|
PR HOME SLEEP TEST/TYPE 3 PORTA
|
Professional
|
Both
|
$366.00
|
|
|
Service Code
|
HCPCS G0399
|
| Min. Negotiated Rate |
$131.80 |
| Max. Negotiated Rate |
$328.38 |
| Rate for Payer: Aetna Commercial |
$187.42
|
| Rate for Payer: Aetna Medicare |
$183.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.42
|
| Rate for Payer: BCBS Complete |
$146.40
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$131.80
|
| Rate for Payer: Priority Health SBD |
$131.80
|
| Rate for Payer: Priority Health Tiered Network |
$131.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.38
|
| Rate for Payer: UHC Core |
$328.38
|
| Rate for Payer: UHC Exchange |
$328.38
|
| Rate for Payer: UMR Bronson Commercial |
$168.36
|
|
|
PR HOME SLEEP TEST/TYPE 4 PORTA
|
Professional
|
Both
|
$366.00
|
|
|
Service Code
|
HCPCS G0400
|
| Min. Negotiated Rate |
$146.40 |
| Max. Negotiated Rate |
$328.38 |
| Rate for Payer: Aetna Commercial |
$162.24
|
| Rate for Payer: Aetna Commercial |
$162.24
|
| Rate for Payer: Aetna Commercial |
$162.24
|
| Rate for Payer: Aetna Medicare |
$107.50
|
| Rate for Payer: Aetna Medicare |
$183.00
|
| Rate for Payer: Aetna Medicare |
$75.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.24
|
| Rate for Payer: BCBS Complete |
$86.00
|
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: BCBS Complete |
$146.40
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$112.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$157.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$157.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$157.07
|
| Rate for Payer: Priority Health SBD |
$157.07
|
| Rate for Payer: Priority Health SBD |
$157.07
|
| Rate for Payer: Priority Health SBD |
$157.07
|
| Rate for Payer: Priority Health Tiered Network |
$157.07
|
| Rate for Payer: Priority Health Tiered Network |
$157.07
|
| Rate for Payer: Priority Health Tiered Network |
$157.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.38
|
| Rate for Payer: UHC Core |
$328.38
|
| Rate for Payer: UHC Core |
$328.38
|
| Rate for Payer: UHC Core |
$328.38
|
| Rate for Payer: UHC Exchange |
$328.38
|
| Rate for Payer: UHC Exchange |
$328.38
|
| Rate for Payer: UHC Exchange |
$328.38
|
| Rate for Payer: UMR Bronson Commercial |
$69.00
|
| Rate for Payer: UMR Bronson Commercial |
$98.90
|
| Rate for Payer: UMR Bronson Commercial |
$168.36
|
|
|
PR HOME VENTILATOR MGMT CARE OVERSIGHT 30 MIN/>
|
Professional
|
Both
|
$197.00
|
|
|
Service Code
|
HCPCS 94005
|
| Min. Negotiated Rate |
$78.80 |
| Max. Negotiated Rate |
$147.77 |
| Rate for Payer: Aetna Commercial |
$100.62
|
| Rate for Payer: Aetna Medicare |
$98.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.62
|
| Rate for Payer: BCBS Complete |
$78.80
|
| Rate for Payer: BCN Commercial |
$134.95
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$147.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$124.46
|
| Rate for Payer: Priority Health SBD |
$124.46
|
| Rate for Payer: Priority Health Tiered Network |
$124.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.77
|
| Rate for Payer: UHC Core |
$147.77
|
| Rate for Payer: UHC Exchange |
$147.77
|
| Rate for Payer: UMR Bronson Commercial |
$90.62
|
|
|
PR HOME VST NEW PATIENT MOD-HI SEVERITY 45 MINUTES
|
Professional
|
Both
|
$246.00
|
|
|
Service Code
|
HCPCS 99343
|
| Min. Negotiated Rate |
$98.40 |
| Max. Negotiated Rate |
$184.50 |
| Rate for Payer: Aetna Medicare |
$123.00
|
| Rate for Payer: BCBS Complete |
$98.40
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$184.50
|
| Rate for Payer: UMR Bronson Commercial |
$113.16
|
|
|
PR HOPD MNTL HLT, 15-29 MIN
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS C7900
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: Aetna Medicare |
$26.50
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: UMR Bronson Commercial |
$24.38
|
|
|
PR HOPD MNTL HLT, 30-60 MIN
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS C7901
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: Aetna Medicare |
$26.50
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: UMR Bronson Commercial |
$24.38
|
|
|
PR HOPD MNTL HLT, EA ADDL
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS C7902
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: Aetna Medicare |
$26.50
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: UMR Bronson Commercial |
$24.38
|
|
|
PR HOSPICE CARE SUPERVISION
|
Professional
|
Both
|
$197.00
|
|
|
Service Code
|
HCPCS G0182
|
| Min. Negotiated Rate |
$78.80 |
| Max. Negotiated Rate |
$170.71 |
| Rate for Payer: Aetna Commercial |
$140.70
|
| Rate for Payer: Aetna Medicare |
$109.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.20
|
| Rate for Payer: BCBS Complete |
$78.80
|
| Rate for Payer: BCBS MAPPO |
$105.00
|
| Rate for Payer: BCN Commercial |
$155.37
|
| Rate for Payer: BCN Medicare Advantage |
$105.00
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$151.20
|
| Rate for Payer: Cofinity Commercial |
$140.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$115.50
|
| Rate for Payer: Nomi Health Commercial |
$126.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$147.75
|
| Rate for Payer: PACE SWMI |
$105.00
|
| Rate for Payer: PHP Commercial |
$147.00
|
| Rate for Payer: PHP Medicare Advantage |
$105.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$143.28
|
| Rate for Payer: Priority Health Medicare |
$105.00
|
| Rate for Payer: Priority Health SBD |
$143.28
|
| Rate for Payer: Priority Health Tiered Network |
$143.28
|
| Rate for Payer: Railroad Medicare Medicare |
$105.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.71
|
| Rate for Payer: UHC Core |
$170.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$105.00
|
| Rate for Payer: UHC Exchange |
$170.71
|
| Rate for Payer: UMR Bronson Commercial |
$90.62
|
|
|
PR HOSPITAL IP/OBS CARE SAME DATE HIGH MDM 85 MIN
|
Professional
|
Both
|
$404.00
|
|
|
Service Code
|
HCPCS 99236
|
| Min. Negotiated Rate |
$120.98 |
| Max. Negotiated Rate |
$307.50 |
| Rate for Payer: Aetna Commercial |
$252.32
|
| Rate for Payer: Aetna Medicare |
$195.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.15
|
| Rate for Payer: BCBS Complete |
$127.03
|
| Rate for Payer: BCBS MAPPO |
$188.30
|
| Rate for Payer: BCN Commercial |
$307.25
|
| Rate for Payer: BCN Medicare Advantage |
$188.30
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cofinity Commercial |
$271.15
|
| Rate for Payer: Cofinity Commercial |
$252.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.72
|
| Rate for Payer: Meridian Medicaid |
$127.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$207.13
|
| Rate for Payer: Nomi Health Commercial |
$225.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.00
|
| Rate for Payer: PACE SWMI |
$188.30
|
| Rate for Payer: PHP Commercial |
$263.62
|
| Rate for Payer: PHP Medicare Advantage |
$188.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$276.38
|
| Rate for Payer: Priority Health Medicare |
$188.30
|
| Rate for Payer: Priority Health SBD |
$276.38
|
| Rate for Payer: Priority Health Tiered Network |
$276.38
|
| Rate for Payer: Railroad Medicare Medicare |
$188.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.50
|
| Rate for Payer: UHC Core |
$307.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$188.30
|
| Rate for Payer: UHC Exchange |
$307.50
|
| Rate for Payer: UHC Medicaid |
$120.98
|
| Rate for Payer: UHCCP Medicaid |
$120.98
|
| Rate for Payer: UMR Bronson Commercial |
$185.84
|
|
|
PR HOSPITAL IP/OBS CARE SAME DATE MOD MDM 70 MIN
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 99235
|
| Min. Negotiated Rate |
$91.16 |
| Max. Negotiated Rate |
$243.75 |
| Rate for Payer: Aetna Commercial |
$189.93
|
| Rate for Payer: Aetna Medicare |
$147.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.11
|
| Rate for Payer: BCBS Complete |
$95.72
|
| Rate for Payer: BCBS MAPPO |
$141.74
|
| Rate for Payer: BCN Commercial |
$235.05
|
| Rate for Payer: BCN Medicare Advantage |
$141.74
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$189.93
|
| Rate for Payer: Cofinity Commercial |
$204.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$148.83
|
| Rate for Payer: Meridian Medicaid |
$95.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$155.91
|
| Rate for Payer: Nomi Health Commercial |
$170.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: PACE SWMI |
$141.74
|
| Rate for Payer: PHP Commercial |
$198.44
|
| Rate for Payer: PHP Medicare Advantage |
$141.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$211.43
|
| Rate for Payer: Priority Health Medicare |
$141.74
|
| Rate for Payer: Priority Health SBD |
$211.43
|
| Rate for Payer: Priority Health Tiered Network |
$211.43
|
| Rate for Payer: Railroad Medicare Medicare |
$141.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.77
|
| Rate for Payer: UHC Core |
$238.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$141.74
|
| Rate for Payer: UHC Exchange |
$238.77
|
| Rate for Payer: UHC Medicaid |
$91.16
|
| Rate for Payer: UHCCP Medicaid |
$91.16
|
| Rate for Payer: UMR Bronson Commercial |
$149.50
|
|
|
PR HOSPITAL IP/OBS CARE SAME DATE SF/LOW MDM 45 MIN
|
Professional
|
Both
|
$248.00
|
|
|
Service Code
|
HCPCS 99234
|
| Min. Negotiated Rate |
$56.23 |
| Max. Negotiated Rate |
$188.83 |
| Rate for Payer: Aetna Commercial |
$117.41
|
| Rate for Payer: Aetna Medicare |
$91.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.17
|
| Rate for Payer: BCBS Complete |
$59.04
|
| Rate for Payer: BCBS MAPPO |
$87.62
|
| Rate for Payer: BCN Commercial |
$144.41
|
| Rate for Payer: BCN Medicare Advantage |
$87.62
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cofinity Commercial |
$117.41
|
| Rate for Payer: Cofinity Commercial |
$126.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.00
|
| Rate for Payer: Meridian Medicaid |
$59.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$96.38
|
| Rate for Payer: Nomi Health Commercial |
$105.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.00
|
| Rate for Payer: PACE SWMI |
$87.62
|
| Rate for Payer: PHP Commercial |
$122.67
|
| Rate for Payer: PHP Medicare Advantage |
$87.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$129.90
|
| Rate for Payer: Priority Health Medicare |
$87.62
|
| Rate for Payer: Priority Health SBD |
$129.90
|
| Rate for Payer: Priority Health Tiered Network |
$129.90
|
| Rate for Payer: Railroad Medicare Medicare |
$87.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.83
|
| Rate for Payer: UHC Core |
$188.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$87.62
|
| Rate for Payer: UHC Exchange |
$188.83
|
| Rate for Payer: UHC Medicaid |
$56.23
|
| Rate for Payer: UHCCP Medicaid |
$56.23
|
| Rate for Payer: UMR Bronson Commercial |
$114.08
|
|
|
PR HOSPITAL IP/OBS DISCHARGE DAY MGMT > 30 MIN
|
Professional
|
Both
|
$263.00
|
|
|
Service Code
|
HCPCS 99239
|
| Min. Negotiated Rate |
$67.95 |
| Max. Negotiated Rate |
$197.25 |
| Rate for Payer: Aetna Commercial |
$140.27
|
| Rate for Payer: Aetna Medicare |
$108.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.74
|
| Rate for Payer: BCBS Complete |
$71.35
|
| Rate for Payer: BCBS MAPPO |
$104.68
|
| Rate for Payer: BCN Commercial |
$170.31
|
| Rate for Payer: BCN Medicare Advantage |
$104.68
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cofinity Commercial |
$140.27
|
| Rate for Payer: Cofinity Commercial |
$150.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.91
|
| Rate for Payer: Meridian Medicaid |
$71.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$115.15
|
| Rate for Payer: Nomi Health Commercial |
$125.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.25
|
| Rate for Payer: PACE SWMI |
$104.68
|
| Rate for Payer: PHP Commercial |
$146.55
|
| Rate for Payer: PHP Medicare Advantage |
$104.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$153.21
|
| Rate for Payer: Priority Health Medicare |
$104.68
|
| Rate for Payer: Priority Health SBD |
$153.21
|
| Rate for Payer: Priority Health Tiered Network |
$153.21
|
| Rate for Payer: Railroad Medicare Medicare |
$104.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.41
|
| Rate for Payer: UHC Core |
$150.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.68
|
| Rate for Payer: UHC Exchange |
$150.41
|
| Rate for Payer: UHC Medicaid |
$67.95
|
| Rate for Payer: UHCCP Medicaid |
$67.95
|
| Rate for Payer: UMR Bronson Commercial |
$120.98
|
|
|
PR HOSPITAL IP/OBS DISCHARGE DAY MGMT 30 MIN/<
|
Professional
|
Both
|
$142.00
|
|
|
Service Code
|
HCPCS 99238
|
| Min. Negotiated Rate |
$47.71 |
| Max. Negotiated Rate |
$120.51 |
| Rate for Payer: Aetna Commercial |
$98.53
|
| Rate for Payer: Aetna Medicare |
$76.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.53
|
| Rate for Payer: BCBS Complete |
$50.10
|
| Rate for Payer: BCBS MAPPO |
$73.53
|
| Rate for Payer: BCN Commercial |
$120.51
|
| Rate for Payer: BCN Medicare Advantage |
$73.53
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cofinity Commercial |
$105.88
|
| Rate for Payer: Cofinity Commercial |
$98.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.21
|
| Rate for Payer: Meridian Medicaid |
$50.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$80.88
|
| Rate for Payer: Nomi Health Commercial |
$88.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.50
|
| Rate for Payer: PACE SWMI |
$73.53
|
| Rate for Payer: PHP Commercial |
$102.94
|
| Rate for Payer: PHP Medicare Advantage |
$73.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$108.40
|
| Rate for Payer: Priority Health Medicare |
$73.53
|
| Rate for Payer: Priority Health SBD |
$108.40
|
| Rate for Payer: Priority Health Tiered Network |
$108.40
|
| Rate for Payer: Railroad Medicare Medicare |
$73.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.55
|
| Rate for Payer: UHC Core |
$102.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$73.53
|
| Rate for Payer: UHC Exchange |
$102.55
|
| Rate for Payer: UHC Medicaid |
$47.71
|
| Rate for Payer: UHCCP Medicaid |
$47.71
|
| Rate for Payer: UMR Bronson Commercial |
$65.32
|
|
|
PR HO W/O JOINTS CF
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS L3919
|
| Min. Negotiated Rate |
$98.77 |
| Max. Negotiated Rate |
$436.18 |
| Rate for Payer: Aetna Commercial |
$405.89
|
| Rate for Payer: Aetna Medicare |
$315.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.18
|
| Rate for Payer: BCBS Complete |
$104.40
|
| Rate for Payer: BCBS MAPPO |
$302.90
|
| Rate for Payer: BCN Commercial |
$290.00
|
| Rate for Payer: BCN Medicare Advantage |
$302.90
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cofinity Commercial |
$405.89
|
| Rate for Payer: Cofinity Commercial |
$436.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.19
|
| Rate for Payer: Nomi Health Commercial |
$363.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.75
|
| Rate for Payer: PACE SWMI |
$302.90
|
| Rate for Payer: PHP Commercial |
$424.06
|
| Rate for Payer: PHP Medicare Advantage |
$302.90
|
| Rate for Payer: Priority Health Medicare |
$302.90
|
| Rate for Payer: Railroad Medicare Medicare |
$302.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.77
|
| Rate for Payer: UHC Core |
$98.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$302.90
|
| Rate for Payer: UHC Exchange |
$98.77
|
| Rate for Payer: UMR Bronson Commercial |
$120.06
|
|
|
PR HRHC 1 COL/GRP W/FSTULECTMY INCL FSSRECTOMY
|
Professional
|
Both
|
$1,217.00
|
|
|
Service Code
|
HCPCS 46258
|
| Min. Negotiated Rate |
$306.72 |
| Max. Negotiated Rate |
$912.75 |
| Rate for Payer: Aetna Commercial |
$628.92
|
| Rate for Payer: Aetna Medicare |
$488.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$675.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$628.92
|
| Rate for Payer: BCBS Complete |
$322.06
|
| Rate for Payer: BCBS MAPPO |
$469.34
|
| Rate for Payer: BCN Commercial |
$734.02
|
| Rate for Payer: BCN Medicare Advantage |
$469.34
|
| Rate for Payer: Cash Price |
$973.60
|
| Rate for Payer: Cash Price |
$973.60
|
| Rate for Payer: Cofinity Commercial |
$675.85
|
| Rate for Payer: Cofinity Commercial |
$628.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$469.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$492.81
|
| Rate for Payer: Meridian Medicaid |
$322.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$516.27
|
| Rate for Payer: Nomi Health Commercial |
$563.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$912.75
|
| Rate for Payer: PACE SWMI |
$469.34
|
| Rate for Payer: PHP Commercial |
$657.08
|
| Rate for Payer: PHP Medicare Advantage |
$469.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$306.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$894.37
|
| Rate for Payer: Priority Health Medicare |
$469.34
|
| Rate for Payer: Priority Health SBD |
$894.37
|
| Rate for Payer: Priority Health Tiered Network |
$894.37
|
| Rate for Payer: Railroad Medicare Medicare |
$469.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$830.76
|
| Rate for Payer: UHC Core |
$830.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$469.34
|
| Rate for Payer: UHC Exchange |
$830.76
|
| Rate for Payer: UHC Medicaid |
$306.72
|
| Rate for Payer: UHCCP Medicaid |
$306.72
|
| Rate for Payer: UMR Bronson Commercial |
$559.82
|
|
|
PR HRHC 2/> COL/GRP W/FSTULECTMY INCL FSSRECTMY
|
Professional
|
Both
|
$1,828.00
|
|
|
Service Code
|
HCPCS 46262
|
| Min. Negotiated Rate |
$374.88 |
| Max. Negotiated Rate |
$1,371.00 |
| Rate for Payer: Aetna Commercial |
$769.13
|
| Rate for Payer: Aetna Medicare |
$596.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$769.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$826.53
|
| Rate for Payer: BCBS Complete |
$393.62
|
| Rate for Payer: BCBS MAPPO |
$573.98
|
| Rate for Payer: BCN Commercial |
$892.38
|
| Rate for Payer: BCN Medicare Advantage |
$573.98
|
| Rate for Payer: Cash Price |
$1,462.40
|
| Rate for Payer: Cash Price |
$1,462.40
|
| Rate for Payer: Cofinity Commercial |
$769.13
|
| Rate for Payer: Cofinity Commercial |
$826.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$573.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$602.68
|
| Rate for Payer: Meridian Medicaid |
$393.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$631.38
|
| Rate for Payer: Nomi Health Commercial |
$688.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,371.00
|
| Rate for Payer: PACE SWMI |
$573.98
|
| Rate for Payer: PHP Commercial |
$803.57
|
| Rate for Payer: PHP Medicare Advantage |
$573.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,087.31
|
| Rate for Payer: Priority Health Medicare |
$573.98
|
| Rate for Payer: Priority Health SBD |
$1,087.31
|
| Rate for Payer: Priority Health Tiered Network |
$1,087.31
|
| Rate for Payer: Railroad Medicare Medicare |
$573.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$972.90
|
| Rate for Payer: UHC Core |
$972.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$573.98
|
| Rate for Payer: UHC Exchange |
$972.90
|
| Rate for Payer: UHC Medicaid |
$374.88
|
| Rate for Payer: UHCCP Medicaid |
$374.88
|
| Rate for Payer: UMR Bronson Commercial |
$840.88
|
|
|
PR HRHC NTRNL & XTRNL 2/> COLUMN/GROUP W/FISSU
|
Professional
|
Both
|
$1,784.00
|
|
|
Service Code
|
HCPCS 46261
|
| Min. Negotiated Rate |
$328.66 |
| Max. Negotiated Rate |
$1,338.00 |
| Rate for Payer: Aetna Commercial |
$673.91
|
| Rate for Payer: Aetna Medicare |
$523.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$673.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$724.20
|
| Rate for Payer: BCBS Complete |
$345.09
|
| Rate for Payer: BCBS MAPPO |
$502.92
|
| Rate for Payer: BCN Commercial |
$806.73
|
| Rate for Payer: BCN Medicare Advantage |
$502.92
|
| Rate for Payer: Cash Price |
$1,427.20
|
| Rate for Payer: Cash Price |
$1,427.20
|
| Rate for Payer: Cofinity Commercial |
$673.91
|
| Rate for Payer: Cofinity Commercial |
$724.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$502.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$528.07
|
| Rate for Payer: Meridian Medicaid |
$345.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$553.21
|
| Rate for Payer: Nomi Health Commercial |
$603.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,338.00
|
| Rate for Payer: PACE SWMI |
$502.92
|
| Rate for Payer: PHP Commercial |
$704.09
|
| Rate for Payer: PHP Medicare Advantage |
$502.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$328.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$982.94
|
| Rate for Payer: Priority Health Medicare |
$502.92
|
| Rate for Payer: Priority Health SBD |
$982.94
|
| Rate for Payer: Priority Health Tiered Network |
$982.94
|
| Rate for Payer: Railroad Medicare Medicare |
$502.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$919.45
|
| Rate for Payer: UHC Core |
$919.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$502.92
|
| Rate for Payer: UHC Exchange |
$919.45
|
| Rate for Payer: UHC Medicaid |
$328.66
|
| Rate for Payer: UHCCP Medicaid |
$328.66
|
| Rate for Payer: UMR Bronson Commercial |
$820.64
|
|
|
PR HRV SKIN FOR SKIN CELL SSP AGRFT 1ST 25 SQ CM/<
|
Professional
|
Both
|
$2,449.00
|
|
|
Service Code
|
HCPCS 15011
|
| Min. Negotiated Rate |
$66.70 |
| Max. Negotiated Rate |
$2,744.01 |
| Rate for Payer: Aetna Medicare |
$1,224.50
|
| Rate for Payer: BCBS Complete |
$70.03
|
| Rate for Payer: BCN Commercial |
$1,710.33
|
| Rate for Payer: Cash Price |
$1,959.20
|
| Rate for Payer: Cash Price |
$1,959.20
|
| Rate for Payer: Meridian Medicaid |
$70.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,836.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,744.01
|
| Rate for Payer: Priority Health SBD |
$2,744.01
|
| Rate for Payer: Priority Health Tiered Network |
$2,744.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.53
|
| Rate for Payer: UHC Core |
$133.53
|
| Rate for Payer: UHC Exchange |
$133.53
|
| Rate for Payer: UHC Medicaid |
$66.70
|
| Rate for Payer: UHCCP Medicaid |
$66.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,126.54
|
|
|
PR HRV SKIN FOR SKIN CELL SSP AGRFT EA ADDL 25 SQCM
|
Professional
|
Both
|
$2,449.00
|
|
|
Service Code
|
HCPCS 15012
|
| Min. Negotiated Rate |
$62.85 |
| Max. Negotiated Rate |
$1,836.75 |
| Rate for Payer: Aetna Medicare |
$1,224.50
|
| Rate for Payer: BCBS Complete |
$70.03
|
| Rate for Payer: Cash Price |
$1,959.20
|
| Rate for Payer: Cash Price |
$1,959.20
|
| Rate for Payer: Meridian Medicaid |
$70.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,836.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.85
|
| Rate for Payer: UHC Core |
$62.85
|
| Rate for Payer: UHC Exchange |
$62.85
|
| Rate for Payer: UHC Medicaid |
$66.70
|
| Rate for Payer: UHCCP Medicaid |
$66.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,126.54
|
|
|
PR HYALGAN SUPARTZ VISCO-3 DOSE
|
Professional
|
Both
|
$312.00
|
|
|
Service Code
|
HCPCS J7321
|
| Min. Negotiated Rate |
$64.00 |
| Max. Negotiated Rate |
$234.00 |
| Rate for Payer: Aetna Commercial |
$99.74
|
| Rate for Payer: Aetna Medicare |
$77.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.18
|
| Rate for Payer: BCBS MAPPO |
$74.43
|
| Rate for Payer: BCBS Trust/PPO |
$64.00
|
| Rate for Payer: BCN Commercial |
$76.58
|
| Rate for Payer: BCN Medicare Advantage |
$74.43
|
| Rate for Payer: Cash Price |
$249.60
|
| Rate for Payer: Cash Price |
$249.60
|
| Rate for Payer: Cofinity Commercial |
$99.74
|
| Rate for Payer: Cofinity Commercial |
$107.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$81.87
|
| Rate for Payer: Nomi Health Commercial |
$89.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.00
|
| Rate for Payer: PACE SWMI |
$74.43
|
| Rate for Payer: PHP Commercial |
$104.20
|
| Rate for Payer: PHP Medicare Advantage |
$74.43
|
| Rate for Payer: Priority Health Medicare |
$74.43
|
| Rate for Payer: Railroad Medicare Medicare |
$74.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.97
|
| Rate for Payer: UHC Core |
$72.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$74.43
|
| Rate for Payer: UHC Exchange |
$72.97
|
| Rate for Payer: UMR Bronson Commercial |
$143.52
|
|
|
PR HYDROCORTISONE SODIUM SUCC I
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J1720
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$31.88 |
| Rate for Payer: Aetna Commercial |
$29.67
|
| Rate for Payer: Aetna Medicare |
$23.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.88
|
| Rate for Payer: BCBS MAPPO |
$22.14
|
| Rate for Payer: BCBS Trust/PPO |
$18.00
|
| Rate for Payer: BCN Commercial |
$17.66
|
| Rate for Payer: BCN Medicare Advantage |
$22.14
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$31.88
|
| Rate for Payer: Cofinity Commercial |
$29.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.35
|
| Rate for Payer: Nomi Health Commercial |
$26.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.50
|
| Rate for Payer: PACE SWMI |
$22.14
|
| Rate for Payer: PHP Commercial |
$31.00
|
| Rate for Payer: PHP Medicare Advantage |
$22.14
|
| Rate for Payer: Priority Health Medicare |
$22.14
|
| Rate for Payer: Railroad Medicare Medicare |
$22.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.06
|
| Rate for Payer: UHC Core |
$22.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.14
|
| Rate for Payer: UHC Exchange |
$22.06
|
| Rate for Payer: UMR Bronson Commercial |
$4.60
|
|
|
PR HYDROMORPHONE INJECTION
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS J1170
|
| Min. Negotiated Rate |
$0.21 |
| Max. Negotiated Rate |
$4.73 |
| Rate for Payer: Aetna Commercial |
$4.73
|
| Rate for Payer: Aetna Medicare |
$2.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.73
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: BCN Commercial |
$0.21
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.75
|
| Rate for Payer: UMR Bronson Commercial |
$2.30
|
|
|
PR HYDROXYPROGESTERONE CAPROATE
|
Professional
|
Both
|
$3.00
|
|
|
Service Code
|
HCPCS J1725
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$2.25 |
| Rate for Payer: Aetna Medicare |
$1.50
|
| Rate for Payer: BCBS Complete |
$1.20
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.25
|
| Rate for Payer: UMR Bronson Commercial |
$1.38
|
|
|
PR HYDROXYZINE HCL INJECTION
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS J3410
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$21.84 |
| Rate for Payer: Aetna Commercial |
$20.33
|
| Rate for Payer: Aetna Medicare |
$15.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.33
|
| Rate for Payer: BCBS MAPPO |
$15.17
|
| Rate for Payer: BCBS Trust/PPO |
$8.65
|
| Rate for Payer: BCN Commercial |
$10.67
|
| Rate for Payer: BCN Medicare Advantage |
$15.17
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$20.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.69
|
| Rate for Payer: Nomi Health Commercial |
$18.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.25
|
| Rate for Payer: PACE SWMI |
$15.17
|
| Rate for Payer: PHP Commercial |
$21.24
|
| Rate for Payer: PHP Medicare Advantage |
$15.17
|
| Rate for Payer: Priority Health Medicare |
$15.17
|
| Rate for Payer: Railroad Medicare Medicare |
$15.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.00
|
| Rate for Payer: UHC Core |
$13.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.17
|
| Rate for Payer: UHC Exchange |
$13.00
|
| Rate for Payer: UMR Bronson Commercial |
$6.90
|
|
|
PR HYMENOTOMY SIMPLE INCISION
|
Professional
|
Both
|
$161.00
|
|
|
Service Code
|
HCPCS 56442
|
| Min. Negotiated Rate |
$27.90 |
| Max. Negotiated Rate |
$120.75 |
| Rate for Payer: Aetna Commercial |
$57.26
|
| Rate for Payer: Aetna Medicare |
$44.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.53
|
| Rate for Payer: BCBS Complete |
$29.30
|
| Rate for Payer: BCBS MAPPO |
$42.73
|
| Rate for Payer: BCN Commercial |
$72.21
|
| Rate for Payer: BCN Medicare Advantage |
$42.73
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$57.26
|
| Rate for Payer: Cofinity Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.87
|
| Rate for Payer: Meridian Medicaid |
$29.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.00
|
| Rate for Payer: Nomi Health Commercial |
$51.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.75
|
| Rate for Payer: PACE SWMI |
$42.73
|
| Rate for Payer: PHP Commercial |
$59.82
|
| Rate for Payer: PHP Medicare Advantage |
$42.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$73.13
|
| Rate for Payer: Priority Health Medicare |
$42.73
|
| Rate for Payer: Priority Health SBD |
$73.13
|
| Rate for Payer: Priority Health Tiered Network |
$73.13
|
| Rate for Payer: Railroad Medicare Medicare |
$42.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.35
|
| Rate for Payer: UHC Core |
$82.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$42.73
|
| Rate for Payer: UHC Exchange |
$82.35
|
| Rate for Payer: UHC Medicaid |
$27.90
|
| Rate for Payer: UHCCP Medicaid |
$27.90
|
| Rate for Payer: UMR Bronson Commercial |
$74.06
|
|
