|
PR EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5CM/>
|
Professional
|
Both
|
$1,894.00
|
|
|
Service Code
|
HCPCS 26113
|
| Min. Negotiated Rate |
$326.53 |
| Max. Negotiated Rate |
$1,420.50 |
| Rate for Payer: Aetna Commercial |
$666.17
|
| Rate for Payer: Aetna Medicare |
$517.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$666.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$715.88
|
| Rate for Payer: BCBS Complete |
$342.86
|
| Rate for Payer: BCBS MAPPO |
$497.14
|
| Rate for Payer: BCN Commercial |
$842.09
|
| Rate for Payer: BCN Medicare Advantage |
$497.14
|
| Rate for Payer: Cash Price |
$1,515.20
|
| Rate for Payer: Cash Price |
$1,515.20
|
| Rate for Payer: Cofinity Commercial |
$666.17
|
| Rate for Payer: Cofinity Commercial |
$715.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$497.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$522.00
|
| Rate for Payer: Meridian Medicaid |
$342.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$546.85
|
| Rate for Payer: Nomi Health Commercial |
$596.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,420.50
|
| Rate for Payer: PACE SWMI |
$497.14
|
| Rate for Payer: PHP Commercial |
$696.00
|
| Rate for Payer: PHP Medicare Advantage |
$497.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$900.17
|
| Rate for Payer: Priority Health Medicare |
$497.14
|
| Rate for Payer: Priority Health SBD |
$900.17
|
| Rate for Payer: Priority Health Tiered Network |
$900.17
|
| Rate for Payer: Railroad Medicare Medicare |
$497.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$950.30
|
| Rate for Payer: UHC Core |
$950.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$497.14
|
| Rate for Payer: UHC Exchange |
$950.30
|
| Rate for Payer: UHC Medicaid |
$326.53
|
| Rate for Payer: UHCCP Medicaid |
$326.53
|
| Rate for Payer: UMR Bronson Commercial |
$871.24
|
|
|
PR FAA PHYSICAL
|
Professional
|
Both
|
$137.00
|
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$54.80 |
| Max. Negotiated Rate |
$102.75 |
| Rate for Payer: Aetna Medicare |
$68.50
|
| Rate for Payer: BCBS Complete |
$54.80
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.75
|
| Rate for Payer: UMR Bronson Commercial |
$63.02
|
|
|
PR FACIAL NERVE FUNCTION STUDIES
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 92516
|
| Min. Negotiated Rate |
$18.51 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$24.80
|
| Rate for Payer: Aetna Medicare |
$19.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.65
|
| Rate for Payer: BCBS Complete |
$52.80
|
| Rate for Payer: BCBS MAPPO |
$18.51
|
| Rate for Payer: BCN Commercial |
$33.36
|
| Rate for Payer: BCN Medicare Advantage |
$18.51
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$26.65
|
| Rate for Payer: Cofinity Commercial |
$24.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.36
|
| Rate for Payer: Nomi Health Commercial |
$22.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.00
|
| Rate for Payer: PACE SWMI |
$18.51
|
| Rate for Payer: PHP Commercial |
$25.91
|
| Rate for Payer: PHP Medicare Advantage |
$18.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$30.77
|
| Rate for Payer: Priority Health Medicare |
$18.51
|
| Rate for Payer: Priority Health SBD |
$30.77
|
| Rate for Payer: Priority Health Tiered Network |
$30.77
|
| Rate for Payer: Railroad Medicare Medicare |
$18.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.82
|
| Rate for Payer: UHC Core |
$36.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.51
|
| Rate for Payer: UHC Exchange |
$36.82
|
| Rate for Payer: UMR Bronson Commercial |
$60.72
|
|
|
PR FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 97156
|
| Min. Negotiated Rate |
$20.79 |
| Max. Negotiated Rate |
$57.07 |
| Rate for Payer: Aetna Commercial |
$20.79
|
| Rate for Payer: Aetna Medicare |
$28.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.79
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCN Commercial |
$37.50
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$45.01
|
| Rate for Payer: Priority Health SBD |
$45.01
|
| Rate for Payer: Priority Health Tiered Network |
$45.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.07
|
| Rate for Payer: UHC Core |
$57.07
|
| Rate for Payer: UHC Exchange |
$57.07
|
| Rate for Payer: UMR Bronson Commercial |
$25.76
|
|
|
PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 90846
|
| Min. Negotiated Rate |
$66.40 |
| Max. Negotiated Rate |
$163.82 |
| Rate for Payer: Aetna Commercial |
$132.32
|
| Rate for Payer: Aetna Medicare |
$102.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.32
|
| Rate for Payer: BCBS Complete |
$66.40
|
| Rate for Payer: BCBS MAPPO |
$98.75
|
| Rate for Payer: BCN Commercial |
$151.39
|
| Rate for Payer: BCN Medicare Advantage |
$98.75
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cofinity Commercial |
$132.32
|
| Rate for Payer: Cofinity Commercial |
$142.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.62
|
| Rate for Payer: Nomi Health Commercial |
$118.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.50
|
| Rate for Payer: PACE SWMI |
$98.75
|
| Rate for Payer: PHP Commercial |
$138.25
|
| Rate for Payer: PHP Medicare Advantage |
$98.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$129.77
|
| Rate for Payer: Priority Health Medicare |
$98.75
|
| Rate for Payer: Priority Health SBD |
$129.77
|
| Rate for Payer: Priority Health Tiered Network |
$129.77
|
| Rate for Payer: Railroad Medicare Medicare |
$98.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.82
|
| Rate for Payer: UHC Core |
$163.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.75
|
| Rate for Payer: UHC Exchange |
$163.82
|
| Rate for Payer: UMR Bronson Commercial |
$76.36
|
|
|
PR FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 90847
|
| Min. Negotiated Rate |
$69.34 |
| Max. Negotiated Rate |
$170.16 |
| Rate for Payer: Aetna Commercial |
$137.19
|
| Rate for Payer: Aetna Medicare |
$106.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.43
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$102.38
|
| Rate for Payer: BCN Commercial |
$124.49
|
| Rate for Payer: BCN Medicare Advantage |
$102.38
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$137.19
|
| Rate for Payer: Cofinity Commercial |
$147.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.50
|
| Rate for Payer: Meridian Medicaid |
$72.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$112.62
|
| Rate for Payer: Nomi Health Commercial |
$122.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: PACE SWMI |
$102.38
|
| Rate for Payer: PHP Commercial |
$143.33
|
| Rate for Payer: PHP Medicare Advantage |
$102.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$137.85
|
| Rate for Payer: Priority Health Medicare |
$102.38
|
| Rate for Payer: Priority Health SBD |
$137.85
|
| Rate for Payer: Priority Health Tiered Network |
$137.85
|
| Rate for Payer: Railroad Medicare Medicare |
$102.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.16
|
| Rate for Payer: UHC Core |
$170.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$102.38
|
| Rate for Payer: UHC Exchange |
$170.16
|
| Rate for Payer: UHC Medicaid |
$69.34
|
| Rate for Payer: UHCCP Medicaid |
$69.34
|
| Rate for Payer: UMR Bronson Commercial |
$96.60
|
|
|
PR FASCIA LATA GRAFT INCISION & AREA EXPOSURE
|
Professional
|
Both
|
$1,109.00
|
|
|
Service Code
|
HCPCS 20922
|
| Min. Negotiated Rate |
$300.12 |
| Max. Negotiated Rate |
$847.54 |
| Rate for Payer: Aetna Commercial |
$616.68
|
| Rate for Payer: Aetna Medicare |
$478.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$662.70
|
| Rate for Payer: BCBS Complete |
$315.13
|
| Rate for Payer: BCBS MAPPO |
$460.21
|
| Rate for Payer: BCN Commercial |
$757.93
|
| Rate for Payer: BCN Medicare Advantage |
$460.21
|
| Rate for Payer: Cash Price |
$887.20
|
| Rate for Payer: Cash Price |
$887.20
|
| Rate for Payer: Cofinity Commercial |
$616.68
|
| Rate for Payer: Cofinity Commercial |
$662.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$460.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$483.22
|
| Rate for Payer: Meridian Medicaid |
$315.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$506.23
|
| Rate for Payer: Nomi Health Commercial |
$552.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$831.75
|
| Rate for Payer: PACE SWMI |
$460.21
|
| Rate for Payer: PHP Commercial |
$644.29
|
| Rate for Payer: PHP Medicare Advantage |
$460.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$810.20
|
| Rate for Payer: Priority Health Medicare |
$460.21
|
| Rate for Payer: Priority Health SBD |
$810.20
|
| Rate for Payer: Priority Health Tiered Network |
$810.20
|
| Rate for Payer: Railroad Medicare Medicare |
$460.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$847.54
|
| Rate for Payer: UHC Core |
$847.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$460.21
|
| Rate for Payer: UHC Exchange |
$847.54
|
| Rate for Payer: UHC Medicaid |
$300.12
|
| Rate for Payer: UHCCP Medicaid |
$300.12
|
| Rate for Payer: UMR Bronson Commercial |
$510.14
|
|
|
PR FASCIECTOMY PLANTAR FASCIA PARTIAL SPX
|
Professional
|
Both
|
$1,004.00
|
|
|
Service Code
|
HCPCS 28060
|
| Min. Negotiated Rate |
$219.18 |
| Max. Negotiated Rate |
$753.00 |
| Rate for Payer: Aetna Commercial |
$446.90
|
| Rate for Payer: Aetna Medicare |
$346.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$480.25
|
| Rate for Payer: BCBS Complete |
$230.14
|
| Rate for Payer: BCBS MAPPO |
$333.51
|
| Rate for Payer: BCN Commercial |
$547.28
|
| Rate for Payer: BCN Medicare Advantage |
$333.51
|
| Rate for Payer: Cash Price |
$803.20
|
| Rate for Payer: Cash Price |
$803.20
|
| Rate for Payer: Cofinity Commercial |
$446.90
|
| Rate for Payer: Cofinity Commercial |
$480.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$333.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.19
|
| Rate for Payer: Meridian Medicaid |
$230.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$366.86
|
| Rate for Payer: Nomi Health Commercial |
$400.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$753.00
|
| Rate for Payer: PACE SWMI |
$333.51
|
| Rate for Payer: PHP Commercial |
$466.91
|
| Rate for Payer: PHP Medicare Advantage |
$333.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$585.03
|
| Rate for Payer: Priority Health Medicare |
$333.51
|
| Rate for Payer: Priority Health SBD |
$585.03
|
| Rate for Payer: Priority Health Tiered Network |
$585.03
|
| Rate for Payer: Railroad Medicare Medicare |
$333.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$627.10
|
| Rate for Payer: UHC Core |
$627.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$333.51
|
| Rate for Payer: UHC Exchange |
$627.10
|
| Rate for Payer: UHC Medicaid |
$219.18
|
| Rate for Payer: UHCCP Medicaid |
$219.18
|
| Rate for Payer: UMR Bronson Commercial |
$461.84
|
|
|
PR FASCIOTOMY FOOT&/TOE
|
Professional
|
Both
|
$741.00
|
|
|
Service Code
|
HCPCS 28008
|
| Min. Negotiated Rate |
$176.15 |
| Max. Negotiated Rate |
$555.75 |
| Rate for Payer: Aetna Commercial |
$359.54
|
| Rate for Payer: Aetna Medicare |
$279.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.37
|
| Rate for Payer: BCBS Complete |
$184.96
|
| Rate for Payer: BCBS MAPPO |
$268.31
|
| Rate for Payer: BCN Commercial |
$448.18
|
| Rate for Payer: BCN Medicare Advantage |
$268.31
|
| Rate for Payer: Cash Price |
$592.80
|
| Rate for Payer: Cash Price |
$592.80
|
| Rate for Payer: Cofinity Commercial |
$359.54
|
| Rate for Payer: Cofinity Commercial |
$386.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$281.73
|
| Rate for Payer: Meridian Medicaid |
$184.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$295.14
|
| Rate for Payer: Nomi Health Commercial |
$321.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$555.75
|
| Rate for Payer: PACE SWMI |
$268.31
|
| Rate for Payer: PHP Commercial |
$375.63
|
| Rate for Payer: PHP Medicare Advantage |
$268.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$176.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$479.10
|
| Rate for Payer: Priority Health Medicare |
$268.31
|
| Rate for Payer: Priority Health SBD |
$479.10
|
| Rate for Payer: Priority Health Tiered Network |
$479.10
|
| Rate for Payer: Railroad Medicare Medicare |
$268.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$514.54
|
| Rate for Payer: UHC Core |
$514.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$268.31
|
| Rate for Payer: UHC Exchange |
$514.54
|
| Rate for Payer: UHC Medicaid |
$176.15
|
| Rate for Payer: UHCCP Medicaid |
$176.15
|
| Rate for Payer: UMR Bronson Commercial |
$340.86
|
|
|
PR FASCIOTOMY HIP/THIGH ANY TYPE
|
Professional
|
Both
|
$3,590.00
|
|
|
Service Code
|
HCPCS 27025
|
| Min. Negotiated Rate |
$560.62 |
| Max. Negotiated Rate |
$2,692.50 |
| Rate for Payer: Aetna Commercial |
$1,150.08
|
| Rate for Payer: Aetna Medicare |
$892.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,150.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,235.91
|
| Rate for Payer: BCBS Complete |
$588.65
|
| Rate for Payer: BCBS MAPPO |
$858.27
|
| Rate for Payer: BCN Commercial |
$1,425.22
|
| Rate for Payer: BCN Medicare Advantage |
$858.27
|
| Rate for Payer: Cash Price |
$2,872.00
|
| Rate for Payer: Cash Price |
$2,872.00
|
| Rate for Payer: Cofinity Commercial |
$1,150.08
|
| Rate for Payer: Cofinity Commercial |
$1,235.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$858.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$901.18
|
| Rate for Payer: Meridian Medicaid |
$588.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$944.10
|
| Rate for Payer: Nomi Health Commercial |
$1,029.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,692.50
|
| Rate for Payer: PACE SWMI |
$858.27
|
| Rate for Payer: PHP Commercial |
$1,201.58
|
| Rate for Payer: PHP Medicare Advantage |
$858.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$560.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,523.53
|
| Rate for Payer: Priority Health Medicare |
$858.27
|
| Rate for Payer: Priority Health SBD |
$1,523.53
|
| Rate for Payer: Priority Health Tiered Network |
$1,523.53
|
| Rate for Payer: Railroad Medicare Medicare |
$858.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,606.26
|
| Rate for Payer: UHC Core |
$1,606.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$858.27
|
| Rate for Payer: UHC Exchange |
$1,606.26
|
| Rate for Payer: UHC Medicaid |
$560.62
|
| Rate for Payer: UHCCP Medicaid |
$560.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,651.40
|
|
|
PR FASCIOTOMY ILIOTIBIAL OPEN
|
Professional
|
Both
|
$1,363.00
|
|
|
Service Code
|
HCPCS 27305
|
| Min. Negotiated Rate |
$296.07 |
| Max. Negotiated Rate |
$1,022.25 |
| Rate for Payer: Aetna Commercial |
$603.56
|
| Rate for Payer: Aetna Medicare |
$468.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$603.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$648.60
|
| Rate for Payer: BCBS Complete |
$310.87
|
| Rate for Payer: BCBS MAPPO |
$450.42
|
| Rate for Payer: BCN Commercial |
$743.48
|
| Rate for Payer: BCN Medicare Advantage |
$450.42
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cofinity Commercial |
$603.56
|
| Rate for Payer: Cofinity Commercial |
$648.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$450.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$472.94
|
| Rate for Payer: Meridian Medicaid |
$310.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$495.46
|
| Rate for Payer: Nomi Health Commercial |
$540.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,022.25
|
| Rate for Payer: PACE SWMI |
$450.42
|
| Rate for Payer: PHP Commercial |
$630.59
|
| Rate for Payer: PHP Medicare Advantage |
$450.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$794.76
|
| Rate for Payer: Priority Health Medicare |
$450.42
|
| Rate for Payer: Priority Health SBD |
$794.76
|
| Rate for Payer: Priority Health Tiered Network |
$794.76
|
| Rate for Payer: Railroad Medicare Medicare |
$450.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$836.31
|
| Rate for Payer: UHC Core |
$836.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$450.42
|
| Rate for Payer: UHC Exchange |
$836.31
|
| Rate for Payer: UHC Medicaid |
$296.07
|
| Rate for Payer: UHCCP Medicaid |
$296.07
|
| Rate for Payer: UMR Bronson Commercial |
$626.98
|
|
|
PR FASCIOTOMY PALMAR OPEN PARTIAL
|
Professional
|
Both
|
$1,409.00
|
|
|
Service Code
|
HCPCS 26045
|
| Min. Negotiated Rate |
$289.04 |
| Max. Negotiated Rate |
$1,056.75 |
| Rate for Payer: Aetna Commercial |
$587.01
|
| Rate for Payer: Aetna Medicare |
$455.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$587.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$630.82
|
| Rate for Payer: BCBS Complete |
$303.49
|
| Rate for Payer: BCBS MAPPO |
$438.07
|
| Rate for Payer: BCN Commercial |
$730.53
|
| Rate for Payer: BCN Medicare Advantage |
$438.07
|
| Rate for Payer: Cash Price |
$1,127.20
|
| Rate for Payer: Cash Price |
$1,127.20
|
| Rate for Payer: Cofinity Commercial |
$587.01
|
| Rate for Payer: Cofinity Commercial |
$630.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$438.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$459.97
|
| Rate for Payer: Meridian Medicaid |
$303.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$481.88
|
| Rate for Payer: Nomi Health Commercial |
$525.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,056.75
|
| Rate for Payer: PACE SWMI |
$438.07
|
| Rate for Payer: PHP Commercial |
$613.30
|
| Rate for Payer: PHP Medicare Advantage |
$438.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$780.92
|
| Rate for Payer: Priority Health Medicare |
$438.07
|
| Rate for Payer: Priority Health SBD |
$780.92
|
| Rate for Payer: Priority Health Tiered Network |
$780.92
|
| Rate for Payer: Railroad Medicare Medicare |
$438.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$812.96
|
| Rate for Payer: UHC Core |
$812.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$438.07
|
| Rate for Payer: UHC Exchange |
$812.96
|
| Rate for Payer: UHC Medicaid |
$289.04
|
| Rate for Payer: UHCCP Medicaid |
$289.04
|
| Rate for Payer: UMR Bronson Commercial |
$648.14
|
|
|
PR FASCIOTOMY PALMAR PERCUTANEOUS
|
Professional
|
Both
|
$958.00
|
|
|
Service Code
|
HCPCS 26040
|
| Min. Negotiated Rate |
$196.81 |
| Max. Negotiated Rate |
$718.50 |
| Rate for Payer: Aetna Commercial |
$396.69
|
| Rate for Payer: Aetna Medicare |
$307.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.30
|
| Rate for Payer: BCBS Complete |
$206.65
|
| Rate for Payer: BCBS MAPPO |
$296.04
|
| Rate for Payer: BCN Commercial |
$491.51
|
| Rate for Payer: BCN Medicare Advantage |
$296.04
|
| Rate for Payer: Cash Price |
$766.40
|
| Rate for Payer: Cash Price |
$766.40
|
| Rate for Payer: Cofinity Commercial |
$396.69
|
| Rate for Payer: Cofinity Commercial |
$426.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$310.84
|
| Rate for Payer: Meridian Medicaid |
$206.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$325.64
|
| Rate for Payer: Nomi Health Commercial |
$355.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$718.50
|
| Rate for Payer: PACE SWMI |
$296.04
|
| Rate for Payer: PHP Commercial |
$414.46
|
| Rate for Payer: PHP Medicare Advantage |
$296.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$525.41
|
| Rate for Payer: Priority Health Medicare |
$296.04
|
| Rate for Payer: Priority Health SBD |
$525.41
|
| Rate for Payer: Priority Health Tiered Network |
$525.41
|
| Rate for Payer: Railroad Medicare Medicare |
$296.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.76
|
| Rate for Payer: UHC Core |
$538.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$296.04
|
| Rate for Payer: UHC Exchange |
$538.76
|
| Rate for Payer: UHC Medicaid |
$196.81
|
| Rate for Payer: UHCCP Medicaid |
$196.81
|
| Rate for Payer: UMR Bronson Commercial |
$440.68
|
|
|
PR FASCT PALM W/WO Z-PLASTY TISSUE REARGMT/SKN GRFT
|
Professional
|
Both
|
$2,432.00
|
|
|
Service Code
|
HCPCS 26121
|
| Min. Negotiated Rate |
$358.27 |
| Max. Negotiated Rate |
$1,824.00 |
| Rate for Payer: Aetna Commercial |
$730.61
|
| Rate for Payer: Aetna Medicare |
$567.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$730.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$785.13
|
| Rate for Payer: BCBS Complete |
$376.18
|
| Rate for Payer: BCBS MAPPO |
$545.23
|
| Rate for Payer: BCN Commercial |
$922.27
|
| Rate for Payer: BCN Medicare Advantage |
$545.23
|
| Rate for Payer: Cash Price |
$1,945.60
|
| Rate for Payer: Cash Price |
$1,945.60
|
| Rate for Payer: Cofinity Commercial |
$730.61
|
| Rate for Payer: Cofinity Commercial |
$785.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$545.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$572.49
|
| Rate for Payer: Meridian Medicaid |
$376.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$599.75
|
| Rate for Payer: Nomi Health Commercial |
$654.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,824.00
|
| Rate for Payer: PACE SWMI |
$545.23
|
| Rate for Payer: PHP Commercial |
$763.32
|
| Rate for Payer: PHP Medicare Advantage |
$545.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$358.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$985.88
|
| Rate for Payer: Priority Health Medicare |
$545.23
|
| Rate for Payer: Priority Health SBD |
$985.88
|
| Rate for Payer: Priority Health Tiered Network |
$985.88
|
| Rate for Payer: Railroad Medicare Medicare |
$545.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,038.61
|
| Rate for Payer: UHC Core |
$1,038.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$545.23
|
| Rate for Payer: UHC Exchange |
$1,038.61
|
| Rate for Payer: UHC Medicaid |
$358.27
|
| Rate for Payer: UHCCP Medicaid |
$358.27
|
| Rate for Payer: UMR Bronson Commercial |
$1,118.72
|
|
|
PR FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR
|
Professional
|
Both
|
$3,041.00
|
|
|
Service Code
|
HCPCS 26123
|
| Min. Negotiated Rate |
$498.21 |
| Max. Negotiated Rate |
$2,280.75 |
| Rate for Payer: Aetna Commercial |
$1,016.63
|
| Rate for Payer: Aetna Medicare |
$789.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,016.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,092.50
|
| Rate for Payer: BCBS Complete |
$523.12
|
| Rate for Payer: BCBS MAPPO |
$758.68
|
| Rate for Payer: BCN Commercial |
$1,285.29
|
| Rate for Payer: BCN Medicare Advantage |
$758.68
|
| Rate for Payer: Cash Price |
$2,432.80
|
| Rate for Payer: Cash Price |
$2,432.80
|
| Rate for Payer: Cofinity Commercial |
$1,016.63
|
| Rate for Payer: Cofinity Commercial |
$1,092.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$758.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$796.61
|
| Rate for Payer: Meridian Medicaid |
$523.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$834.55
|
| Rate for Payer: Nomi Health Commercial |
$910.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,280.75
|
| Rate for Payer: PACE SWMI |
$758.68
|
| Rate for Payer: PHP Commercial |
$1,062.15
|
| Rate for Payer: PHP Medicare Advantage |
$758.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,373.93
|
| Rate for Payer: Priority Health Medicare |
$758.68
|
| Rate for Payer: Priority Health SBD |
$1,373.93
|
| Rate for Payer: Priority Health Tiered Network |
$1,373.93
|
| Rate for Payer: Railroad Medicare Medicare |
$758.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,449.66
|
| Rate for Payer: UHC Core |
$1,449.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$758.68
|
| Rate for Payer: UHC Exchange |
$1,449.66
|
| Rate for Payer: UHC Medicaid |
$498.21
|
| Rate for Payer: UHCCP Medicaid |
$498.21
|
| Rate for Payer: UMR Bronson Commercial |
$1,398.86
|
|
|
PR FASCT PRTL PALMR ADDL DGT PROX IPHAL JT W/WO RPR
|
Professional
|
Both
|
$912.00
|
|
|
Service Code
|
HCPCS 26125
|
| Min. Negotiated Rate |
$145.48 |
| Max. Negotiated Rate |
$684.00 |
| Rate for Payer: Aetna Commercial |
$304.89
|
| Rate for Payer: Aetna Medicare |
$236.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$327.64
|
| Rate for Payer: BCBS Complete |
$152.75
|
| Rate for Payer: BCBS MAPPO |
$227.53
|
| Rate for Payer: BCN Commercial |
$401.38
|
| Rate for Payer: BCN Medicare Advantage |
$227.53
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cash Price |
$729.60
|
| Rate for Payer: Cofinity Commercial |
$304.89
|
| Rate for Payer: Cofinity Commercial |
$327.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.91
|
| Rate for Payer: Meridian Medicaid |
$152.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$250.28
|
| Rate for Payer: Nomi Health Commercial |
$273.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$684.00
|
| Rate for Payer: PACE SWMI |
$227.53
|
| Rate for Payer: PHP Commercial |
$318.54
|
| Rate for Payer: PHP Medicare Advantage |
$227.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$429.05
|
| Rate for Payer: Priority Health Medicare |
$227.53
|
| Rate for Payer: Priority Health SBD |
$429.05
|
| Rate for Payer: Priority Health Tiered Network |
$429.05
|
| Rate for Payer: Railroad Medicare Medicare |
$227.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$481.08
|
| Rate for Payer: UHC Core |
$481.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$227.53
|
| Rate for Payer: UHC Exchange |
$481.08
|
| Rate for Payer: UHC Medicaid |
$145.48
|
| Rate for Payer: UHCCP Medicaid |
$145.48
|
| Rate for Payer: UMR Bronson Commercial |
$419.52
|
|
|
PR FECAL BLOOD SCRN IMMUNOASSAY
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS G0328
|
| Min. Negotiated Rate |
$7.58 |
| Max. Negotiated Rate |
$29.25 |
| Rate for Payer: Aetna Commercial |
$24.19
|
| Rate for Payer: Aetna Medicare |
$18.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.99
|
| Rate for Payer: BCBS MAPPO |
$18.05
|
| Rate for Payer: BCN Commercial |
$18.05
|
| Rate for Payer: BCN Medicare Advantage |
$18.05
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$24.19
|
| Rate for Payer: Cofinity Commercial |
$25.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.86
|
| Rate for Payer: Nomi Health Commercial |
$21.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.25
|
| Rate for Payer: PACE SWMI |
$18.05
|
| Rate for Payer: PHP Commercial |
$25.27
|
| Rate for Payer: PHP Medicare Advantage |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.82
|
| Rate for Payer: Priority Health Medicare |
$18.05
|
| Rate for Payer: Priority Health SBD |
$18.82
|
| Rate for Payer: Priority Health Tiered Network |
$18.82
|
| Rate for Payer: Railroad Medicare Medicare |
$18.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.58
|
| Rate for Payer: UHC Core |
$7.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.05
|
| Rate for Payer: UHC Exchange |
$7.58
|
| Rate for Payer: UMR Bronson Commercial |
$17.94
|
|
|
PR FECAL MICROBIOTA PREP INSTIL
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS G0455
|
| Min. Negotiated Rate |
$39.19 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$81.65
|
| Rate for Payer: Aetna Medicare |
$63.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.74
|
| Rate for Payer: BCBS Complete |
$41.15
|
| Rate for Payer: BCBS MAPPO |
$60.93
|
| Rate for Payer: BCN Commercial |
$104.58
|
| Rate for Payer: BCN Medicare Advantage |
$60.93
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$87.74
|
| Rate for Payer: Cofinity Commercial |
$81.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.98
|
| Rate for Payer: Meridian Medicaid |
$41.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.02
|
| Rate for Payer: Nomi Health Commercial |
$73.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: PACE SWMI |
$60.93
|
| Rate for Payer: PHP Commercial |
$85.30
|
| Rate for Payer: PHP Medicare Advantage |
$60.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$127.42
|
| Rate for Payer: Priority Health Medicare |
$60.93
|
| Rate for Payer: Priority Health SBD |
$127.42
|
| Rate for Payer: Priority Health Tiered Network |
$127.42
|
| Rate for Payer: Railroad Medicare Medicare |
$60.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.30
|
| Rate for Payer: UHC Core |
$117.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$60.93
|
| Rate for Payer: UHC Exchange |
$117.30
|
| Rate for Payer: UHC Medicaid |
$39.19
|
| Rate for Payer: UHCCP Medicaid |
$39.19
|
| Rate for Payer: UMR Bronson Commercial |
$96.60
|
|
|
PR FERN TEST
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS Q0114
|
| Min. Negotiated Rate |
$2.76 |
| Max. Negotiated Rate |
$14.03 |
| Rate for Payer: Aetna Commercial |
$13.05
|
| Rate for Payer: Aetna Medicare |
$10.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.05
|
| Rate for Payer: BCBS MAPPO |
$9.74
|
| Rate for Payer: BCN Commercial |
$6.83
|
| Rate for Payer: BCN Medicare Advantage |
$9.74
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cofinity Commercial |
$14.03
|
| Rate for Payer: Cofinity Commercial |
$13.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.71
|
| Rate for Payer: Nomi Health Commercial |
$11.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.50
|
| Rate for Payer: PACE SWMI |
$9.74
|
| Rate for Payer: PHP Commercial |
$13.64
|
| Rate for Payer: PHP Medicare Advantage |
$9.74
|
| Rate for Payer: Priority Health Medicare |
$9.74
|
| Rate for Payer: Railroad Medicare Medicare |
$9.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.84
|
| Rate for Payer: UHC Core |
$5.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.74
|
| Rate for Payer: UHC Exchange |
$5.84
|
| Rate for Payer: UMR Bronson Commercial |
$2.76
|
|
|
PR FETAL CONTRACTION STRESS TEST
|
Professional
|
Both
|
$169.00
|
|
|
Service Code
|
HCPCS 59020
|
| Min. Negotiated Rate |
$69.71 |
| Max. Negotiated Rate |
$126.75 |
| Rate for Payer: Aetna Commercial |
$93.41
|
| Rate for Payer: Aetna Medicare |
$72.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.38
|
| Rate for Payer: BCBS MAPPO |
$69.71
|
| Rate for Payer: BCN Commercial |
$106.07
|
| Rate for Payer: BCN Medicare Advantage |
$69.71
|
| Rate for Payer: Cash Price |
$135.20
|
| Rate for Payer: Cash Price |
$135.20
|
| Rate for Payer: Cofinity Commercial |
$93.41
|
| Rate for Payer: Cofinity Commercial |
$100.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$76.68
|
| Rate for Payer: Nomi Health Commercial |
$83.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.75
|
| Rate for Payer: PACE SWMI |
$69.71
|
| Rate for Payer: PHP Commercial |
$97.59
|
| Rate for Payer: PHP Medicare Advantage |
$69.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$100.13
|
| Rate for Payer: Priority Health Medicare |
$69.71
|
| Rate for Payer: Priority Health SBD |
$100.13
|
| Rate for Payer: Priority Health Tiered Network |
$100.13
|
| Rate for Payer: Railroad Medicare Medicare |
$69.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.33
|
| Rate for Payer: UHC Core |
$119.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$69.71
|
| Rate for Payer: UHC Exchange |
$119.33
|
| Rate for Payer: UMR Bronson Commercial |
$77.74
|
|
|
PR FETAL FLUID DRAINAGE W/ULTRASOUND GUIDANCE
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 59074
|
| Min. Negotiated Rate |
$175.73 |
| Max. Negotiated Rate |
$650.25 |
| Rate for Payer: Aetna Commercial |
$372.77
|
| Rate for Payer: Aetna Medicare |
$289.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$400.59
|
| Rate for Payer: BCBS Complete |
$184.52
|
| Rate for Payer: BCBS MAPPO |
$278.19
|
| Rate for Payer: BCN Commercial |
$461.63
|
| Rate for Payer: BCN Medicare Advantage |
$278.19
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$372.77
|
| Rate for Payer: Cofinity Commercial |
$400.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.10
|
| Rate for Payer: Meridian Medicaid |
$184.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.01
|
| Rate for Payer: Nomi Health Commercial |
$333.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$650.25
|
| Rate for Payer: PACE SWMI |
$278.19
|
| Rate for Payer: PHP Commercial |
$389.47
|
| Rate for Payer: PHP Medicare Advantage |
$278.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$435.78
|
| Rate for Payer: Priority Health Medicare |
$278.19
|
| Rate for Payer: Priority Health SBD |
$435.78
|
| Rate for Payer: Priority Health Tiered Network |
$435.78
|
| Rate for Payer: Railroad Medicare Medicare |
$278.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$552.12
|
| Rate for Payer: UHC Core |
$552.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.19
|
| Rate for Payer: UHC Exchange |
$552.12
|
| Rate for Payer: UHC Medicaid |
$175.73
|
| Rate for Payer: UHCCP Medicaid |
$175.73
|
| Rate for Payer: UMR Bronson Commercial |
$398.82
|
|
|
PR FETAL NONSTRESS TEST
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS 59025
|
| Min. Negotiated Rate |
$48.30 |
| Max. Negotiated Rate |
$82.18 |
| Rate for Payer: Aetna Commercial |
$65.08
|
| Rate for Payer: Aetna Medicare |
$50.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.94
|
| Rate for Payer: BCBS MAPPO |
$48.57
|
| Rate for Payer: BCN Commercial |
$73.70
|
| Rate for Payer: BCN Medicare Advantage |
$48.57
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$65.08
|
| Rate for Payer: Cofinity Commercial |
$69.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.43
|
| Rate for Payer: Nomi Health Commercial |
$58.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.75
|
| Rate for Payer: PACE SWMI |
$48.57
|
| Rate for Payer: PHP Commercial |
$68.00
|
| Rate for Payer: PHP Medicare Advantage |
$48.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$69.57
|
| Rate for Payer: Priority Health Medicare |
$48.57
|
| Rate for Payer: Priority Health SBD |
$69.57
|
| Rate for Payer: Priority Health Tiered Network |
$69.57
|
| Rate for Payer: Railroad Medicare Medicare |
$48.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.18
|
| Rate for Payer: UHC Core |
$82.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$48.57
|
| Rate for Payer: UHC Exchange |
$82.18
|
| Rate for Payer: UMR Bronson Commercial |
$48.30
|
|
|
PR FETAL SHUNT PLACEMENT W/ULTRASOUND GUIDANCE
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 59076
|
| Min. Negotiated Rate |
$295.22 |
| Max. Negotiated Rate |
$934.43 |
| Rate for Payer: Aetna Commercial |
$627.68
|
| Rate for Payer: Aetna Medicare |
$487.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$627.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$674.52
|
| Rate for Payer: BCBS Complete |
$309.98
|
| Rate for Payer: BCBS MAPPO |
$468.42
|
| Rate for Payer: BCN Commercial |
$777.85
|
| Rate for Payer: BCN Medicare Advantage |
$468.42
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$674.52
|
| Rate for Payer: Cofinity Commercial |
$627.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$468.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$491.84
|
| Rate for Payer: Meridian Medicaid |
$309.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$515.26
|
| Rate for Payer: Nomi Health Commercial |
$562.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$823.50
|
| Rate for Payer: PACE SWMI |
$468.42
|
| Rate for Payer: PHP Commercial |
$655.79
|
| Rate for Payer: PHP Medicare Advantage |
$468.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$295.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$734.29
|
| Rate for Payer: Priority Health Medicare |
$468.42
|
| Rate for Payer: Priority Health SBD |
$734.29
|
| Rate for Payer: Priority Health Tiered Network |
$734.29
|
| Rate for Payer: Railroad Medicare Medicare |
$468.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$934.43
|
| Rate for Payer: UHC Core |
$934.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$468.42
|
| Rate for Payer: UHC Exchange |
$934.43
|
| Rate for Payer: UHC Medicaid |
$295.22
|
| Rate for Payer: UHCCP Medicaid |
$295.22
|
| Rate for Payer: UMR Bronson Commercial |
$505.08
|
|
|
PR FILLETED FINGER/TOE FLAP W/PREPJ RECIPIENT SITE
|
Professional
|
Both
|
$1,332.00
|
|
|
Service Code
|
HCPCS 14350
|
| Min. Negotiated Rate |
$392.13 |
| Max. Negotiated Rate |
$1,198.81 |
| Rate for Payer: Aetna Commercial |
$804.96
|
| Rate for Payer: Aetna Medicare |
$624.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$804.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$865.04
|
| Rate for Payer: BCBS Complete |
$411.74
|
| Rate for Payer: BCBS MAPPO |
$600.72
|
| Rate for Payer: BCN Commercial |
$1,001.94
|
| Rate for Payer: BCN Medicare Advantage |
$600.72
|
| Rate for Payer: Cash Price |
$1,065.60
|
| Rate for Payer: Cash Price |
$1,065.60
|
| Rate for Payer: Cofinity Commercial |
$804.96
|
| Rate for Payer: Cofinity Commercial |
$865.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$600.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$630.76
|
| Rate for Payer: Meridian Medicaid |
$411.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$660.79
|
| Rate for Payer: Nomi Health Commercial |
$720.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$999.00
|
| Rate for Payer: PACE SWMI |
$600.72
|
| Rate for Payer: PHP Commercial |
$841.01
|
| Rate for Payer: PHP Medicare Advantage |
$600.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$917.03
|
| Rate for Payer: Priority Health Medicare |
$600.72
|
| Rate for Payer: Priority Health SBD |
$917.03
|
| Rate for Payer: Priority Health Tiered Network |
$917.03
|
| Rate for Payer: Railroad Medicare Medicare |
$600.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,198.81
|
| Rate for Payer: UHC Core |
$1,198.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$600.72
|
| Rate for Payer: UHC Exchange |
$1,198.81
|
| Rate for Payer: UHC Medicaid |
$392.13
|
| Rate for Payer: UHCCP Medicaid |
$392.13
|
| Rate for Payer: UMR Bronson Commercial |
$612.72
|
|
|
PR FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION
|
Professional
|
Both
|
$273.00
|
|
|
Service Code
|
HCPCS 10009
|
| Min. Negotiated Rate |
$59.43 |
| Max. Negotiated Rate |
$204.75 |
| Rate for Payer: Aetna Commercial |
$124.79
|
| Rate for Payer: Aetna Commercial |
$124.79
|
| Rate for Payer: Aetna Medicare |
$96.86
|
| Rate for Payer: Aetna Medicare |
$96.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.11
|
| Rate for Payer: BCBS Complete |
$62.40
|
| Rate for Payer: BCBS Complete |
$62.40
|
| Rate for Payer: BCBS MAPPO |
$93.13
|
| Rate for Payer: BCBS MAPPO |
$93.13
|
| Rate for Payer: BCN Commercial |
$126.06
|
| Rate for Payer: BCN Commercial |
$126.06
|
| Rate for Payer: BCN Medicare Advantage |
$93.13
|
| Rate for Payer: BCN Medicare Advantage |
$93.13
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cash Price |
$606.40
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cash Price |
$606.40
|
| Rate for Payer: Cofinity Commercial |
$124.79
|
| Rate for Payer: Cofinity Commercial |
$134.11
|
| Rate for Payer: Cofinity Commercial |
$124.79
|
| Rate for Payer: Cofinity Commercial |
$134.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.79
|
| Rate for Payer: Meridian Medicaid |
$62.40
|
| Rate for Payer: Meridian Medicaid |
$62.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$102.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$102.44
|
| Rate for Payer: Nomi Health Commercial |
$111.76
|
| Rate for Payer: Nomi Health Commercial |
$111.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$568.50
|
| Rate for Payer: PACE SWMI |
$93.13
|
| Rate for Payer: PACE SWMI |
$93.13
|
| Rate for Payer: PHP Commercial |
$130.38
|
| Rate for Payer: PHP Commercial |
$130.38
|
| Rate for Payer: PHP Medicare Advantage |
$93.13
|
| Rate for Payer: PHP Medicare Advantage |
$93.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$146.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$146.30
|
| Rate for Payer: Priority Health Medicare |
$93.13
|
| Rate for Payer: Priority Health Medicare |
$93.13
|
| Rate for Payer: Priority Health SBD |
$146.30
|
| Rate for Payer: Priority Health SBD |
$146.30
|
| Rate for Payer: Priority Health Tiered Network |
$146.30
|
| Rate for Payer: Priority Health Tiered Network |
$146.30
|
| Rate for Payer: Railroad Medicare Medicare |
$93.13
|
| Rate for Payer: Railroad Medicare Medicare |
$93.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.68
|
| Rate for Payer: UHC Core |
$201.68
|
| Rate for Payer: UHC Core |
$201.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$93.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$93.13
|
| Rate for Payer: UHC Exchange |
$201.68
|
| Rate for Payer: UHC Exchange |
$201.68
|
| Rate for Payer: UHC Medicaid |
$59.43
|
| Rate for Payer: UHC Medicaid |
$59.43
|
| Rate for Payer: UHCCP Medicaid |
$59.43
|
| Rate for Payer: UHCCP Medicaid |
$59.43
|
| Rate for Payer: UMR Bronson Commercial |
$125.58
|
| Rate for Payer: UMR Bronson Commercial |
$348.68
|
|
