|
PR DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL UNI STD
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 93986
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$186.91 |
| Rate for Payer: Aetna Commercial |
$173.93
|
| Rate for Payer: Aetna Medicare |
$134.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.93
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: BCBS MAPPO |
$129.80
|
| Rate for Payer: BCN Medicare Advantage |
$129.80
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$186.91
|
| Rate for Payer: Cofinity Commercial |
$173.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.29
|
| Rate for Payer: Nomi Health Commercial |
$155.76
|
| Rate for Payer: PACE SWMI |
$129.80
|
| Rate for Payer: PHP Commercial |
$181.72
|
| Rate for Payer: PHP Medicare Advantage |
$129.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: Priority Health Medicare |
$129.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.80
|
| Rate for Payer: UHC Medicare Advantage |
$129.80
|
| Rate for Payer: UMR Bronson Commercial |
$22.08
|
|
|
PR DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY
|
Professional
|
Both
|
$444.00
|
|
|
Service Code
|
HCPCS 93880
|
| Min. Negotiated Rate |
$168.67 |
| Max. Negotiated Rate |
$288.60 |
| Rate for Payer: Aetna Commercial |
$226.02
|
| Rate for Payer: Aetna Medicare |
$175.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$226.02
|
| Rate for Payer: BCBS Complete |
$177.60
|
| Rate for Payer: BCBS MAPPO |
$168.67
|
| Rate for Payer: BCN Medicare Advantage |
$168.67
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cofinity Commercial |
$242.88
|
| Rate for Payer: Cofinity Commercial |
$226.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$177.10
|
| Rate for Payer: Nomi Health Commercial |
$202.40
|
| Rate for Payer: PACE SWMI |
$168.67
|
| Rate for Payer: PHP Commercial |
$236.14
|
| Rate for Payer: PHP Medicare Advantage |
$168.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$288.60
|
| Rate for Payer: Priority Health Medicare |
$168.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$168.67
|
| Rate for Payer: UHC Medicare Advantage |
$168.67
|
| Rate for Payer: UMR Bronson Commercial |
$204.24
|
|
|
PR DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY
|
Professional
|
Both
|
$318.00
|
|
|
Service Code
|
HCPCS 93882
|
| Min. Negotiated Rate |
$110.47 |
| Max. Negotiated Rate |
$206.70 |
| Rate for Payer: Aetna Commercial |
$148.03
|
| Rate for Payer: Aetna Medicare |
$114.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.03
|
| Rate for Payer: BCBS Complete |
$127.20
|
| Rate for Payer: BCBS MAPPO |
$110.47
|
| Rate for Payer: BCN Medicare Advantage |
$110.47
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cofinity Commercial |
$159.08
|
| Rate for Payer: Cofinity Commercial |
$148.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.99
|
| Rate for Payer: Nomi Health Commercial |
$132.56
|
| Rate for Payer: PACE SWMI |
$110.47
|
| Rate for Payer: PHP Commercial |
$154.66
|
| Rate for Payer: PHP Medicare Advantage |
$110.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.70
|
| Rate for Payer: Priority Health Medicare |
$110.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.47
|
| Rate for Payer: UHC Medicare Advantage |
$110.47
|
| Rate for Payer: UMR Bronson Commercial |
$146.28
|
|
|
PR DUPLEX SCAN HEMODIALYSIS ACCESS
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 93990
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$187.46 |
| Rate for Payer: Aetna Commercial |
$174.44
|
| Rate for Payer: Aetna Commercial |
$174.44
|
| Rate for Payer: Aetna Medicare |
$135.39
|
| Rate for Payer: Aetna Medicare |
$135.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.46
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS Complete |
$138.80
|
| Rate for Payer: BCBS MAPPO |
$130.18
|
| Rate for Payer: BCBS MAPPO |
$130.18
|
| Rate for Payer: BCN Medicare Advantage |
$130.18
|
| Rate for Payer: BCN Medicare Advantage |
$130.18
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$187.46
|
| Rate for Payer: Cofinity Commercial |
$187.46
|
| Rate for Payer: Cofinity Commercial |
$174.44
|
| Rate for Payer: Cofinity Commercial |
$174.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.69
|
| Rate for Payer: Nomi Health Commercial |
$156.22
|
| Rate for Payer: Nomi Health Commercial |
$156.22
|
| Rate for Payer: PACE SWMI |
$130.18
|
| Rate for Payer: PACE SWMI |
$130.18
|
| Rate for Payer: PHP Commercial |
$182.25
|
| Rate for Payer: PHP Commercial |
$182.25
|
| Rate for Payer: PHP Medicare Advantage |
$130.18
|
| Rate for Payer: PHP Medicare Advantage |
$130.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Medicare |
$130.18
|
| Rate for Payer: Priority Health Medicare |
$130.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.18
|
| Rate for Payer: UHC Medicare Advantage |
$130.18
|
| Rate for Payer: UHC Medicare Advantage |
$130.18
|
| Rate for Payer: UMR Bronson Commercial |
$17.94
|
| Rate for Payer: UMR Bronson Commercial |
$159.62
|
|
|
PR DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 93978
|
| Min. Negotiated Rate |
$32.40 |
| Max. Negotiated Rate |
$233.44 |
| Rate for Payer: Aetna Commercial |
$217.23
|
| Rate for Payer: Aetna Commercial |
$217.23
|
| Rate for Payer: Aetna Medicare |
$168.59
|
| Rate for Payer: Aetna Medicare |
$168.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.44
|
| Rate for Payer: BCBS Complete |
$32.40
|
| Rate for Payer: BCBS Complete |
$159.20
|
| Rate for Payer: BCBS MAPPO |
$162.11
|
| Rate for Payer: BCBS MAPPO |
$162.11
|
| Rate for Payer: BCN Medicare Advantage |
$162.11
|
| Rate for Payer: BCN Medicare Advantage |
$162.11
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$233.44
|
| Rate for Payer: Cofinity Commercial |
$233.44
|
| Rate for Payer: Cofinity Commercial |
$217.23
|
| Rate for Payer: Cofinity Commercial |
$217.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.22
|
| Rate for Payer: Nomi Health Commercial |
$194.53
|
| Rate for Payer: Nomi Health Commercial |
$194.53
|
| Rate for Payer: PACE SWMI |
$162.11
|
| Rate for Payer: PACE SWMI |
$162.11
|
| Rate for Payer: PHP Commercial |
$226.95
|
| Rate for Payer: PHP Commercial |
$226.95
|
| Rate for Payer: PHP Medicare Advantage |
$162.11
|
| Rate for Payer: PHP Medicare Advantage |
$162.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.65
|
| Rate for Payer: Priority Health Medicare |
$162.11
|
| Rate for Payer: Priority Health Medicare |
$162.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.11
|
| Rate for Payer: UHC Medicare Advantage |
$162.11
|
| Rate for Payer: UHC Medicare Advantage |
$162.11
|
| Rate for Payer: UMR Bronson Commercial |
$37.26
|
| Rate for Payer: UMR Bronson Commercial |
$183.08
|
|
|
PR DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD
|
Professional
|
Both
|
$52.00
|
|
|
Service Code
|
HCPCS 93979
|
| Min. Negotiated Rate |
$20.80 |
| Max. Negotiated Rate |
$151.01 |
| Rate for Payer: Aetna Commercial |
$140.53
|
| Rate for Payer: Aetna Commercial |
$140.53
|
| Rate for Payer: Aetna Medicare |
$109.06
|
| Rate for Payer: Aetna Medicare |
$109.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.01
|
| Rate for Payer: BCBS Complete |
$20.80
|
| Rate for Payer: BCBS Complete |
$110.00
|
| Rate for Payer: BCBS MAPPO |
$104.87
|
| Rate for Payer: BCBS MAPPO |
$104.87
|
| Rate for Payer: BCN Medicare Advantage |
$104.87
|
| Rate for Payer: BCN Medicare Advantage |
$104.87
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$151.01
|
| Rate for Payer: Cofinity Commercial |
$151.01
|
| Rate for Payer: Cofinity Commercial |
$140.53
|
| Rate for Payer: Cofinity Commercial |
$140.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.11
|
| Rate for Payer: Nomi Health Commercial |
$125.84
|
| Rate for Payer: Nomi Health Commercial |
$125.84
|
| Rate for Payer: PACE SWMI |
$104.87
|
| Rate for Payer: PACE SWMI |
$104.87
|
| Rate for Payer: PHP Commercial |
$146.82
|
| Rate for Payer: PHP Commercial |
$146.82
|
| Rate for Payer: PHP Medicare Advantage |
$104.87
|
| Rate for Payer: PHP Medicare Advantage |
$104.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.80
|
| Rate for Payer: Priority Health Medicare |
$104.87
|
| Rate for Payer: Priority Health Medicare |
$104.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.87
|
| Rate for Payer: UHC Medicare Advantage |
$104.87
|
| Rate for Payer: UHC Medicare Advantage |
$104.87
|
| Rate for Payer: UMR Bronson Commercial |
$23.92
|
| Rate for Payer: UMR Bronson Commercial |
$126.50
|
|
|
PR DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM
|
Professional
|
Both
|
$619.00
|
|
|
Service Code
|
HCPCS 93975
|
| Min. Negotiated Rate |
$234.50 |
| Max. Negotiated Rate |
$402.35 |
| Rate for Payer: Aetna Commercial |
$314.23
|
| Rate for Payer: Aetna Commercial |
$314.23
|
| Rate for Payer: Aetna Medicare |
$243.88
|
| Rate for Payer: Aetna Medicare |
$243.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$314.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$314.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.68
|
| Rate for Payer: BCBS Complete |
$247.60
|
| Rate for Payer: BCBS Complete |
$103.20
|
| Rate for Payer: BCBS MAPPO |
$234.50
|
| Rate for Payer: BCBS MAPPO |
$234.50
|
| Rate for Payer: BCN Medicare Advantage |
$234.50
|
| Rate for Payer: BCN Medicare Advantage |
$234.50
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cash Price |
$495.20
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cash Price |
$495.20
|
| Rate for Payer: Cofinity Commercial |
$337.68
|
| Rate for Payer: Cofinity Commercial |
$337.68
|
| Rate for Payer: Cofinity Commercial |
$314.23
|
| Rate for Payer: Cofinity Commercial |
$314.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$234.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$234.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.22
|
| Rate for Payer: Nomi Health Commercial |
$281.40
|
| Rate for Payer: Nomi Health Commercial |
$281.40
|
| Rate for Payer: PACE SWMI |
$234.50
|
| Rate for Payer: PACE SWMI |
$234.50
|
| Rate for Payer: PHP Commercial |
$328.30
|
| Rate for Payer: PHP Commercial |
$328.30
|
| Rate for Payer: PHP Medicare Advantage |
$234.50
|
| Rate for Payer: PHP Medicare Advantage |
$234.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$402.35
|
| Rate for Payer: Priority Health Medicare |
$234.50
|
| Rate for Payer: Priority Health Medicare |
$234.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$234.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$234.50
|
| Rate for Payer: UHC Medicare Advantage |
$234.50
|
| Rate for Payer: UHC Medicare Advantage |
$234.50
|
| Rate for Payer: UMR Bronson Commercial |
$284.74
|
| Rate for Payer: UMR Bronson Commercial |
$118.68
|
|
|
PR DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT
|
Professional
|
Both
|
$643.00
|
|
|
Service Code
|
HCPCS 93976
|
| Min. Negotiated Rate |
$142.28 |
| Max. Negotiated Rate |
$417.95 |
| Rate for Payer: Aetna Commercial |
$190.66
|
| Rate for Payer: Aetna Commercial |
$190.66
|
| Rate for Payer: Aetna Medicare |
$147.97
|
| Rate for Payer: Aetna Medicare |
$147.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.88
|
| Rate for Payer: BCBS Complete |
$257.20
|
| Rate for Payer: BCBS Complete |
$72.40
|
| Rate for Payer: BCBS MAPPO |
$142.28
|
| Rate for Payer: BCBS MAPPO |
$142.28
|
| Rate for Payer: BCN Medicare Advantage |
$142.28
|
| Rate for Payer: BCN Medicare Advantage |
$142.28
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cofinity Commercial |
$204.88
|
| Rate for Payer: Cofinity Commercial |
$204.88
|
| Rate for Payer: Cofinity Commercial |
$190.66
|
| Rate for Payer: Cofinity Commercial |
$190.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.39
|
| Rate for Payer: Nomi Health Commercial |
$170.74
|
| Rate for Payer: Nomi Health Commercial |
$170.74
|
| Rate for Payer: PACE SWMI |
$142.28
|
| Rate for Payer: PACE SWMI |
$142.28
|
| Rate for Payer: PHP Commercial |
$199.19
|
| Rate for Payer: PHP Commercial |
$199.19
|
| Rate for Payer: PHP Medicare Advantage |
$142.28
|
| Rate for Payer: PHP Medicare Advantage |
$142.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.95
|
| Rate for Payer: Priority Health Medicare |
$142.28
|
| Rate for Payer: Priority Health Medicare |
$142.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.28
|
| Rate for Payer: UHC Medicare Advantage |
$142.28
|
| Rate for Payer: UHC Medicare Advantage |
$142.28
|
| Rate for Payer: UMR Bronson Commercial |
$295.78
|
| Rate for Payer: UMR Bronson Commercial |
$83.26
|
|
|
PR DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY
|
Professional
|
Both
|
$428.00
|
|
|
Service Code
|
HCPCS 93925
|
| Min. Negotiated Rate |
$171.20 |
| Max. Negotiated Rate |
$304.96 |
| Rate for Payer: Aetna Commercial |
$283.79
|
| Rate for Payer: Aetna Commercial |
$283.79
|
| Rate for Payer: Aetna Medicare |
$220.25
|
| Rate for Payer: Aetna Medicare |
$220.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.96
|
| Rate for Payer: BCBS Complete |
$171.20
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCBS MAPPO |
$211.78
|
| Rate for Payer: BCBS MAPPO |
$211.78
|
| Rate for Payer: BCN Medicare Advantage |
$211.78
|
| Rate for Payer: BCN Medicare Advantage |
$211.78
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$342.40
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$342.40
|
| Rate for Payer: Cofinity Commercial |
$304.96
|
| Rate for Payer: Cofinity Commercial |
$304.96
|
| Rate for Payer: Cofinity Commercial |
$283.79
|
| Rate for Payer: Cofinity Commercial |
$283.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$222.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$222.37
|
| Rate for Payer: Nomi Health Commercial |
$254.14
|
| Rate for Payer: Nomi Health Commercial |
$254.14
|
| Rate for Payer: PACE SWMI |
$211.78
|
| Rate for Payer: PACE SWMI |
$211.78
|
| Rate for Payer: PHP Commercial |
$296.49
|
| Rate for Payer: PHP Commercial |
$296.49
|
| Rate for Payer: PHP Medicare Advantage |
$211.78
|
| Rate for Payer: PHP Medicare Advantage |
$211.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.20
|
| Rate for Payer: Priority Health Medicare |
$211.78
|
| Rate for Payer: Priority Health Medicare |
$211.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$211.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$211.78
|
| Rate for Payer: UHC Medicare Advantage |
$211.78
|
| Rate for Payer: UHC Medicare Advantage |
$211.78
|
| Rate for Payer: UMR Bronson Commercial |
$196.88
|
| Rate for Payer: UMR Bronson Commercial |
$46.92
|
|
|
PR DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS 93926
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$183.27 |
| Rate for Payer: Aetna Commercial |
$170.54
|
| Rate for Payer: Aetna Commercial |
$170.54
|
| Rate for Payer: Aetna Medicare |
$132.36
|
| Rate for Payer: Aetna Medicare |
$132.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.27
|
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: BCBS Complete |
$133.60
|
| Rate for Payer: BCBS MAPPO |
$127.27
|
| Rate for Payer: BCBS MAPPO |
$127.27
|
| Rate for Payer: BCN Medicare Advantage |
$127.27
|
| Rate for Payer: BCN Medicare Advantage |
$127.27
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cofinity Commercial |
$183.27
|
| Rate for Payer: Cofinity Commercial |
$183.27
|
| Rate for Payer: Cofinity Commercial |
$170.54
|
| Rate for Payer: Cofinity Commercial |
$170.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.63
|
| Rate for Payer: Nomi Health Commercial |
$152.72
|
| Rate for Payer: Nomi Health Commercial |
$152.72
|
| Rate for Payer: PACE SWMI |
$127.27
|
| Rate for Payer: PACE SWMI |
$127.27
|
| Rate for Payer: PHP Commercial |
$178.18
|
| Rate for Payer: PHP Commercial |
$178.18
|
| Rate for Payer: PHP Medicare Advantage |
$127.27
|
| Rate for Payer: PHP Medicare Advantage |
$127.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.65
|
| Rate for Payer: Priority Health Medicare |
$127.27
|
| Rate for Payer: Priority Health Medicare |
$127.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.27
|
| Rate for Payer: UHC Medicare Advantage |
$127.27
|
| Rate for Payer: UHC Medicare Advantage |
$127.27
|
| Rate for Payer: UMR Bronson Commercial |
$18.86
|
| Rate for Payer: UMR Bronson Commercial |
$153.64
|
|
|
PR DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 93930
|
| Min. Negotiated Rate |
$25.60 |
| Max. Negotiated Rate |
$255.01 |
| Rate for Payer: Aetna Commercial |
$237.30
|
| Rate for Payer: Aetna Commercial |
$237.30
|
| Rate for Payer: Aetna Medicare |
$184.17
|
| Rate for Payer: Aetna Medicare |
$184.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.01
|
| Rate for Payer: BCBS Complete |
$25.60
|
| Rate for Payer: BCBS Complete |
$162.40
|
| Rate for Payer: BCBS MAPPO |
$177.09
|
| Rate for Payer: BCBS MAPPO |
$177.09
|
| Rate for Payer: BCN Medicare Advantage |
$177.09
|
| Rate for Payer: BCN Medicare Advantage |
$177.09
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$255.01
|
| Rate for Payer: Cofinity Commercial |
$255.01
|
| Rate for Payer: Cofinity Commercial |
$237.30
|
| Rate for Payer: Cofinity Commercial |
$237.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.94
|
| Rate for Payer: Nomi Health Commercial |
$212.51
|
| Rate for Payer: Nomi Health Commercial |
$212.51
|
| Rate for Payer: PACE SWMI |
$177.09
|
| Rate for Payer: PACE SWMI |
$177.09
|
| Rate for Payer: PHP Commercial |
$247.93
|
| Rate for Payer: PHP Commercial |
$247.93
|
| Rate for Payer: PHP Medicare Advantage |
$177.09
|
| Rate for Payer: PHP Medicare Advantage |
$177.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.60
|
| Rate for Payer: Priority Health Medicare |
$177.09
|
| Rate for Payer: Priority Health Medicare |
$177.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.09
|
| Rate for Payer: UHC Medicare Advantage |
$177.09
|
| Rate for Payer: UHC Medicare Advantage |
$177.09
|
| Rate for Payer: UMR Bronson Commercial |
$29.44
|
| Rate for Payer: UMR Bronson Commercial |
$186.76
|
|
|
PR DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 93931
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$158.11 |
| Rate for Payer: Aetna Commercial |
$147.13
|
| Rate for Payer: Aetna Commercial |
$147.13
|
| Rate for Payer: Aetna Medicare |
$114.19
|
| Rate for Payer: Aetna Medicare |
$114.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.11
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS Complete |
$108.80
|
| Rate for Payer: BCBS MAPPO |
$109.80
|
| Rate for Payer: BCBS MAPPO |
$109.80
|
| Rate for Payer: BCN Medicare Advantage |
$109.80
|
| Rate for Payer: BCN Medicare Advantage |
$109.80
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$158.11
|
| Rate for Payer: Cofinity Commercial |
$158.11
|
| Rate for Payer: Cofinity Commercial |
$147.13
|
| Rate for Payer: Cofinity Commercial |
$147.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.29
|
| Rate for Payer: Nomi Health Commercial |
$131.76
|
| Rate for Payer: Nomi Health Commercial |
$131.76
|
| Rate for Payer: PACE SWMI |
$109.80
|
| Rate for Payer: PACE SWMI |
$109.80
|
| Rate for Payer: PHP Commercial |
$153.72
|
| Rate for Payer: PHP Commercial |
$153.72
|
| Rate for Payer: PHP Medicare Advantage |
$109.80
|
| Rate for Payer: PHP Medicare Advantage |
$109.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health Medicare |
$109.80
|
| Rate for Payer: Priority Health Medicare |
$109.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.80
|
| Rate for Payer: UHC Medicare Advantage |
$109.80
|
| Rate for Payer: UHC Medicare Advantage |
$109.80
|
| Rate for Payer: UMR Bronson Commercial |
$15.18
|
| Rate for Payer: UMR Bronson Commercial |
$125.12
|
|
|
PR DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY
|
Professional
|
Both
|
$422.00
|
|
|
Service Code
|
HCPCS 93970
|
| Min. Negotiated Rate |
$165.65 |
| Max. Negotiated Rate |
$274.30 |
| Rate for Payer: Aetna Commercial |
$221.97
|
| Rate for Payer: Aetna Commercial |
$221.97
|
| Rate for Payer: Aetna Medicare |
$172.28
|
| Rate for Payer: Aetna Medicare |
$172.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.54
|
| Rate for Payer: BCBS Complete |
$168.80
|
| Rate for Payer: BCBS Complete |
$46.80
|
| Rate for Payer: BCBS MAPPO |
$165.65
|
| Rate for Payer: BCBS MAPPO |
$165.65
|
| Rate for Payer: BCN Medicare Advantage |
$165.65
|
| Rate for Payer: BCN Medicare Advantage |
$165.65
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cofinity Commercial |
$238.54
|
| Rate for Payer: Cofinity Commercial |
$238.54
|
| Rate for Payer: Cofinity Commercial |
$221.97
|
| Rate for Payer: Cofinity Commercial |
$221.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.93
|
| Rate for Payer: Nomi Health Commercial |
$198.78
|
| Rate for Payer: Nomi Health Commercial |
$198.78
|
| Rate for Payer: PACE SWMI |
$165.65
|
| Rate for Payer: PACE SWMI |
$165.65
|
| Rate for Payer: PHP Commercial |
$231.91
|
| Rate for Payer: PHP Commercial |
$231.91
|
| Rate for Payer: PHP Medicare Advantage |
$165.65
|
| Rate for Payer: PHP Medicare Advantage |
$165.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.30
|
| Rate for Payer: Priority Health Medicare |
$165.65
|
| Rate for Payer: Priority Health Medicare |
$165.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.65
|
| Rate for Payer: UHC Medicare Advantage |
$165.65
|
| Rate for Payer: UHC Medicare Advantage |
$165.65
|
| Rate for Payer: UMR Bronson Commercial |
$194.12
|
| Rate for Payer: UMR Bronson Commercial |
$53.82
|
|
|
PR DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
HCPCS 93971
|
| Min. Negotiated Rate |
$29.60 |
| Max. Negotiated Rate |
$152.68 |
| Rate for Payer: Aetna Commercial |
$142.08
|
| Rate for Payer: Aetna Commercial |
$142.08
|
| Rate for Payer: Aetna Medicare |
$110.27
|
| Rate for Payer: Aetna Medicare |
$110.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.68
|
| Rate for Payer: BCBS Complete |
$29.60
|
| Rate for Payer: BCBS Complete |
$111.60
|
| Rate for Payer: BCBS MAPPO |
$106.03
|
| Rate for Payer: BCBS MAPPO |
$106.03
|
| Rate for Payer: BCN Medicare Advantage |
$106.03
|
| Rate for Payer: BCN Medicare Advantage |
$106.03
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cofinity Commercial |
$152.68
|
| Rate for Payer: Cofinity Commercial |
$152.68
|
| Rate for Payer: Cofinity Commercial |
$142.08
|
| Rate for Payer: Cofinity Commercial |
$142.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.33
|
| Rate for Payer: Nomi Health Commercial |
$127.24
|
| Rate for Payer: Nomi Health Commercial |
$127.24
|
| Rate for Payer: PACE SWMI |
$106.03
|
| Rate for Payer: PACE SWMI |
$106.03
|
| Rate for Payer: PHP Commercial |
$148.44
|
| Rate for Payer: PHP Commercial |
$148.44
|
| Rate for Payer: PHP Medicare Advantage |
$106.03
|
| Rate for Payer: PHP Medicare Advantage |
$106.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.10
|
| Rate for Payer: Priority Health Medicare |
$106.03
|
| Rate for Payer: Priority Health Medicare |
$106.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.03
|
| Rate for Payer: UHC Medicare Advantage |
$106.03
|
| Rate for Payer: UHC Medicare Advantage |
$106.03
|
| Rate for Payer: UMR Bronson Commercial |
$34.04
|
| Rate for Payer: UMR Bronson Commercial |
$128.34
|
|
|
PR DURAL GRAFT SPINAL
|
Professional
|
Both
|
$5,092.00
|
|
|
Service Code
|
HCPCS 63710
|
| Min. Negotiated Rate |
$1,061.01 |
| Max. Negotiated Rate |
$3,309.80 |
| Rate for Payer: Aetna Commercial |
$1,421.75
|
| Rate for Payer: Aetna Medicare |
$1,103.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,527.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,421.75
|
| Rate for Payer: BCBS Complete |
$2,036.80
|
| Rate for Payer: BCBS MAPPO |
$1,061.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,061.01
|
| Rate for Payer: Cash Price |
$4,073.60
|
| Rate for Payer: Cash Price |
$4,073.60
|
| Rate for Payer: Cofinity Commercial |
$1,527.85
|
| Rate for Payer: Cofinity Commercial |
$1,421.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,061.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,114.06
|
| Rate for Payer: Nomi Health Commercial |
$1,273.21
|
| Rate for Payer: PACE SWMI |
$1,061.01
|
| Rate for Payer: PHP Commercial |
$1,485.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,061.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,309.80
|
| Rate for Payer: Priority Health Medicare |
$1,061.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,061.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,061.01
|
| Rate for Payer: UMR Bronson Commercial |
$2,342.32
|
|
|
PR DX ALY PRGRMG&VERIF AUD OI SOUND PROCESSR 1ST 60
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 92622
|
| Min. Negotiated Rate |
$62.20 |
| Max. Negotiated Rate |
$107.90 |
| Rate for Payer: Aetna Commercial |
$83.35
|
| Rate for Payer: Aetna Medicare |
$64.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.35
|
| Rate for Payer: BCBS Complete |
$66.40
|
| Rate for Payer: BCBS MAPPO |
$62.20
|
| Rate for Payer: BCN Medicare Advantage |
$62.20
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cofinity Commercial |
$89.57
|
| Rate for Payer: Cofinity Commercial |
$83.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.31
|
| Rate for Payer: Nomi Health Commercial |
$74.64
|
| Rate for Payer: PACE SWMI |
$62.20
|
| Rate for Payer: PHP Commercial |
$87.08
|
| Rate for Payer: PHP Medicare Advantage |
$62.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.90
|
| Rate for Payer: Priority Health Medicare |
$62.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.20
|
| Rate for Payer: UHC Medicare Advantage |
$62.20
|
| Rate for Payer: UMR Bronson Commercial |
$76.36
|
|
|
PR DX ALY PRGRMG&VERIF AUD OI SOUND PROCESSR EA ADL
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 92623
|
| Min. Negotiated Rate |
$16.36 |
| Max. Negotiated Rate |
$27.95 |
| Rate for Payer: Aetna Commercial |
$21.92
|
| Rate for Payer: Aetna Medicare |
$17.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.92
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS MAPPO |
$16.36
|
| Rate for Payer: BCN Medicare Advantage |
$16.36
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$23.56
|
| Rate for Payer: Cofinity Commercial |
$21.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.18
|
| Rate for Payer: Nomi Health Commercial |
$19.63
|
| Rate for Payer: PACE SWMI |
$16.36
|
| Rate for Payer: PHP Commercial |
$22.90
|
| Rate for Payer: PHP Medicare Advantage |
$16.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health Medicare |
$16.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.36
|
| Rate for Payer: UHC Medicare Advantage |
$16.36
|
| Rate for Payer: UMR Bronson Commercial |
$19.78
|
|
|
PR DYSPORT
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS 00385
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Aetna Medicare |
$6.00
|
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.80
|
| Rate for Payer: UMR Bronson Commercial |
$5.52
|
|
|
PR EAR MOLD/INSERT
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS V5264
|
| Min. Negotiated Rate |
$51.20 |
| Max. Negotiated Rate |
$83.20 |
| Rate for Payer: Aetna Medicare |
$64.00
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: UMR Bronson Commercial |
$58.88
|
|
|
PR EAR PIERCING
|
Professional
|
Both
|
$71.00
|
|
|
Service Code
|
HCPCS 69090
|
| Min. Negotiated Rate |
$28.40 |
| Max. Negotiated Rate |
$46.15 |
| Rate for Payer: Aetna Medicare |
$35.50
|
| Rate for Payer: BCBS Complete |
$28.40
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.15
|
| Rate for Payer: UMR Bronson Commercial |
$32.66
|
|
|
PR ECG ROUTINE ECG W/LEAST 12 LDS I&R ONLY
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 93010
|
| Min. Negotiated Rate |
$7.65 |
| Max. Negotiated Rate |
$14.95 |
| Rate for Payer: Aetna Commercial |
$10.25
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.02
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCBS MAPPO |
$7.65
|
| Rate for Payer: BCN Medicare Advantage |
$7.65
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cofinity Commercial |
$10.25
|
| Rate for Payer: Cofinity Commercial |
$11.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.03
|
| Rate for Payer: Nomi Health Commercial |
$9.18
|
| Rate for Payer: PACE SWMI |
$7.65
|
| Rate for Payer: PHP Commercial |
$10.71
|
| Rate for Payer: PHP Medicare Advantage |
$7.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.95
|
| Rate for Payer: Priority Health Medicare |
$7.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.65
|
| Rate for Payer: UHC Medicare Advantage |
$7.65
|
| Rate for Payer: UMR Bronson Commercial |
$10.58
|
|
|
PR ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 93005
|
| Min. Negotiated Rate |
$5.68 |
| Max. Negotiated Rate |
$27.95 |
| Rate for Payer: Aetna Commercial |
$7.61
|
| Rate for Payer: Aetna Medicare |
$5.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.61
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS MAPPO |
$5.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.68
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$8.18
|
| Rate for Payer: Cofinity Commercial |
$7.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.96
|
| Rate for Payer: Nomi Health Commercial |
$6.82
|
| Rate for Payer: PACE SWMI |
$5.68
|
| Rate for Payer: PHP Commercial |
$7.95
|
| Rate for Payer: PHP Medicare Advantage |
$5.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health Medicare |
$5.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.68
|
| Rate for Payer: UHC Medicare Advantage |
$5.68
|
| Rate for Payer: UMR Bronson Commercial |
$19.78
|
|
|
PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 93000
|
| Min. Negotiated Rate |
$13.33 |
| Max. Negotiated Rate |
$51.35 |
| Rate for Payer: Aetna Commercial |
$17.86
|
| Rate for Payer: Aetna Medicare |
$13.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.86
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: BCBS MAPPO |
$13.33
|
| Rate for Payer: BCN Medicare Advantage |
$13.33
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$17.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.00
|
| Rate for Payer: Nomi Health Commercial |
$16.00
|
| Rate for Payer: PACE SWMI |
$13.33
|
| Rate for Payer: PHP Commercial |
$18.66
|
| Rate for Payer: PHP Medicare Advantage |
$13.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
| Rate for Payer: Priority Health Medicare |
$13.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.33
|
| Rate for Payer: UHC Medicare Advantage |
$13.33
|
| Rate for Payer: UMR Bronson Commercial |
$36.34
|
|
|
PR ECHO GUIDANCE RADIOTHERAPY
|
Professional
|
Both
|
$383.00
|
|
|
Service Code
|
HCPCS G6001
|
| Min. Negotiated Rate |
$153.20 |
| Max. Negotiated Rate |
$248.95 |
| Rate for Payer: Aetna Commercial |
$212.26
|
| Rate for Payer: Aetna Medicare |
$164.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.26
|
| Rate for Payer: BCBS Complete |
$153.20
|
| Rate for Payer: BCBS MAPPO |
$158.40
|
| Rate for Payer: BCN Medicare Advantage |
$158.40
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cofinity Commercial |
$228.10
|
| Rate for Payer: Cofinity Commercial |
$212.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.32
|
| Rate for Payer: Nomi Health Commercial |
$190.08
|
| Rate for Payer: PACE SWMI |
$158.40
|
| Rate for Payer: PHP Commercial |
$221.76
|
| Rate for Payer: PHP Medicare Advantage |
$158.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.95
|
| Rate for Payer: Priority Health Medicare |
$158.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$158.40
|
| Rate for Payer: UHC Medicare Advantage |
$158.40
|
| Rate for Payer: UMR Bronson Commercial |
$176.18
|
|
|
PR ECHO R-T 2D W/PROBE PLACEMENT ONLY
|
Professional
|
Both
|
$761.00
|
|
|
Service Code
|
HCPCS 93313
|
| Min. Negotiated Rate |
$10.64 |
| Max. Negotiated Rate |
$494.65 |
| Rate for Payer: Aetna Commercial |
$14.26
|
| Rate for Payer: Aetna Medicare |
$11.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.26
|
| Rate for Payer: BCBS Complete |
$304.40
|
| Rate for Payer: BCBS MAPPO |
$10.64
|
| Rate for Payer: BCN Medicare Advantage |
$10.64
|
| Rate for Payer: Cash Price |
$608.80
|
| Rate for Payer: Cash Price |
$608.80
|
| Rate for Payer: Cofinity Commercial |
$15.32
|
| Rate for Payer: Cofinity Commercial |
$14.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.17
|
| Rate for Payer: Nomi Health Commercial |
$12.77
|
| Rate for Payer: PACE SWMI |
$10.64
|
| Rate for Payer: PHP Commercial |
$14.90
|
| Rate for Payer: PHP Medicare Advantage |
$10.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$494.65
|
| Rate for Payer: Priority Health Medicare |
$10.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.64
|
| Rate for Payer: UHC Medicare Advantage |
$10.64
|
| Rate for Payer: UMR Bronson Commercial |
$350.06
|
|
