|
PR DOPPLER ECHO COLOR FLOW VELOCITY MAPPING
|
Facility
|
OP
|
$201.00
|
|
|
Service Code
|
CPT 93325
|
| Hospital Charge Code |
93325
|
| Min. Negotiated Rate |
$74.37 |
| Max. Negotiated Rate |
$180.90 |
| Rate for Payer: Aetna American Axle |
$130.65
|
| Rate for Payer: Aetna American Axle |
$214.50
|
| Rate for Payer: Aetna Commercial |
$170.85
|
| Rate for Payer: Aetna Commercial |
$280.50
|
| Rate for Payer: Aetna Medicare |
$100.50
|
| Rate for Payer: Aetna Medicare |
$165.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.50
|
| Rate for Payer: BCBS Complete |
$132.00
|
| Rate for Payer: BCBS Complete |
$80.40
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cofinity Commercial |
$172.86
|
| Rate for Payer: Cofinity Commercial |
$140.70
|
| Rate for Payer: Cofinity Commercial |
$231.00
|
| Rate for Payer: Cofinity Commercial |
$283.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$231.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$140.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.00
|
| Rate for Payer: Healthscope Commercial |
$297.00
|
| Rate for Payer: Healthscope Commercial |
$180.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$231.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.50
|
| Rate for Payer: PHP Commercial |
$280.50
|
| Rate for Payer: PHP Commercial |
$170.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
| Rate for Payer: Priority Health SBD |
$207.90
|
| Rate for Payer: Priority Health SBD |
$126.63
|
| Rate for Payer: UMR Bronson Commercial |
$74.37
|
| Rate for Payer: UMR Bronson Commercial |
$122.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.75
|
|
|
PR DOPPLER ECHO COLOR FLOW VELOCITY MAPPING
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS 93325
|
| Min. Negotiated Rate |
$20.24 |
| Max. Negotiated Rate |
$214.50 |
| Rate for Payer: Aetna Commercial |
$27.12
|
| Rate for Payer: Aetna Commercial |
$27.12
|
| Rate for Payer: Aetna Medicare |
$21.05
|
| Rate for Payer: Aetna Medicare |
$21.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.12
|
| Rate for Payer: BCBS Complete |
$80.40
|
| Rate for Payer: BCBS Complete |
$132.00
|
| Rate for Payer: BCBS MAPPO |
$20.24
|
| Rate for Payer: BCBS MAPPO |
$20.24
|
| Rate for Payer: BCN Medicare Advantage |
$20.24
|
| Rate for Payer: BCN Medicare Advantage |
$20.24
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cofinity Commercial |
$29.15
|
| Rate for Payer: Cofinity Commercial |
$29.15
|
| Rate for Payer: Cofinity Commercial |
$27.12
|
| Rate for Payer: Cofinity Commercial |
$27.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.25
|
| Rate for Payer: Nomi Health Commercial |
$24.29
|
| Rate for Payer: Nomi Health Commercial |
$24.29
|
| Rate for Payer: PACE SWMI |
$20.24
|
| Rate for Payer: PACE SWMI |
$20.24
|
| Rate for Payer: PHP Commercial |
$28.34
|
| Rate for Payer: PHP Commercial |
$28.34
|
| Rate for Payer: PHP Medicare Advantage |
$20.24
|
| Rate for Payer: PHP Medicare Advantage |
$20.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
| Rate for Payer: Priority Health Medicare |
$20.24
|
| Rate for Payer: Priority Health Medicare |
$20.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.24
|
| Rate for Payer: UHC Medicare Advantage |
$20.24
|
| Rate for Payer: UHC Medicare Advantage |
$20.24
|
| Rate for Payer: UMR Bronson Commercial |
$151.80
|
| Rate for Payer: UMR Bronson Commercial |
$92.46
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 93320
|
| Min. Negotiated Rate |
$45.46 |
| Max. Negotiated Rate |
$168.35 |
| Rate for Payer: Aetna Commercial |
$60.92
|
| Rate for Payer: Aetna Commercial |
$60.92
|
| Rate for Payer: Aetna Medicare |
$47.28
|
| Rate for Payer: Aetna Medicare |
$47.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.46
|
| Rate for Payer: BCBS Complete |
$103.60
|
| Rate for Payer: BCBS Complete |
$70.40
|
| Rate for Payer: BCBS MAPPO |
$45.46
|
| Rate for Payer: BCBS MAPPO |
$45.46
|
| Rate for Payer: BCN Medicare Advantage |
$45.46
|
| Rate for Payer: BCN Medicare Advantage |
$45.46
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$65.46
|
| Rate for Payer: Cofinity Commercial |
$65.46
|
| Rate for Payer: Cofinity Commercial |
$60.92
|
| Rate for Payer: Cofinity Commercial |
$60.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.73
|
| Rate for Payer: Nomi Health Commercial |
$54.55
|
| Rate for Payer: Nomi Health Commercial |
$54.55
|
| Rate for Payer: PACE SWMI |
$45.46
|
| Rate for Payer: PACE SWMI |
$45.46
|
| Rate for Payer: PHP Commercial |
$63.64
|
| Rate for Payer: PHP Commercial |
$63.64
|
| Rate for Payer: PHP Medicare Advantage |
$45.46
|
| Rate for Payer: PHP Medicare Advantage |
$45.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health Medicare |
$45.46
|
| Rate for Payer: Priority Health Medicare |
$45.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.46
|
| Rate for Payer: UHC Medicare Advantage |
$45.46
|
| Rate for Payer: UHC Medicare Advantage |
$45.46
|
| Rate for Payer: UMR Bronson Commercial |
$119.14
|
| Rate for Payer: UMR Bronson Commercial |
$80.96
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 93320
|
| Hospital Charge Code |
93320
|
| Min. Negotiated Rate |
$45.46 |
| Max. Negotiated Rate |
$168.35 |
| Rate for Payer: Aetna Commercial |
$60.92
|
| Rate for Payer: Aetna Commercial |
$60.92
|
| Rate for Payer: Aetna Medicare |
$47.28
|
| Rate for Payer: Aetna Medicare |
$47.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.46
|
| Rate for Payer: BCBS Complete |
$103.60
|
| Rate for Payer: BCBS Complete |
$70.40
|
| Rate for Payer: BCBS MAPPO |
$45.46
|
| Rate for Payer: BCBS MAPPO |
$45.46
|
| Rate for Payer: BCN Medicare Advantage |
$45.46
|
| Rate for Payer: BCN Medicare Advantage |
$45.46
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$65.46
|
| Rate for Payer: Cofinity Commercial |
$65.46
|
| Rate for Payer: Cofinity Commercial |
$60.92
|
| Rate for Payer: Cofinity Commercial |
$60.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.73
|
| Rate for Payer: Nomi Health Commercial |
$54.55
|
| Rate for Payer: Nomi Health Commercial |
$54.55
|
| Rate for Payer: PACE SWMI |
$45.46
|
| Rate for Payer: PACE SWMI |
$45.46
|
| Rate for Payer: PHP Commercial |
$63.64
|
| Rate for Payer: PHP Commercial |
$63.64
|
| Rate for Payer: PHP Medicare Advantage |
$45.46
|
| Rate for Payer: PHP Medicare Advantage |
$45.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health Medicare |
$45.46
|
| Rate for Payer: Priority Health Medicare |
$45.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.46
|
| Rate for Payer: UHC Medicare Advantage |
$45.46
|
| Rate for Payer: UHC Medicare Advantage |
$45.46
|
| Rate for Payer: UMR Bronson Commercial |
$119.14
|
| Rate for Payer: UMR Bronson Commercial |
$80.96
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Facility
|
OP
|
$176.00
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
93320
|
| Min. Negotiated Rate |
$65.12 |
| Max. Negotiated Rate |
$158.40 |
| Rate for Payer: Aetna American Axle |
$114.40
|
| Rate for Payer: Aetna American Axle |
$168.35
|
| Rate for Payer: Aetna Commercial |
$149.60
|
| Rate for Payer: Aetna Commercial |
$220.15
|
| Rate for Payer: Aetna Medicare |
$88.00
|
| Rate for Payer: Aetna Medicare |
$129.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.35
|
| Rate for Payer: BCBS Complete |
$103.60
|
| Rate for Payer: BCBS Complete |
$70.40
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$151.36
|
| Rate for Payer: Cofinity Commercial |
$123.20
|
| Rate for Payer: Cofinity Commercial |
$181.30
|
| Rate for Payer: Cofinity Commercial |
$222.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$181.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$123.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.20
|
| Rate for Payer: Healthscope Commercial |
$233.10
|
| Rate for Payer: Healthscope Commercial |
$158.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$123.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$181.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.15
|
| Rate for Payer: PHP Commercial |
$220.15
|
| Rate for Payer: PHP Commercial |
$149.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health SBD |
$163.17
|
| Rate for Payer: Priority Health SBD |
$110.88
|
| Rate for Payer: UMR Bronson Commercial |
$65.12
|
| Rate for Payer: UMR Bronson Commercial |
$95.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.00
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Facility
|
IP
|
$176.00
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
93320
|
| Min. Negotiated Rate |
$77.44 |
| Max. Negotiated Rate |
$158.40 |
| Rate for Payer: Aetna American Axle |
$114.40
|
| Rate for Payer: Aetna American Axle |
$168.35
|
| Rate for Payer: Aetna Commercial |
$149.60
|
| Rate for Payer: Aetna Commercial |
$220.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.35
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$222.74
|
| Rate for Payer: Cofinity Commercial |
$181.30
|
| Rate for Payer: Cofinity Commercial |
$123.20
|
| Rate for Payer: Cofinity Commercial |
$151.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$123.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$181.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.20
|
| Rate for Payer: Healthscope Commercial |
$158.40
|
| Rate for Payer: Healthscope Commercial |
$233.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$123.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$181.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.60
|
| Rate for Payer: PHP Commercial |
$220.15
|
| Rate for Payer: PHP Commercial |
$149.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health SBD |
$110.88
|
| Rate for Payer: Priority Health SBD |
$163.17
|
| Rate for Payer: UMR Bronson Commercial |
$77.44
|
| Rate for Payer: UMR Bronson Commercial |
$113.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.25
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL F-UP/LMTD STD
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 93321
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$35.10 |
| Rate for Payer: Aetna Commercial |
$29.91
|
| Rate for Payer: Aetna Medicare |
$23.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.91
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: BCBS MAPPO |
$22.32
|
| Rate for Payer: BCN Medicare Advantage |
$22.32
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$32.14
|
| Rate for Payer: Cofinity Commercial |
$29.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.44
|
| Rate for Payer: Nomi Health Commercial |
$26.78
|
| Rate for Payer: PACE SWMI |
$22.32
|
| Rate for Payer: PHP Commercial |
$31.25
|
| Rate for Payer: PHP Medicare Advantage |
$22.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health Medicare |
$22.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.32
|
| Rate for Payer: UHC Medicare Advantage |
$22.32
|
| Rate for Payer: UMR Bronson Commercial |
$24.84
|
|
|
PR DRAIN ABD ABSCESS PERCUTANEOUS
|
Professional
|
Both
|
$619.00
|
|
|
Service Code
|
HCPCS 49021
|
| Min. Negotiated Rate |
$247.60 |
| Max. Negotiated Rate |
$402.35 |
| Rate for Payer: Aetna Medicare |
$309.50
|
| Rate for Payer: BCBS Complete |
$247.60
|
| Rate for Payer: Cash Price |
$495.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$402.35
|
| Rate for Payer: UMR Bronson Commercial |
$284.74
|
|
|
PR DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH
|
Professional
|
Both
|
$374.00
|
|
|
Service Code
|
HCPCS 30000
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$243.10 |
| Rate for Payer: Aetna Commercial |
$154.70
|
| Rate for Payer: Aetna Medicare |
$120.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.25
|
| Rate for Payer: BCBS Complete |
$149.60
|
| Rate for Payer: BCBS MAPPO |
$115.45
|
| Rate for Payer: BCN Medicare Advantage |
$115.45
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cofinity Commercial |
$154.70
|
| Rate for Payer: Cofinity Commercial |
$166.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.22
|
| Rate for Payer: Nomi Health Commercial |
$138.54
|
| Rate for Payer: PACE SWMI |
$115.45
|
| Rate for Payer: PHP Commercial |
$161.63
|
| Rate for Payer: PHP Medicare Advantage |
$115.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.10
|
| Rate for Payer: Priority Health Medicare |
$115.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.45
|
| Rate for Payer: UHC Medicare Advantage |
$115.45
|
| Rate for Payer: UMR Bronson Commercial |
$172.04
|
|
|
PR DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM
|
Professional
|
Both
|
$304.00
|
|
|
Service Code
|
HCPCS 30020
|
| Min. Negotiated Rate |
$115.66 |
| Max. Negotiated Rate |
$197.60 |
| Rate for Payer: Aetna Commercial |
$154.98
|
| Rate for Payer: Aetna Medicare |
$120.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.98
|
| Rate for Payer: BCBS Complete |
$121.60
|
| Rate for Payer: BCBS MAPPO |
$115.66
|
| Rate for Payer: BCN Medicare Advantage |
$115.66
|
| Rate for Payer: Cash Price |
$243.20
|
| Rate for Payer: Cash Price |
$243.20
|
| Rate for Payer: Cofinity Commercial |
$166.55
|
| Rate for Payer: Cofinity Commercial |
$154.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.44
|
| Rate for Payer: Nomi Health Commercial |
$138.79
|
| Rate for Payer: PACE SWMI |
$115.66
|
| Rate for Payer: PHP Commercial |
$161.92
|
| Rate for Payer: PHP Medicare Advantage |
$115.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$197.60
|
| Rate for Payer: Priority Health Medicare |
$115.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.66
|
| Rate for Payer: UHC Medicare Advantage |
$115.66
|
| Rate for Payer: UMR Bronson Commercial |
$139.84
|
|
|
PR DRAINAGE ABSCESS PALATE UVULA
|
Professional
|
Both
|
$336.00
|
|
|
Service Code
|
HCPCS 42000
|
| Min. Negotiated Rate |
$103.04 |
| Max. Negotiated Rate |
$218.40 |
| Rate for Payer: Aetna Commercial |
$138.07
|
| Rate for Payer: Aetna Medicare |
$107.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.07
|
| Rate for Payer: BCBS Complete |
$134.40
|
| Rate for Payer: BCBS MAPPO |
$103.04
|
| Rate for Payer: BCN Medicare Advantage |
$103.04
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cofinity Commercial |
$148.38
|
| Rate for Payer: Cofinity Commercial |
$138.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.19
|
| Rate for Payer: Nomi Health Commercial |
$123.65
|
| Rate for Payer: PACE SWMI |
$103.04
|
| Rate for Payer: PHP Commercial |
$144.26
|
| Rate for Payer: PHP Medicare Advantage |
$103.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.40
|
| Rate for Payer: Priority Health Medicare |
$103.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.04
|
| Rate for Payer: UHC Medicare Advantage |
$103.04
|
| Rate for Payer: UMR Bronson Commercial |
$154.56
|
|
|
PR DRAINAGE ABSCESS PAROTID COMPLICATED
|
Professional
|
Both
|
$783.00
|
|
|
Service Code
|
HCPCS 42305
|
| Min. Negotiated Rate |
$313.20 |
| Max. Negotiated Rate |
$595.57 |
| Rate for Payer: Aetna Commercial |
$554.21
|
| Rate for Payer: Aetna Medicare |
$430.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$595.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.21
|
| Rate for Payer: BCBS Complete |
$313.20
|
| Rate for Payer: BCBS MAPPO |
$413.59
|
| Rate for Payer: BCN Medicare Advantage |
$413.59
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cofinity Commercial |
$595.57
|
| Rate for Payer: Cofinity Commercial |
$554.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$434.27
|
| Rate for Payer: Nomi Health Commercial |
$496.31
|
| Rate for Payer: PACE SWMI |
$413.59
|
| Rate for Payer: PHP Commercial |
$579.03
|
| Rate for Payer: PHP Medicare Advantage |
$413.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$508.95
|
| Rate for Payer: Priority Health Medicare |
$413.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$413.59
|
| Rate for Payer: UHC Medicare Advantage |
$413.59
|
| Rate for Payer: UMR Bronson Commercial |
$360.18
|
|
|
PR DRAINAGE ABSCESS PAROTID SIMPLE
|
Professional
|
Both
|
$349.00
|
|
|
Service Code
|
HCPCS 42300
|
| Min. Negotiated Rate |
$139.60 |
| Max. Negotiated Rate |
$226.85 |
| Rate for Payer: Aetna Commercial |
$198.37
|
| Rate for Payer: Aetna Medicare |
$153.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.37
|
| Rate for Payer: BCBS Complete |
$139.60
|
| Rate for Payer: BCBS MAPPO |
$148.04
|
| Rate for Payer: BCN Medicare Advantage |
$148.04
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cofinity Commercial |
$213.18
|
| Rate for Payer: Cofinity Commercial |
$198.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$155.44
|
| Rate for Payer: Nomi Health Commercial |
$177.65
|
| Rate for Payer: PACE SWMI |
$148.04
|
| Rate for Payer: PHP Commercial |
$207.26
|
| Rate for Payer: PHP Medicare Advantage |
$148.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$226.85
|
| Rate for Payer: Priority Health Medicare |
$148.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$148.04
|
| Rate for Payer: UHC Medicare Advantage |
$148.04
|
| Rate for Payer: UMR Bronson Commercial |
$160.54
|
|
|
PR DRAINAGE DEEP PERIURETHRAL ABSCESS
|
Professional
|
Both
|
$815.00
|
|
|
Service Code
|
HCPCS 53040
|
| Min. Negotiated Rate |
$326.00 |
| Max. Negotiated Rate |
$541.45 |
| Rate for Payer: Aetna Commercial |
$503.85
|
| Rate for Payer: Aetna Medicare |
$391.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$503.85
|
| Rate for Payer: BCBS Complete |
$326.00
|
| Rate for Payer: BCBS MAPPO |
$376.01
|
| Rate for Payer: BCN Medicare Advantage |
$376.01
|
| Rate for Payer: Cash Price |
$652.00
|
| Rate for Payer: Cash Price |
$652.00
|
| Rate for Payer: Cofinity Commercial |
$541.45
|
| Rate for Payer: Cofinity Commercial |
$503.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$376.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$394.81
|
| Rate for Payer: Nomi Health Commercial |
$451.21
|
| Rate for Payer: PACE SWMI |
$376.01
|
| Rate for Payer: PHP Commercial |
$526.41
|
| Rate for Payer: PHP Medicare Advantage |
$376.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.75
|
| Rate for Payer: Priority Health Medicare |
$376.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$376.01
|
| Rate for Payer: UHC Medicare Advantage |
$376.01
|
| Rate for Payer: UMR Bronson Commercial |
$374.90
|
|
|
PR DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS
|
Professional
|
Both
|
$380.00
|
|
|
Service Code
|
HCPCS 69020
|
| Min. Negotiated Rate |
$134.37 |
| Max. Negotiated Rate |
$247.00 |
| Rate for Payer: Aetna Commercial |
$180.06
|
| Rate for Payer: Aetna Medicare |
$139.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.06
|
| Rate for Payer: BCBS Complete |
$152.00
|
| Rate for Payer: BCBS MAPPO |
$134.37
|
| Rate for Payer: BCN Medicare Advantage |
$134.37
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cofinity Commercial |
$193.49
|
| Rate for Payer: Cofinity Commercial |
$180.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.09
|
| Rate for Payer: Nomi Health Commercial |
$161.24
|
| Rate for Payer: PACE SWMI |
$134.37
|
| Rate for Payer: PHP Commercial |
$188.12
|
| Rate for Payer: PHP Medicare Advantage |
$134.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.00
|
| Rate for Payer: Priority Health Medicare |
$134.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.37
|
| Rate for Payer: UHC Medicare Advantage |
$134.37
|
| Rate for Payer: UMR Bronson Commercial |
$174.80
|
|
|
PR DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA COMP
|
Professional
|
Both
|
$385.00
|
|
|
Service Code
|
HCPCS 69005
|
| Min. Negotiated Rate |
$153.41 |
| Max. Negotiated Rate |
$250.25 |
| Rate for Payer: Aetna Commercial |
$205.57
|
| Rate for Payer: Aetna Medicare |
$159.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.57
|
| Rate for Payer: BCBS Complete |
$154.00
|
| Rate for Payer: BCBS MAPPO |
$153.41
|
| Rate for Payer: BCN Medicare Advantage |
$153.41
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: Cofinity Commercial |
$220.91
|
| Rate for Payer: Cofinity Commercial |
$205.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.08
|
| Rate for Payer: Nomi Health Commercial |
$184.09
|
| Rate for Payer: PACE SWMI |
$153.41
|
| Rate for Payer: PHP Commercial |
$214.77
|
| Rate for Payer: PHP Medicare Advantage |
$153.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.25
|
| Rate for Payer: Priority Health Medicare |
$153.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.41
|
| Rate for Payer: UHC Medicare Advantage |
$153.41
|
| Rate for Payer: UMR Bronson Commercial |
$177.10
|
|
|
PR DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE
|
Professional
|
Both
|
$317.00
|
|
|
Service Code
|
HCPCS 69000
|
| Min. Negotiated Rate |
$118.16 |
| Max. Negotiated Rate |
$206.05 |
| Rate for Payer: Aetna Commercial |
$158.33
|
| Rate for Payer: Aetna Medicare |
$122.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.33
|
| Rate for Payer: BCBS Complete |
$126.80
|
| Rate for Payer: BCBS MAPPO |
$118.16
|
| Rate for Payer: BCN Medicare Advantage |
$118.16
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cofinity Commercial |
$170.15
|
| Rate for Payer: Cofinity Commercial |
$158.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.07
|
| Rate for Payer: Nomi Health Commercial |
$141.79
|
| Rate for Payer: PACE SWMI |
$118.16
|
| Rate for Payer: PHP Commercial |
$165.42
|
| Rate for Payer: PHP Medicare Advantage |
$118.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.05
|
| Rate for Payer: Priority Health Medicare |
$118.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.16
|
| Rate for Payer: UHC Medicare Advantage |
$118.16
|
| Rate for Payer: UMR Bronson Commercial |
$145.82
|
|
|
PR DRAINAGE FINGER ABSCESS COMPLICATED
|
Professional
|
Both
|
$811.00
|
|
|
Service Code
|
HCPCS 26011
|
| Min. Negotiated Rate |
$177.38 |
| Max. Negotiated Rate |
$527.15 |
| Rate for Payer: Aetna Commercial |
$237.69
|
| Rate for Payer: Aetna Medicare |
$184.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.69
|
| Rate for Payer: BCBS Complete |
$324.40
|
| Rate for Payer: BCBS MAPPO |
$177.38
|
| Rate for Payer: BCN Medicare Advantage |
$177.38
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Cash Price |
$648.80
|
| Rate for Payer: Cofinity Commercial |
$255.43
|
| Rate for Payer: Cofinity Commercial |
$237.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.25
|
| Rate for Payer: Nomi Health Commercial |
$212.86
|
| Rate for Payer: PACE SWMI |
$177.38
|
| Rate for Payer: PHP Commercial |
$248.33
|
| Rate for Payer: PHP Medicare Advantage |
$177.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.15
|
| Rate for Payer: Priority Health Medicare |
$177.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.38
|
| Rate for Payer: UHC Medicare Advantage |
$177.38
|
| Rate for Payer: UMR Bronson Commercial |
$373.06
|
|
|
PR DRAINAGE FINGER ABSCESS SIMPLE
|
Professional
|
Both
|
$576.00
|
|
|
Service Code
|
HCPCS 26010
|
| Min. Negotiated Rate |
$133.96 |
| Max. Negotiated Rate |
$374.40 |
| Rate for Payer: Aetna Commercial |
$179.51
|
| Rate for Payer: Aetna Medicare |
$139.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.51
|
| Rate for Payer: BCBS Complete |
$230.40
|
| Rate for Payer: BCBS MAPPO |
$133.96
|
| Rate for Payer: BCN Medicare Advantage |
$133.96
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cofinity Commercial |
$192.90
|
| Rate for Payer: Cofinity Commercial |
$179.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.66
|
| Rate for Payer: Nomi Health Commercial |
$160.75
|
| Rate for Payer: PACE SWMI |
$133.96
|
| Rate for Payer: PHP Commercial |
$187.54
|
| Rate for Payer: PHP Medicare Advantage |
$133.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.40
|
| Rate for Payer: Priority Health Medicare |
$133.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.96
|
| Rate for Payer: UHC Medicare Advantage |
$133.96
|
| Rate for Payer: UMR Bronson Commercial |
$264.96
|
|
|
PR DRAINAGE OF PALMAR BURSA MULTIPLE BURSA
|
Professional
|
Both
|
$3,178.00
|
|
|
Service Code
|
HCPCS 26030
|
| Min. Negotiated Rate |
$475.90 |
| Max. Negotiated Rate |
$2,065.70 |
| Rate for Payer: Aetna Commercial |
$637.71
|
| Rate for Payer: Aetna Medicare |
$494.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$685.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$637.71
|
| Rate for Payer: BCBS Complete |
$1,271.20
|
| Rate for Payer: BCBS MAPPO |
$475.90
|
| Rate for Payer: BCN Medicare Advantage |
$475.90
|
| Rate for Payer: Cash Price |
$2,542.40
|
| Rate for Payer: Cash Price |
$2,542.40
|
| Rate for Payer: Cofinity Commercial |
$685.30
|
| Rate for Payer: Cofinity Commercial |
$637.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$475.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$499.69
|
| Rate for Payer: Nomi Health Commercial |
$571.08
|
| Rate for Payer: PACE SWMI |
$475.90
|
| Rate for Payer: PHP Commercial |
$666.26
|
| Rate for Payer: PHP Medicare Advantage |
$475.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,065.70
|
| Rate for Payer: Priority Health Medicare |
$475.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$475.90
|
| Rate for Payer: UHC Medicare Advantage |
$475.90
|
| Rate for Payer: UMR Bronson Commercial |
$1,461.88
|
|
|
PR DRAINAGE OF PALMAR BURSA SINGLE BURSA
|
Professional
|
Both
|
$1,363.00
|
|
|
Service Code
|
HCPCS 26025
|
| Min. Negotiated Rate |
$403.95 |
| Max. Negotiated Rate |
$885.95 |
| Rate for Payer: Aetna Commercial |
$541.29
|
| Rate for Payer: Aetna Medicare |
$420.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.29
|
| Rate for Payer: BCBS Complete |
$545.20
|
| Rate for Payer: BCBS MAPPO |
$403.95
|
| Rate for Payer: BCN Medicare Advantage |
$403.95
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cofinity Commercial |
$581.69
|
| Rate for Payer: Cofinity Commercial |
$541.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$424.15
|
| Rate for Payer: Nomi Health Commercial |
$484.74
|
| Rate for Payer: PACE SWMI |
$403.95
|
| Rate for Payer: PHP Commercial |
$565.53
|
| Rate for Payer: PHP Medicare Advantage |
$403.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.95
|
| Rate for Payer: Priority Health Medicare |
$403.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$403.95
|
| Rate for Payer: UHC Medicare Advantage |
$403.95
|
| Rate for Payer: UMR Bronson Commercial |
$626.98
|
|
|
PR DRAINAGE OF RETROPERITONEAL ABSCESS OPEN
|
Professional
|
Both
|
$2,249.00
|
|
|
Service Code
|
HCPCS 49060
|
| Min. Negotiated Rate |
$899.60 |
| Max. Negotiated Rate |
$1,540.86 |
| Rate for Payer: Aetna Commercial |
$1,433.85
|
| Rate for Payer: Aetna Medicare |
$1,112.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,540.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,433.85
|
| Rate for Payer: BCBS Complete |
$899.60
|
| Rate for Payer: BCBS MAPPO |
$1,070.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,070.04
|
| Rate for Payer: Cash Price |
$1,799.20
|
| Rate for Payer: Cash Price |
$1,799.20
|
| Rate for Payer: Cofinity Commercial |
$1,540.86
|
| Rate for Payer: Cofinity Commercial |
$1,433.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,070.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,123.54
|
| Rate for Payer: Nomi Health Commercial |
$1,284.05
|
| Rate for Payer: PACE SWMI |
$1,070.04
|
| Rate for Payer: PHP Commercial |
$1,498.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,070.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,461.85
|
| Rate for Payer: Priority Health Medicare |
$1,070.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,070.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,070.04
|
| Rate for Payer: UMR Bronson Commercial |
$1,034.54
|
|
|
PR DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Professional
|
Both
|
$1,725.00
|
|
|
Service Code
|
HCPCS 58822
|
| Min. Negotiated Rate |
$684.92 |
| Max. Negotiated Rate |
$1,121.25 |
| Rate for Payer: Aetna Commercial |
$917.79
|
| Rate for Payer: Aetna Medicare |
$712.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$986.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$917.79
|
| Rate for Payer: BCBS Complete |
$690.00
|
| Rate for Payer: BCBS MAPPO |
$684.92
|
| Rate for Payer: BCN Medicare Advantage |
$684.92
|
| Rate for Payer: Cash Price |
$1,380.00
|
| Rate for Payer: Cash Price |
$1,380.00
|
| Rate for Payer: Cofinity Commercial |
$986.28
|
| Rate for Payer: Cofinity Commercial |
$917.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$684.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$719.17
|
| Rate for Payer: Nomi Health Commercial |
$821.90
|
| Rate for Payer: PACE SWMI |
$684.92
|
| Rate for Payer: PHP Commercial |
$958.89
|
| Rate for Payer: PHP Medicare Advantage |
$684.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,121.25
|
| Rate for Payer: Priority Health Medicare |
$684.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$684.92
|
| Rate for Payer: UHC Medicare Advantage |
$684.92
|
| Rate for Payer: UMR Bronson Commercial |
$793.50
|
|
|
PR DRAINAGE OVARIAN ABSCESS VAGINAL APPR OPEN
|
Professional
|
Both
|
$897.00
|
|
|
Service Code
|
HCPCS 58820
|
| Min. Negotiated Rate |
$322.35 |
| Max. Negotiated Rate |
$583.05 |
| Rate for Payer: Aetna Commercial |
$431.95
|
| Rate for Payer: Aetna Medicare |
$335.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$431.95
|
| Rate for Payer: BCBS Complete |
$358.80
|
| Rate for Payer: BCBS MAPPO |
$322.35
|
| Rate for Payer: BCN Medicare Advantage |
$322.35
|
| Rate for Payer: Cash Price |
$717.60
|
| Rate for Payer: Cash Price |
$717.60
|
| Rate for Payer: Cofinity Commercial |
$464.18
|
| Rate for Payer: Cofinity Commercial |
$431.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$338.47
|
| Rate for Payer: Nomi Health Commercial |
$386.82
|
| Rate for Payer: PACE SWMI |
$322.35
|
| Rate for Payer: PHP Commercial |
$451.29
|
| Rate for Payer: PHP Medicare Advantage |
$322.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$583.05
|
| Rate for Payer: Priority Health Medicare |
$322.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$322.35
|
| Rate for Payer: UHC Medicare Advantage |
$322.35
|
| Rate for Payer: UMR Bronson Commercial |
$412.62
|
|
|
PR DRAINAGE OVARIAN CYST UNI/BI SPX ABDOMINAL
|
Professional
|
Both
|
$1,612.00
|
|
|
Service Code
|
HCPCS 58805
|
| Min. Negotiated Rate |
$407.68 |
| Max. Negotiated Rate |
$1,047.80 |
| Rate for Payer: Aetna Commercial |
$546.29
|
| Rate for Payer: Aetna Medicare |
$423.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$587.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$546.29
|
| Rate for Payer: BCBS Complete |
$644.80
|
| Rate for Payer: BCBS MAPPO |
$407.68
|
| Rate for Payer: BCN Medicare Advantage |
$407.68
|
| Rate for Payer: Cash Price |
$1,289.60
|
| Rate for Payer: Cash Price |
$1,289.60
|
| Rate for Payer: Cofinity Commercial |
$587.06
|
| Rate for Payer: Cofinity Commercial |
$546.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$407.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$428.06
|
| Rate for Payer: Nomi Health Commercial |
$489.22
|
| Rate for Payer: PACE SWMI |
$407.68
|
| Rate for Payer: PHP Commercial |
$570.75
|
| Rate for Payer: PHP Medicare Advantage |
$407.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,047.80
|
| Rate for Payer: Priority Health Medicare |
$407.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$407.68
|
| Rate for Payer: UHC Medicare Advantage |
$407.68
|
| Rate for Payer: UMR Bronson Commercial |
$741.52
|
|
