
|
| Rate for Payer: Aetna Medicare |
$858.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,105.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,188.43
|
| Rate for Payer: BCBS Complete |
$560.91
|
| Rate for Payer: BCBS MAPPO |
$825.30
|
| Rate for Payer: BCN Commercial |
$1,325.13
|
| Rate for Payer: BCN Medicare Advantage |
$825.30
|
| Rate for Payer: Cash Price |
$2,161.60
|
| Rate for Payer: Cash Price |
$2,161.60
|
| Rate for Payer: Cofinity Commercial |
$1,105.90
|
| Rate for Payer: Cofinity Commercial |
$1,188.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$825.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$866.57
|
| Rate for Payer: Meridian Medicaid |
$560.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$907.83
|
| Rate for Payer: Nomi Health Commercial |
$990.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,026.50
|
| Rate for Payer: PACE SWMI |
$825.30
|
| Rate for Payer: PHP Commercial |
$1,155.42
|
| Rate for Payer: PHP Medicare Advantage |
$825.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$534.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,614.58
|
| Rate for Payer: Priority Health Medicare |
$825.30
|
| Rate for Payer: Priority Health SBD |
$1,614.58
|
| Rate for Payer: Priority Health Tiered Network |
$1,614.58
|
| Rate for Payer: Railroad Medicare Medicare |
$825.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,559.16
|
| Rate for Payer: UHC Core |
$1,559.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$825.30
|
| Rate for Payer: UHC Exchange |
$1,559.16
|
| Rate for Payer: UHC Medicaid |
$534.20
|
| Rate for Payer: UHCCP Medicaid |
$534.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,242.92
|
|
