|
PR ELEC ALYS NSTIM PLS GEN CPLX SC/PERPH EA 30 MIN
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 95973
|
| Min. Negotiated Rate |
$67.20 |
| Max. Negotiated Rate |
$109.20 |
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
| Rate for Payer: UMR Bronson Commercial |
$77.28
|
|
|
PR ELEC STIM OTHER THAN WOUND
|
Professional
|
Both
|
$26.00
|
|
|
Service Code
|
HCPCS G0283
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$16.99 |
| Rate for Payer: Aetna Commercial |
$15.81
|
| Rate for Payer: Aetna Medicare |
$12.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.81
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS MAPPO |
$11.80
|
| Rate for Payer: BCN Medicare Advantage |
$11.80
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$16.99
|
| Rate for Payer: Cofinity Commercial |
$15.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.39
|
| Rate for Payer: Nomi Health Commercial |
$14.16
|
| Rate for Payer: PACE SWMI |
$11.80
|
| Rate for Payer: PHP Commercial |
$16.52
|
| Rate for Payer: PHP Medicare Advantage |
$11.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.90
|
| Rate for Payer: Priority Health Medicare |
$11.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.80
|
| Rate for Payer: UHC Medicare Advantage |
$11.80
|
| Rate for Payer: UMR Bronson Commercial |
$11.96
|
|
|
PR ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 62368
|
| Min. Negotiated Rate |
$32.58 |
| Max. Negotiated Rate |
$136.50 |
| Rate for Payer: Aetna Commercial |
$43.66
|
| Rate for Payer: Aetna Medicare |
$33.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.66
|
| Rate for Payer: BCBS Complete |
$84.00
|
| Rate for Payer: BCBS MAPPO |
$32.58
|
| Rate for Payer: BCN Medicare Advantage |
$32.58
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$46.92
|
| Rate for Payer: Cofinity Commercial |
$43.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.21
|
| Rate for Payer: Nomi Health Commercial |
$39.10
|
| Rate for Payer: PACE SWMI |
$32.58
|
| Rate for Payer: PHP Commercial |
$45.61
|
| Rate for Payer: PHP Medicare Advantage |
$32.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
| Rate for Payer: Priority Health Medicare |
$32.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.58
|
| Rate for Payer: UHC Medicare Advantage |
$32.58
|
| Rate for Payer: UMR Bronson Commercial |
$96.60
|
|
|
PR ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL
|
Professional
|
Both
|
$383.00
|
|
|
Service Code
|
HCPCS 62367
|
| Min. Negotiated Rate |
$23.32 |
| Max. Negotiated Rate |
$248.95 |
| Rate for Payer: Aetna Commercial |
$31.25
|
| Rate for Payer: Aetna Medicare |
$24.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.25
|
| Rate for Payer: BCBS Complete |
$153.20
|
| Rate for Payer: BCBS MAPPO |
$23.32
|
| Rate for Payer: BCN Medicare Advantage |
$23.32
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cofinity Commercial |
$33.58
|
| Rate for Payer: Cofinity Commercial |
$31.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.49
|
| Rate for Payer: Nomi Health Commercial |
$27.98
|
| Rate for Payer: PACE SWMI |
$23.32
|
| Rate for Payer: PHP Commercial |
$32.65
|
| Rate for Payer: PHP Medicare Advantage |
$23.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.95
|
| Rate for Payer: Priority Health Medicare |
$23.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.32
|
| Rate for Payer: UHC Medicare Advantage |
$23.32
|
| Rate for Payer: UMR Bronson Commercial |
$176.18
|
|
|
PR ELECTROACOUS EVAL HEARING AID BINAURAL
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 92595
|
| Min. Negotiated Rate |
$31.60 |
| Max. Negotiated Rate |
$51.35 |
| Rate for Payer: Aetna Medicare |
$39.50
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
| Rate for Payer: UMR Bronson Commercial |
$36.34
|
|
|
PR ELECTROACOUS EVAL HEARING AID MONAURAL
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 92594
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$17.55 |
| Rate for Payer: Aetna Medicare |
$13.50
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
| Rate for Payer: UMR Bronson Commercial |
$12.42
|
|
|
PR ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY
|
Professional
|
Both
|
$201.00
|
|
|
Service Code
|
HCPCS 95824
|
| Min. Negotiated Rate |
$80.40 |
| Max. Negotiated Rate |
$130.65 |
| Rate for Payer: Aetna Medicare |
$100.50
|
| Rate for Payer: BCBS Complete |
$80.40
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: UMR Bronson Commercial |
$92.46
|
|
|
PR ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN
|
Professional
|
Both
|
$753.00
|
|
|
Service Code
|
HCPCS 95812
|
| Min. Negotiated Rate |
$301.20 |
| Max. Negotiated Rate |
$489.45 |
| Rate for Payer: Aetna Commercial |
$416.53
|
| Rate for Payer: Aetna Medicare |
$323.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.61
|
| Rate for Payer: BCBS Complete |
$301.20
|
| Rate for Payer: BCBS MAPPO |
$310.84
|
| Rate for Payer: BCN Medicare Advantage |
$310.84
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cofinity Commercial |
$416.53
|
| Rate for Payer: Cofinity Commercial |
$447.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$326.38
|
| Rate for Payer: Nomi Health Commercial |
$373.01
|
| Rate for Payer: PACE SWMI |
$310.84
|
| Rate for Payer: PHP Commercial |
$435.18
|
| Rate for Payer: PHP Medicare Advantage |
$310.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$489.45
|
| Rate for Payer: Priority Health Medicare |
$310.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$310.84
|
| Rate for Payer: UHC Medicare Advantage |
$310.84
|
| Rate for Payer: UMR Bronson Commercial |
$346.38
|
|
|
PR ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY
|
Professional
|
Both
|
$367.00
|
|
|
Service Code
|
HCPCS 95822
|
| Min. Negotiated Rate |
$146.80 |
| Max. Negotiated Rate |
$536.30 |
| Rate for Payer: Aetna Commercial |
$499.06
|
| Rate for Payer: Aetna Medicare |
$387.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$536.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.06
|
| Rate for Payer: BCBS Complete |
$146.80
|
| Rate for Payer: BCBS MAPPO |
$372.43
|
| Rate for Payer: BCN Medicare Advantage |
$372.43
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cofinity Commercial |
$536.30
|
| Rate for Payer: Cofinity Commercial |
$499.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.05
|
| Rate for Payer: Nomi Health Commercial |
$446.92
|
| Rate for Payer: PACE SWMI |
$372.43
|
| Rate for Payer: PHP Commercial |
$521.40
|
| Rate for Payer: PHP Medicare Advantage |
$372.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.55
|
| Rate for Payer: Priority Health Medicare |
$372.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$372.43
|
| Rate for Payer: UHC Medicare Advantage |
$372.43
|
| Rate for Payer: UMR Bronson Commercial |
$168.82
|
|
|
PR ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP
|
Professional
|
Both
|
$794.00
|
|
|
Service Code
|
HCPCS 95819
|
| Min. Negotiated Rate |
$317.60 |
| Max. Negotiated Rate |
$579.70 |
| Rate for Payer: Aetna Commercial |
$539.44
|
| Rate for Payer: Aetna Commercial |
$539.44
|
| Rate for Payer: Aetna Medicare |
$418.67
|
| Rate for Payer: Aetna Medicare |
$418.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$539.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$539.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$579.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$579.70
|
| Rate for Payer: BCBS Complete |
$317.60
|
| Rate for Payer: BCBS Complete |
$82.40
|
| Rate for Payer: BCBS MAPPO |
$402.57
|
| Rate for Payer: BCBS MAPPO |
$402.57
|
| Rate for Payer: BCN Medicare Advantage |
$402.57
|
| Rate for Payer: BCN Medicare Advantage |
$402.57
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$635.20
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$635.20
|
| Rate for Payer: Cofinity Commercial |
$579.70
|
| Rate for Payer: Cofinity Commercial |
$579.70
|
| Rate for Payer: Cofinity Commercial |
$539.44
|
| Rate for Payer: Cofinity Commercial |
$539.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$402.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$402.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$422.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$422.70
|
| Rate for Payer: Nomi Health Commercial |
$483.08
|
| Rate for Payer: Nomi Health Commercial |
$483.08
|
| Rate for Payer: PACE SWMI |
$402.57
|
| Rate for Payer: PACE SWMI |
$402.57
|
| Rate for Payer: PHP Commercial |
$563.60
|
| Rate for Payer: PHP Commercial |
$563.60
|
| Rate for Payer: PHP Medicare Advantage |
$402.57
|
| Rate for Payer: PHP Medicare Advantage |
$402.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$516.10
|
| Rate for Payer: Priority Health Medicare |
$402.57
|
| Rate for Payer: Priority Health Medicare |
$402.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$402.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$402.57
|
| Rate for Payer: UHC Medicare Advantage |
$402.57
|
| Rate for Payer: UHC Medicare Advantage |
$402.57
|
| Rate for Payer: UMR Bronson Commercial |
$365.24
|
| Rate for Payer: UMR Bronson Commercial |
$94.76
|
|
|
PR ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY
|
Professional
|
Both
|
$692.00
|
|
|
Service Code
|
HCPCS 95816
|
| Min. Negotiated Rate |
$276.80 |
| Max. Negotiated Rate |
$498.53 |
| Rate for Payer: Aetna Commercial |
$463.91
|
| Rate for Payer: Aetna Commercial |
$463.91
|
| Rate for Payer: Aetna Medicare |
$360.05
|
| Rate for Payer: Aetna Medicare |
$360.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$463.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$463.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$498.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$498.53
|
| Rate for Payer: BCBS Complete |
$276.80
|
| Rate for Payer: BCBS Complete |
$112.80
|
| Rate for Payer: BCBS MAPPO |
$346.20
|
| Rate for Payer: BCBS MAPPO |
$346.20
|
| Rate for Payer: BCN Medicare Advantage |
$346.20
|
| Rate for Payer: BCN Medicare Advantage |
$346.20
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cash Price |
$553.60
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cash Price |
$553.60
|
| Rate for Payer: Cofinity Commercial |
$498.53
|
| Rate for Payer: Cofinity Commercial |
$498.53
|
| Rate for Payer: Cofinity Commercial |
$463.91
|
| Rate for Payer: Cofinity Commercial |
$463.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$363.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$363.51
|
| Rate for Payer: Nomi Health Commercial |
$415.44
|
| Rate for Payer: Nomi Health Commercial |
$415.44
|
| Rate for Payer: PACE SWMI |
$346.20
|
| Rate for Payer: PACE SWMI |
$346.20
|
| Rate for Payer: PHP Commercial |
$484.68
|
| Rate for Payer: PHP Commercial |
$484.68
|
| Rate for Payer: PHP Medicare Advantage |
$346.20
|
| Rate for Payer: PHP Medicare Advantage |
$346.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.80
|
| Rate for Payer: Priority Health Medicare |
$346.20
|
| Rate for Payer: Priority Health Medicare |
$346.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$346.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$346.20
|
| Rate for Payer: UHC Medicare Advantage |
$346.20
|
| Rate for Payer: UHC Medicare Advantage |
$346.20
|
| Rate for Payer: UMR Bronson Commercial |
$318.32
|
| Rate for Payer: UMR Bronson Commercial |
$129.72
|
|
|
PR ELECTROGASTROGRAPHY DX TRANSCUTANEOUS
|
Professional
|
Both
|
$282.00
|
|
|
Service Code
|
HCPCS 91132
|
| Min. Negotiated Rate |
$112.80 |
| Max. Negotiated Rate |
$533.36 |
| Rate for Payer: Aetna Commercial |
$496.32
|
| Rate for Payer: Aetna Medicare |
$385.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$496.32
|
| Rate for Payer: BCBS Complete |
$112.80
|
| Rate for Payer: BCBS MAPPO |
$370.39
|
| Rate for Payer: BCN Medicare Advantage |
$370.39
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cofinity Commercial |
$533.36
|
| Rate for Payer: Cofinity Commercial |
$496.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$370.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$388.91
|
| Rate for Payer: Nomi Health Commercial |
$444.47
|
| Rate for Payer: PACE SWMI |
$370.39
|
| Rate for Payer: PHP Commercial |
$518.55
|
| Rate for Payer: PHP Medicare Advantage |
$370.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.30
|
| Rate for Payer: Priority Health Medicare |
$370.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$370.39
|
| Rate for Payer: UHC Medicare Advantage |
$370.39
|
| Rate for Payer: UMR Bronson Commercial |
$129.72
|
|
|
PR ELECTRONIC ALYS ANTITACHYCARDIA PACEMAKER SYS
|
Professional
|
Both
|
$571.00
|
|
|
Service Code
|
HCPCS 93724
|
| Min. Negotiated Rate |
$228.40 |
| Max. Negotiated Rate |
$374.93 |
| Rate for Payer: Aetna Commercial |
$348.90
|
| Rate for Payer: Aetna Medicare |
$270.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.90
|
| Rate for Payer: BCBS Complete |
$228.40
|
| Rate for Payer: BCBS MAPPO |
$260.37
|
| Rate for Payer: BCN Medicare Advantage |
$260.37
|
| Rate for Payer: Cash Price |
$456.80
|
| Rate for Payer: Cash Price |
$456.80
|
| Rate for Payer: Cofinity Commercial |
$374.93
|
| Rate for Payer: Cofinity Commercial |
$348.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.39
|
| Rate for Payer: Nomi Health Commercial |
$312.44
|
| Rate for Payer: PACE SWMI |
$260.37
|
| Rate for Payer: PHP Commercial |
$364.52
|
| Rate for Payer: PHP Medicare Advantage |
$260.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.15
|
| Rate for Payer: Priority Health Medicare |
$260.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.37
|
| Rate for Payer: UHC Medicare Advantage |
$260.37
|
| Rate for Payer: UMR Bronson Commercial |
$262.66
|
|
|
PR ELEVATION DEPRESSED SKULL FX SIMPLE EXTRADURAL
|
Professional
|
Both
|
$4,144.00
|
|
|
Service Code
|
HCPCS 62000
|
| Min. Negotiated Rate |
$1,028.09 |
| Max. Negotiated Rate |
$2,693.60 |
| Rate for Payer: Aetna Commercial |
$1,377.64
|
| Rate for Payer: Aetna Medicare |
$1,069.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,480.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,377.64
|
| Rate for Payer: BCBS Complete |
$1,657.60
|
| Rate for Payer: BCBS MAPPO |
$1,028.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,028.09
|
| Rate for Payer: Cash Price |
$3,315.20
|
| Rate for Payer: Cash Price |
$3,315.20
|
| Rate for Payer: Cofinity Commercial |
$1,480.45
|
| Rate for Payer: Cofinity Commercial |
$1,377.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,028.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,079.49
|
| Rate for Payer: Nomi Health Commercial |
$1,233.71
|
| Rate for Payer: PACE SWMI |
$1,028.09
|
| Rate for Payer: PHP Commercial |
$1,439.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,028.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,693.60
|
| Rate for Payer: Priority Health Medicare |
$1,028.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,028.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,028.09
|
| Rate for Payer: UMR Bronson Commercial |
$1,906.24
|
|
|
PR ELVTN DEPRS SKL FX COMPOUND/COMMIND XDRL
|
Professional
|
Both
|
$5,239.00
|
|
|
Service Code
|
HCPCS 62005
|
| Min. Negotiated Rate |
$1,264.76 |
| Max. Negotiated Rate |
$3,405.35 |
| Rate for Payer: Aetna Commercial |
$1,694.78
|
| Rate for Payer: Aetna Medicare |
$1,315.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,821.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,694.78
|
| Rate for Payer: BCBS Complete |
$2,095.60
|
| Rate for Payer: BCBS MAPPO |
$1,264.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,264.76
|
| Rate for Payer: Cash Price |
$4,191.20
|
| Rate for Payer: Cash Price |
$4,191.20
|
| Rate for Payer: Cofinity Commercial |
$1,821.25
|
| Rate for Payer: Cofinity Commercial |
$1,694.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,264.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,328.00
|
| Rate for Payer: Nomi Health Commercial |
$1,517.71
|
| Rate for Payer: PACE SWMI |
$1,264.76
|
| Rate for Payer: PHP Commercial |
$1,770.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,264.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,405.35
|
| Rate for Payer: Priority Health Medicare |
$1,264.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,264.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,264.76
|
| Rate for Payer: UMR Bronson Commercial |
$2,409.94
|
|
|
PR ELVTN DEPRS SKL FX W/RPR DURA&/DBRDMT BRN
|
Professional
|
Both
|
$6,878.00
|
|
|
Service Code
|
HCPCS 62010
|
| Min. Negotiated Rate |
$1,526.64 |
| Max. Negotiated Rate |
$4,470.70 |
| Rate for Payer: Aetna Commercial |
$2,045.70
|
| Rate for Payer: Aetna Medicare |
$1,587.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,198.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,045.70
|
| Rate for Payer: BCBS Complete |
$2,751.20
|
| Rate for Payer: BCBS MAPPO |
$1,526.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,526.64
|
| Rate for Payer: Cash Price |
$5,502.40
|
| Rate for Payer: Cash Price |
$5,502.40
|
| Rate for Payer: Cofinity Commercial |
$2,198.36
|
| Rate for Payer: Cofinity Commercial |
$2,045.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,526.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,602.97
|
| Rate for Payer: Nomi Health Commercial |
$1,831.97
|
| Rate for Payer: PACE SWMI |
$1,526.64
|
| Rate for Payer: PHP Commercial |
$2,137.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,526.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,470.70
|
| Rate for Payer: Priority Health Medicare |
$1,526.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,526.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,526.64
|
| Rate for Payer: UMR Bronson Commercial |
$3,163.88
|
|
|
PR E/M ANNUAL NURSING FACILITY ASSESS STABLE 30 MIN
|
Professional
|
Both
|
$145.00
|
|
|
Service Code
|
HCPCS 99318
|
| Min. Negotiated Rate |
$58.00 |
| Max. Negotiated Rate |
$94.25 |
| Rate for Payer: Aetna Medicare |
$72.50
|
| Rate for Payer: BCBS Complete |
$58.00
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.25
|
| Rate for Payer: UMR Bronson Commercial |
$66.70
|
|
|
PR EMBLC/THRMBC AX BRACH INNOMINATE SUBCLA ART
|
Professional
|
Both
|
$2,337.00
|
|
|
Service Code
|
HCPCS 34101
|
| Min. Negotiated Rate |
$571.84 |
| Max. Negotiated Rate |
$1,519.05 |
| Rate for Payer: Aetna Commercial |
$766.27
|
| Rate for Payer: Aetna Medicare |
$594.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$766.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$823.45
|
| Rate for Payer: BCBS Complete |
$934.80
|
| Rate for Payer: BCBS MAPPO |
$571.84
|
| Rate for Payer: BCN Medicare Advantage |
$571.84
|
| Rate for Payer: Cash Price |
$1,869.60
|
| Rate for Payer: Cash Price |
$1,869.60
|
| Rate for Payer: Cofinity Commercial |
$766.27
|
| Rate for Payer: Cofinity Commercial |
$823.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$571.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$600.43
|
| Rate for Payer: Nomi Health Commercial |
$686.21
|
| Rate for Payer: PACE SWMI |
$571.84
|
| Rate for Payer: PHP Commercial |
$800.58
|
| Rate for Payer: PHP Medicare Advantage |
$571.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,519.05
|
| Rate for Payer: Priority Health Medicare |
$571.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$571.84
|
| Rate for Payer: UHC Medicare Advantage |
$571.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,075.02
|
|
|
PR EMBLC/THRMBC CATH CRTD SUBCLA/INNOMINATE ART
|
Professional
|
Both
|
$2,034.00
|
|
|
Service Code
|
HCPCS 34001
|
| Min. Negotiated Rate |
$813.60 |
| Max. Negotiated Rate |
$1,322.10 |
| Rate for Payer: Aetna Commercial |
$1,181.53
|
| Rate for Payer: Aetna Medicare |
$917.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,269.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,181.53
|
| Rate for Payer: BCBS Complete |
$813.60
|
| Rate for Payer: BCBS MAPPO |
$881.74
|
| Rate for Payer: BCN Medicare Advantage |
$881.74
|
| Rate for Payer: Cash Price |
$1,627.20
|
| Rate for Payer: Cash Price |
$1,627.20
|
| Rate for Payer: Cofinity Commercial |
$1,269.71
|
| Rate for Payer: Cofinity Commercial |
$1,181.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.83
|
| Rate for Payer: Nomi Health Commercial |
$1,058.09
|
| Rate for Payer: PACE SWMI |
$881.74
|
| Rate for Payer: PHP Commercial |
$1,234.44
|
| Rate for Payer: PHP Medicare Advantage |
$881.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,322.10
|
| Rate for Payer: Priority Health Medicare |
$881.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$881.74
|
| Rate for Payer: UHC Medicare Advantage |
$881.74
|
| Rate for Payer: UMR Bronson Commercial |
$935.64
|
|
|
PR EMBLC/THRMBC FEMORAL POPLITEAL AORTO-ILIAC ART
|
Professional
|
Both
|
$1,995.00
|
|
|
Service Code
|
HCPCS 34201
|
| Min. Negotiated Rate |
$798.00 |
| Max. Negotiated Rate |
$1,409.85 |
| Rate for Payer: Aetna Commercial |
$1,311.94
|
| Rate for Payer: Aetna Medicare |
$1,018.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,409.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,311.94
|
| Rate for Payer: BCBS Complete |
$798.00
|
| Rate for Payer: BCBS MAPPO |
$979.06
|
| Rate for Payer: BCN Medicare Advantage |
$979.06
|
| Rate for Payer: Cash Price |
$1,596.00
|
| Rate for Payer: Cash Price |
$1,596.00
|
| Rate for Payer: Cofinity Commercial |
$1,409.85
|
| Rate for Payer: Cofinity Commercial |
$1,311.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$979.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,028.01
|
| Rate for Payer: Nomi Health Commercial |
$1,174.87
|
| Rate for Payer: PACE SWMI |
$979.06
|
| Rate for Payer: PHP Commercial |
$1,370.68
|
| Rate for Payer: PHP Medicare Advantage |
$979.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.75
|
| Rate for Payer: Priority Health Medicare |
$979.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$979.06
|
| Rate for Payer: UHC Medicare Advantage |
$979.06
|
| Rate for Payer: UMR Bronson Commercial |
$917.70
|
|
|
PR EMBLC/THRMBC INNOMINATE SUBCLAVIAN ARTERY
|
Professional
|
Both
|
$2,010.00
|
|
|
Service Code
|
HCPCS 34051
|
| Min. Negotiated Rate |
$804.00 |
| Max. Negotiated Rate |
$1,367.76 |
| Rate for Payer: Aetna Commercial |
$1,272.77
|
| Rate for Payer: Aetna Medicare |
$987.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,272.77
|
| Rate for Payer: BCBS Complete |
$804.00
|
| Rate for Payer: BCBS MAPPO |
$949.83
|
| Rate for Payer: BCN Medicare Advantage |
$949.83
|
| Rate for Payer: Cash Price |
$1,608.00
|
| Rate for Payer: Cash Price |
$1,608.00
|
| Rate for Payer: Cofinity Commercial |
$1,367.76
|
| Rate for Payer: Cofinity Commercial |
$1,272.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$949.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$997.32
|
| Rate for Payer: Nomi Health Commercial |
$1,139.80
|
| Rate for Payer: PACE SWMI |
$949.83
|
| Rate for Payer: PHP Commercial |
$1,329.76
|
| Rate for Payer: PHP Medicare Advantage |
$949.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,306.50
|
| Rate for Payer: Priority Health Medicare |
$949.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$949.83
|
| Rate for Payer: UHC Medicare Advantage |
$949.83
|
| Rate for Payer: UMR Bronson Commercial |
$924.60
|
|
|
PR EMBLC/THRMBC POPLITEAL-TIBIO-PRONEAL ART LEG INC
|
Professional
|
Both
|
$1,977.00
|
|
|
Service Code
|
HCPCS 34203
|
| Min. Negotiated Rate |
$790.80 |
| Max. Negotiated Rate |
$1,310.23 |
| Rate for Payer: Aetna Commercial |
$1,219.24
|
| Rate for Payer: Aetna Medicare |
$946.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,310.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,219.24
|
| Rate for Payer: BCBS Complete |
$790.80
|
| Rate for Payer: BCBS MAPPO |
$909.88
|
| Rate for Payer: BCN Medicare Advantage |
$909.88
|
| Rate for Payer: Cash Price |
$1,581.60
|
| Rate for Payer: Cash Price |
$1,581.60
|
| Rate for Payer: Cofinity Commercial |
$1,310.23
|
| Rate for Payer: Cofinity Commercial |
$1,219.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$909.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$955.37
|
| Rate for Payer: Nomi Health Commercial |
$1,091.86
|
| Rate for Payer: PACE SWMI |
$909.88
|
| Rate for Payer: PHP Commercial |
$1,273.83
|
| Rate for Payer: PHP Medicare Advantage |
$909.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,285.05
|
| Rate for Payer: Priority Health Medicare |
$909.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$909.88
|
| Rate for Payer: UHC Medicare Advantage |
$909.88
|
| Rate for Payer: UMR Bronson Commercial |
$909.42
|
|
|
PR EMBLC/THRMBC RNL CELIAC MESENTRY AORTO-ILIAC ART
|
Professional
|
Both
|
$2,730.00
|
|
|
Service Code
|
HCPCS 34151
|
| Min. Negotiated Rate |
$1,092.00 |
| Max. Negotiated Rate |
$1,923.03 |
| Rate for Payer: Aetna Commercial |
$1,789.49
|
| Rate for Payer: Aetna Medicare |
$1,388.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,923.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,789.49
|
| Rate for Payer: BCBS Complete |
$1,092.00
|
| Rate for Payer: BCBS MAPPO |
$1,335.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,335.44
|
| Rate for Payer: Cash Price |
$2,184.00
|
| Rate for Payer: Cash Price |
$2,184.00
|
| Rate for Payer: Cofinity Commercial |
$1,923.03
|
| Rate for Payer: Cofinity Commercial |
$1,789.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,335.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,402.21
|
| Rate for Payer: Nomi Health Commercial |
$1,602.53
|
| Rate for Payer: PACE SWMI |
$1,335.44
|
| Rate for Payer: PHP Commercial |
$1,869.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,335.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,774.50
|
| Rate for Payer: Priority Health Medicare |
$1,335.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,335.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,335.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,255.80
|
|
|
PR EMBLC/THRMBC W/WO CATH RADIAL/ULNAR ART ARM INC
|
Professional
|
Both
|
$1,258.00
|
|
|
Service Code
|
HCPCS 34111
|
| Min. Negotiated Rate |
$503.20 |
| Max. Negotiated Rate |
$821.75 |
| Rate for Payer: Aetna Commercial |
$764.68
|
| Rate for Payer: Aetna Medicare |
$593.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$821.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$764.68
|
| Rate for Payer: BCBS Complete |
$503.20
|
| Rate for Payer: BCBS MAPPO |
$570.66
|
| Rate for Payer: BCN Medicare Advantage |
$570.66
|
| Rate for Payer: Cash Price |
$1,006.40
|
| Rate for Payer: Cash Price |
$1,006.40
|
| Rate for Payer: Cofinity Commercial |
$821.75
|
| Rate for Payer: Cofinity Commercial |
$764.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$570.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$599.19
|
| Rate for Payer: Nomi Health Commercial |
$684.79
|
| Rate for Payer: PACE SWMI |
$570.66
|
| Rate for Payer: PHP Commercial |
$798.92
|
| Rate for Payer: PHP Medicare Advantage |
$570.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$817.70
|
| Rate for Payer: Priority Health Medicare |
$570.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$570.66
|
| Rate for Payer: UHC Medicare Advantage |
$570.66
|
| Rate for Payer: UMR Bronson Commercial |
$578.68
|
|
|
PR EMERGENCY DEPARTMENT VISIT HIGH MDM
|
Professional
|
Both
|
$371.00
|
|
|
Service Code
|
HCPCS 99285
|
| Min. Negotiated Rate |
$148.40 |
| Max. Negotiated Rate |
$243.33 |
| Rate for Payer: Aetna Commercial |
$226.43
|
| Rate for Payer: Aetna Medicare |
$175.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$226.43
|
| Rate for Payer: BCBS Complete |
$148.40
|
| Rate for Payer: BCBS MAPPO |
$168.98
|
| Rate for Payer: BCN Medicare Advantage |
$168.98
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cofinity Commercial |
$243.33
|
| Rate for Payer: Cofinity Commercial |
$226.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$177.43
|
| Rate for Payer: Nomi Health Commercial |
$202.78
|
| Rate for Payer: PACE SWMI |
$168.98
|
| Rate for Payer: PHP Commercial |
$236.57
|
| Rate for Payer: PHP Medicare Advantage |
$168.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.15
|
| Rate for Payer: Priority Health Medicare |
$168.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$168.98
|
| Rate for Payer: UHC Medicare Advantage |
$168.98
|
| Rate for Payer: UMR Bronson Commercial |
$170.66
|
|
