|
PR I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$639.00
|
|
|
Service Code
|
HCPCS 23930
|
| Min. Negotiated Rate |
$130.78 |
| Max. Negotiated Rate |
$479.25 |
| Rate for Payer: Aetna Commercial |
$268.17
|
| Rate for Payer: Aetna Medicare |
$208.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.19
|
| Rate for Payer: BCBS Complete |
$137.32
|
| Rate for Payer: BCBS MAPPO |
$200.13
|
| Rate for Payer: BCN Commercial |
$329.17
|
| Rate for Payer: BCN Medicare Advantage |
$200.13
|
| Rate for Payer: Cash Price |
$511.20
|
| Rate for Payer: Cash Price |
$511.20
|
| Rate for Payer: Cofinity Commercial |
$268.17
|
| Rate for Payer: Cofinity Commercial |
$288.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$210.14
|
| Rate for Payer: Meridian Medicaid |
$137.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$220.14
|
| Rate for Payer: Nomi Health Commercial |
$240.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$479.25
|
| Rate for Payer: PACE SWMI |
$200.13
|
| Rate for Payer: PHP Commercial |
$280.18
|
| Rate for Payer: PHP Medicare Advantage |
$200.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$351.87
|
| Rate for Payer: Priority Health Medicare |
$200.13
|
| Rate for Payer: Priority Health SBD |
$351.87
|
| Rate for Payer: Priority Health Tiered Network |
$351.87
|
| Rate for Payer: Railroad Medicare Medicare |
$200.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$370.60
|
| Rate for Payer: UHC Core |
$370.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$200.13
|
| Rate for Payer: UHC Exchange |
$370.60
|
| Rate for Payer: UHC Medicaid |
$130.78
|
| Rate for Payer: UHCCP Medicaid |
$130.78
|
| Rate for Payer: UMR Bronson Commercial |
$293.94
|
|
|
PR I&D VAGINAL HEMATOMA NON-OBSTETRICAL
|
Professional
|
Both
|
$542.00
|
|
|
Service Code
|
HCPCS 57023
|
| Min. Negotiated Rate |
$180.62 |
| Max. Negotiated Rate |
$558.24 |
| Rate for Payer: Aetna Commercial |
$374.78
|
| Rate for Payer: Aetna Medicare |
$290.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.75
|
| Rate for Payer: BCBS Complete |
$189.65
|
| Rate for Payer: BCBS MAPPO |
$279.69
|
| Rate for Payer: BCN Commercial |
$480.06
|
| Rate for Payer: BCN Medicare Advantage |
$279.69
|
| Rate for Payer: Cash Price |
$433.60
|
| Rate for Payer: Cash Price |
$433.60
|
| Rate for Payer: Cofinity Commercial |
$374.78
|
| Rate for Payer: Cofinity Commercial |
$402.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.67
|
| Rate for Payer: Meridian Medicaid |
$189.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$307.66
|
| Rate for Payer: Nomi Health Commercial |
$335.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$406.50
|
| Rate for Payer: PACE SWMI |
$279.69
|
| Rate for Payer: PHP Commercial |
$391.57
|
| Rate for Payer: PHP Medicare Advantage |
$279.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$180.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$486.19
|
| Rate for Payer: Priority Health Medicare |
$279.69
|
| Rate for Payer: Priority Health SBD |
$486.19
|
| Rate for Payer: Priority Health Tiered Network |
$486.19
|
| Rate for Payer: Railroad Medicare Medicare |
$279.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$558.24
|
| Rate for Payer: UHC Core |
$558.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$279.69
|
| Rate for Payer: UHC Exchange |
$558.24
|
| Rate for Payer: UHC Medicaid |
$180.62
|
| Rate for Payer: UHCCP Medicaid |
$180.62
|
| Rate for Payer: UMR Bronson Commercial |
$249.32
|
|
|
PR I&D VAGINAL HEMATOMA OBSTETRICAL/POSTPARTUM
|
Professional
|
Both
|
$472.00
|
|
|
Service Code
|
HCPCS 57022
|
| Min. Negotiated Rate |
$101.81 |
| Max. Negotiated Rate |
$354.00 |
| Rate for Payer: Aetna Commercial |
$210.13
|
| Rate for Payer: Aetna Medicare |
$163.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.81
|
| Rate for Payer: BCBS Complete |
$106.90
|
| Rate for Payer: BCBS MAPPO |
$156.81
|
| Rate for Payer: BCN Commercial |
$272.89
|
| Rate for Payer: BCN Medicare Advantage |
$156.81
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cofinity Commercial |
$210.13
|
| Rate for Payer: Cofinity Commercial |
$225.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.65
|
| Rate for Payer: Meridian Medicaid |
$106.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$172.49
|
| Rate for Payer: Nomi Health Commercial |
$188.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.00
|
| Rate for Payer: PACE SWMI |
$156.81
|
| Rate for Payer: PHP Commercial |
$219.53
|
| Rate for Payer: PHP Medicare Advantage |
$156.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$276.38
|
| Rate for Payer: Priority Health Medicare |
$156.81
|
| Rate for Payer: Priority Health SBD |
$276.38
|
| Rate for Payer: Priority Health Tiered Network |
$276.38
|
| Rate for Payer: Railroad Medicare Medicare |
$156.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.93
|
| Rate for Payer: UHC Core |
$309.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$156.81
|
| Rate for Payer: UHC Exchange |
$309.93
|
| Rate for Payer: UHC Medicaid |
$101.81
|
| Rate for Payer: UHCCP Medicaid |
$101.81
|
| Rate for Payer: UMR Bronson Commercial |
$217.12
|
|
|
PR I&D VULVA/PERINEAL ABSCESS
|
Professional
|
Both
|
$286.00
|
|
|
Service Code
|
HCPCS 56405
|
| Min. Negotiated Rate |
$74.55 |
| Max. Negotiated Rate |
$214.50 |
| Rate for Payer: Aetna Commercial |
$151.18
|
| Rate for Payer: Aetna Medicare |
$117.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.46
|
| Rate for Payer: BCBS Complete |
$78.28
|
| Rate for Payer: BCBS MAPPO |
$112.82
|
| Rate for Payer: BCN Commercial |
$191.72
|
| Rate for Payer: BCN Medicare Advantage |
$112.82
|
| Rate for Payer: Cash Price |
$228.80
|
| Rate for Payer: Cash Price |
$228.80
|
| Rate for Payer: Cofinity Commercial |
$151.18
|
| Rate for Payer: Cofinity Commercial |
$162.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.46
|
| Rate for Payer: Meridian Medicaid |
$78.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$124.10
|
| Rate for Payer: Nomi Health Commercial |
$135.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.50
|
| Rate for Payer: PACE SWMI |
$112.82
|
| Rate for Payer: PHP Commercial |
$157.95
|
| Rate for Payer: PHP Medicare Advantage |
$112.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$194.17
|
| Rate for Payer: Priority Health Medicare |
$112.82
|
| Rate for Payer: Priority Health SBD |
$194.17
|
| Rate for Payer: Priority Health Tiered Network |
$194.17
|
| Rate for Payer: Railroad Medicare Medicare |
$112.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.40
|
| Rate for Payer: UHC Core |
$206.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$112.82
|
| Rate for Payer: UHC Exchange |
$206.40
|
| Rate for Payer: UHC Medicaid |
$74.55
|
| Rate for Payer: UHCCP Medicaid |
$74.55
|
| Rate for Payer: UMR Bronson Commercial |
$131.56
|
|
|
PR IIV3 VACCINE SPLIT VIRUS 0.25 ML DOSAGE IM USE
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 90657
|
| Min. Negotiated Rate |
$9.74 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: Aetna Commercial |
$14.78
|
| Rate for Payer: Aetna Medicare |
$11.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.88
|
| Rate for Payer: BCBS MAPPO |
$11.03
|
| Rate for Payer: BCBS Trust/PPO |
$9.74
|
| Rate for Payer: BCN Commercial |
$9.75
|
| Rate for Payer: BCN Medicare Advantage |
$11.03
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$14.78
|
| Rate for Payer: Cofinity Commercial |
$15.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.13
|
| Rate for Payer: Nomi Health Commercial |
$13.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE SWMI |
$11.03
|
| Rate for Payer: PHP Commercial |
$15.44
|
| Rate for Payer: PHP Medicare Advantage |
$11.03
|
| Rate for Payer: Priority Health Medicare |
$11.03
|
| Rate for Payer: Railroad Medicare Medicare |
$11.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.06
|
| Rate for Payer: UHC Core |
$10.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.03
|
| Rate for Payer: UHC Exchange |
$10.06
|
| Rate for Payer: UMR Bronson Commercial |
$20.24
|
|
|
PR IIV3 VACCINE SPLIT VIRUS 0.5 ML DOSAGE IM USE
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 90658
|
| Min. Negotiated Rate |
$19.48 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: Aetna Commercial |
$29.57
|
| Rate for Payer: Aetna Medicare |
$22.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.78
|
| Rate for Payer: BCBS MAPPO |
$22.07
|
| Rate for Payer: BCBS Trust/PPO |
$19.48
|
| Rate for Payer: BCN Commercial |
$19.51
|
| Rate for Payer: BCN Medicare Advantage |
$22.07
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$31.78
|
| Rate for Payer: Cofinity Commercial |
$29.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.28
|
| Rate for Payer: Nomi Health Commercial |
$26.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE SWMI |
$22.07
|
| Rate for Payer: PHP Commercial |
$30.90
|
| Rate for Payer: PHP Medicare Advantage |
$22.07
|
| Rate for Payer: Priority Health Medicare |
$22.07
|
| Rate for Payer: Railroad Medicare Medicare |
$22.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.11
|
| Rate for Payer: UHC Core |
$20.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.07
|
| Rate for Payer: UHC Exchange |
$20.11
|
| Rate for Payer: UMR Bronson Commercial |
$20.24
|
|
|
PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 90656
|
| Min. Negotiated Rate |
$20.24 |
| Max. Negotiated Rate |
$33.44 |
| Rate for Payer: Aetna Commercial |
$31.11
|
| Rate for Payer: Aetna Medicare |
$24.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.44
|
| Rate for Payer: BCBS MAPPO |
$23.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.49
|
| Rate for Payer: BCN Commercial |
$21.12
|
| Rate for Payer: BCN Medicare Advantage |
$23.22
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$33.44
|
| Rate for Payer: Cofinity Commercial |
$31.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.54
|
| Rate for Payer: Nomi Health Commercial |
$27.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE SWMI |
$23.22
|
| Rate for Payer: PHP Commercial |
$32.51
|
| Rate for Payer: PHP Medicare Advantage |
$23.22
|
| Rate for Payer: Priority Health Medicare |
$23.22
|
| Rate for Payer: Railroad Medicare Medicare |
$23.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.07
|
| Rate for Payer: UHC Core |
$21.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.22
|
| Rate for Payer: UHC Exchange |
$21.07
|
| Rate for Payer: UMR Bronson Commercial |
$20.24
|
|
|
PR IIV3 VACC PRESRV FREE 0.25 ML DOSAGE IM USE
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS 90655
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$20.49 |
| Rate for Payer: Aetna Commercial |
$16.30
|
| Rate for Payer: Aetna Medicare |
$12.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.30
|
| Rate for Payer: BCBS Trust/PPO |
$20.49
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.38
|
| Rate for Payer: UHC Core |
$13.38
|
| Rate for Payer: UHC Exchange |
$13.38
|
| Rate for Payer: UMR Bronson Commercial |
$11.04
|
|
|
PR IIV4 VACC PRESRV FREE 0.5 ML DOS FOR IM USE
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 90686
|
| Min. Negotiated Rate |
$12.42 |
| Max. Negotiated Rate |
$22.65 |
| Rate for Payer: Aetna Commercial |
$22.35
|
| Rate for Payer: Aetna Medicare |
$13.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.35
|
| Rate for Payer: BCBS Trust/PPO |
$19.73
|
| Rate for Payer: BCN Commercial |
$22.65
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.35
|
| Rate for Payer: UHC Core |
$22.35
|
| Rate for Payer: UHC Exchange |
$22.35
|
| Rate for Payer: UMR Bronson Commercial |
$12.42
|
|
|
PR IIV4 VACC PRSRV FREE 0.25 ML DOS FOR IM USE
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 90685
|
| Min. Negotiated Rate |
$12.42 |
| Max. Negotiated Rate |
$22.78 |
| Rate for Payer: Aetna Commercial |
$19.36
|
| Rate for Payer: Aetna Medicare |
$13.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.36
|
| Rate for Payer: BCBS Trust/PPO |
$22.05
|
| Rate for Payer: BCN Commercial |
$22.05
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.78
|
| Rate for Payer: UHC Core |
$22.78
|
| Rate for Payer: UHC Exchange |
$22.78
|
| Rate for Payer: UMR Bronson Commercial |
$12.42
|
|
|
PR IIV4 VACC SPLIT VIRUS 0.25 ML DOS FOR IM USE
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 90687
|
| Min. Negotiated Rate |
$9.22 |
| Max. Negotiated Rate |
$20.25 |
| Rate for Payer: Aetna Commercial |
$10.44
|
| Rate for Payer: Aetna Medicare |
$13.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.44
|
| Rate for Payer: BCBS Trust/PPO |
$9.22
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.44
|
| Rate for Payer: UHC Core |
$10.44
|
| Rate for Payer: UHC Exchange |
$10.44
|
| Rate for Payer: UMR Bronson Commercial |
$12.42
|
|
|
PR IIV4 VACC SPLIT VIRUS 0.5 ML DOS FOR IM USE
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 90688
|
| Min. Negotiated Rate |
$12.42 |
| Max. Negotiated Rate |
$21.56 |
| Rate for Payer: Aetna Commercial |
$20.88
|
| Rate for Payer: Aetna Medicare |
$13.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.88
|
| Rate for Payer: BCBS Trust/PPO |
$18.44
|
| Rate for Payer: BCN Commercial |
$21.56
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.88
|
| Rate for Payer: UHC Core |
$20.88
|
| Rate for Payer: UHC Exchange |
$20.88
|
| Rate for Payer: UMR Bronson Commercial |
$12.42
|
|
|
PR IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS 90653
|
| Min. Negotiated Rate |
$28.98 |
| Max. Negotiated Rate |
$141.35 |
| Rate for Payer: Aetna Commercial |
$131.53
|
| Rate for Payer: Aetna Medicare |
$102.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.35
|
| Rate for Payer: BCBS MAPPO |
$98.16
|
| Rate for Payer: BCBS Trust/PPO |
$86.23
|
| Rate for Payer: BCN Commercial |
$72.06
|
| Rate for Payer: BCN Medicare Advantage |
$98.16
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$131.53
|
| Rate for Payer: Cofinity Commercial |
$141.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.98
|
| Rate for Payer: Nomi Health Commercial |
$117.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
| Rate for Payer: PACE SWMI |
$98.16
|
| Rate for Payer: PHP Commercial |
$137.42
|
| Rate for Payer: PHP Medicare Advantage |
$98.16
|
| Rate for Payer: Priority Health Medicare |
$98.16
|
| Rate for Payer: Railroad Medicare Medicare |
$98.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.23
|
| Rate for Payer: UHC Core |
$86.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.16
|
| Rate for Payer: UHC Exchange |
$86.23
|
| Rate for Payer: UMR Bronson Commercial |
$28.98
|
|
|
PR IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 90662
|
| Min. Negotiated Rate |
$52.44 |
| Max. Negotiated Rate |
$141.35 |
| Rate for Payer: Aetna Commercial |
$131.53
|
| Rate for Payer: Aetna Medicare |
$102.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.53
|
| Rate for Payer: BCBS MAPPO |
$98.16
|
| Rate for Payer: BCBS Trust/PPO |
$86.23
|
| Rate for Payer: BCN Commercial |
$72.06
|
| Rate for Payer: BCN Medicare Advantage |
$98.16
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$131.53
|
| Rate for Payer: Cofinity Commercial |
$141.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.98
|
| Rate for Payer: Nomi Health Commercial |
$117.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.50
|
| Rate for Payer: PACE SWMI |
$98.16
|
| Rate for Payer: PHP Commercial |
$137.42
|
| Rate for Payer: PHP Medicare Advantage |
$98.16
|
| Rate for Payer: Priority Health Medicare |
$98.16
|
| Rate for Payer: Railroad Medicare Medicare |
$98.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.23
|
| Rate for Payer: UHC Core |
$86.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.16
|
| Rate for Payer: UHC Exchange |
$86.23
|
| Rate for Payer: UMR Bronson Commercial |
$52.44
|
|
|
PR ILEOSCOPY STOMA W/BALLOON DILATION
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 44381
|
| Min. Negotiated Rate |
$49.42 |
| Max. Negotiated Rate |
$181.50 |
| Rate for Payer: Aetna Commercial |
$101.71
|
| Rate for Payer: Aetna Medicare |
$78.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.71
|
| Rate for Payer: BCBS Complete |
$51.89
|
| Rate for Payer: BCBS MAPPO |
$75.90
|
| Rate for Payer: BCN Commercial |
$124.99
|
| Rate for Payer: BCN Medicare Advantage |
$75.90
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cofinity Commercial |
$109.30
|
| Rate for Payer: Cofinity Commercial |
$101.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.69
|
| Rate for Payer: Meridian Medicaid |
$51.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$83.49
|
| Rate for Payer: Nomi Health Commercial |
$91.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$181.50
|
| Rate for Payer: PACE SWMI |
$75.90
|
| Rate for Payer: PHP Commercial |
$106.26
|
| Rate for Payer: PHP Medicare Advantage |
$75.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$152.30
|
| Rate for Payer: Priority Health Medicare |
$75.90
|
| Rate for Payer: Priority Health SBD |
$152.30
|
| Rate for Payer: Priority Health Tiered Network |
$152.30
|
| Rate for Payer: Railroad Medicare Medicare |
$75.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.11
|
| Rate for Payer: UHC Core |
$146.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$75.90
|
| Rate for Payer: UHC Exchange |
$146.11
|
| Rate for Payer: UHC Medicaid |
$49.42
|
| Rate for Payer: UHCCP Medicaid |
$49.42
|
| Rate for Payer: UMR Bronson Commercial |
$111.32
|
|
|
PR ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$965.00
|
|
|
Service Code
|
HCPCS 44382
|
| Min. Negotiated Rate |
$43.24 |
| Max. Negotiated Rate |
$723.75 |
| Rate for Payer: Aetna Commercial |
$88.65
|
| Rate for Payer: Aetna Medicare |
$68.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.27
|
| Rate for Payer: BCBS Complete |
$45.40
|
| Rate for Payer: BCBS MAPPO |
$66.16
|
| Rate for Payer: BCN Commercial |
$110.05
|
| Rate for Payer: BCN Medicare Advantage |
$66.16
|
| Rate for Payer: Cash Price |
$772.00
|
| Rate for Payer: Cash Price |
$772.00
|
| Rate for Payer: Cofinity Commercial |
$88.65
|
| Rate for Payer: Cofinity Commercial |
$95.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.47
|
| Rate for Payer: Meridian Medicaid |
$45.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.78
|
| Rate for Payer: Nomi Health Commercial |
$79.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$723.75
|
| Rate for Payer: PACE SWMI |
$66.16
|
| Rate for Payer: PHP Commercial |
$92.62
|
| Rate for Payer: PHP Medicare Advantage |
$66.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$134.10
|
| Rate for Payer: Priority Health Medicare |
$66.16
|
| Rate for Payer: Priority Health SBD |
$134.10
|
| Rate for Payer: Priority Health Tiered Network |
$134.10
|
| Rate for Payer: Railroad Medicare Medicare |
$66.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.59
|
| Rate for Payer: UHC Core |
$127.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$66.16
|
| Rate for Payer: UHC Exchange |
$127.59
|
| Rate for Payer: UHC Medicaid |
$43.24
|
| Rate for Payer: UHCCP Medicaid |
$43.24
|
| Rate for Payer: UMR Bronson Commercial |
$443.90
|
|
|
PR ILEOSCOPY STOMA W/PLMT OF ENDOSCOPIC STENT
|
Professional
|
Both
|
$247.00
|
|
|
Service Code
|
HCPCS 44384
|
| Min. Negotiated Rate |
$86.05 |
| Max. Negotiated Rate |
$275.46 |
| Rate for Payer: Aetna Commercial |
$179.40
|
| Rate for Payer: Aetna Medicare |
$139.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.79
|
| Rate for Payer: BCBS Complete |
$90.35
|
| Rate for Payer: BCBS MAPPO |
$133.88
|
| Rate for Payer: BCN Commercial |
$226.08
|
| Rate for Payer: BCN Medicare Advantage |
$133.88
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cofinity Commercial |
$179.40
|
| Rate for Payer: Cofinity Commercial |
$192.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.57
|
| Rate for Payer: Meridian Medicaid |
$90.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.27
|
| Rate for Payer: Nomi Health Commercial |
$160.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.25
|
| Rate for Payer: PACE SWMI |
$133.88
|
| Rate for Payer: PHP Commercial |
$187.43
|
| Rate for Payer: PHP Medicare Advantage |
$133.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$275.46
|
| Rate for Payer: Priority Health Medicare |
$133.88
|
| Rate for Payer: Priority Health SBD |
$275.46
|
| Rate for Payer: Priority Health Tiered Network |
$275.46
|
| Rate for Payer: Railroad Medicare Medicare |
$133.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.12
|
| Rate for Payer: UHC Core |
$272.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$133.88
|
| Rate for Payer: UHC Exchange |
$272.12
|
| Rate for Payer: UHC Medicaid |
$86.05
|
| Rate for Payer: UHCCP Medicaid |
$86.05
|
| Rate for Payer: UMR Bronson Commercial |
$113.62
|
|
|
PR ILEOSCOPY THRU STOMA DX W/COLLJ SPEC WHEN PRFMD
|
Professional
|
Both
|
$863.00
|
|
|
Service Code
|
HCPCS 44380
|
| Min. Negotiated Rate |
$33.87 |
| Max. Negotiated Rate |
$647.25 |
| Rate for Payer: Aetna Commercial |
$69.16
|
| Rate for Payer: Aetna Medicare |
$53.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.32
|
| Rate for Payer: BCBS Complete |
$35.56
|
| Rate for Payer: BCBS MAPPO |
$51.61
|
| Rate for Payer: BCN Commercial |
$86.15
|
| Rate for Payer: BCN Medicare Advantage |
$51.61
|
| Rate for Payer: Cash Price |
$690.40
|
| Rate for Payer: Cash Price |
$690.40
|
| Rate for Payer: Cofinity Commercial |
$69.16
|
| Rate for Payer: Cofinity Commercial |
$74.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.19
|
| Rate for Payer: Meridian Medicaid |
$35.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.77
|
| Rate for Payer: Nomi Health Commercial |
$61.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$647.25
|
| Rate for Payer: PACE SWMI |
$51.61
|
| Rate for Payer: PHP Commercial |
$72.25
|
| Rate for Payer: PHP Medicare Advantage |
$51.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$104.97
|
| Rate for Payer: Priority Health Medicare |
$51.61
|
| Rate for Payer: Priority Health SBD |
$104.97
|
| Rate for Payer: Priority Health Tiered Network |
$104.97
|
| Rate for Payer: Railroad Medicare Medicare |
$51.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.63
|
| Rate for Payer: UHC Core |
$97.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.61
|
| Rate for Payer: UHC Exchange |
$97.63
|
| Rate for Payer: UHC Medicaid |
$33.87
|
| Rate for Payer: UHCCP Medicaid |
$33.87
|
| Rate for Payer: UMR Bronson Commercial |
$396.98
|
|
|
PR ILEOSCOPY,THRU STOMA,TRANSENDO STENT
|
Professional
|
Both
|
$1,120.00
|
|
|
Service Code
|
HCPCS 44383
|
| Min. Negotiated Rate |
$448.00 |
| Max. Negotiated Rate |
$840.00 |
| Rate for Payer: Aetna Medicare |
$560.00
|
| Rate for Payer: BCBS Complete |
$448.00
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$840.00
|
| Rate for Payer: UMR Bronson Commercial |
$515.20
|
|
|
PR ILEOSTOMY/JEJUNOSTOMY NON-TUBE
|
Professional
|
Both
|
$2,631.00
|
|
|
Service Code
|
HCPCS 44310
|
| Min. Negotiated Rate |
$617.06 |
| Max. Negotiated Rate |
$1,973.25 |
| Rate for Payer: Aetna Commercial |
$1,287.81
|
| Rate for Payer: Aetna Medicare |
$999.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,287.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,383.91
|
| Rate for Payer: BCBS Complete |
$647.91
|
| Rate for Payer: BCBS MAPPO |
$961.05
|
| Rate for Payer: BCN Commercial |
$1,556.69
|
| Rate for Payer: BCN Medicare Advantage |
$961.05
|
| Rate for Payer: Cash Price |
$2,104.80
|
| Rate for Payer: Cash Price |
$2,104.80
|
| Rate for Payer: Cofinity Commercial |
$1,383.91
|
| Rate for Payer: Cofinity Commercial |
$1,287.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$961.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,009.10
|
| Rate for Payer: Meridian Medicaid |
$647.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,057.15
|
| Rate for Payer: Nomi Health Commercial |
$1,153.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,973.25
|
| Rate for Payer: PACE SWMI |
$961.05
|
| Rate for Payer: PHP Commercial |
$1,345.47
|
| Rate for Payer: PHP Medicare Advantage |
$961.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$617.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,896.72
|
| Rate for Payer: Priority Health Medicare |
$961.05
|
| Rate for Payer: Priority Health SBD |
$1,896.72
|
| Rate for Payer: Priority Health Tiered Network |
$1,896.72
|
| Rate for Payer: Railroad Medicare Medicare |
$961.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,851.78
|
| Rate for Payer: UHC Core |
$1,851.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$961.05
|
| Rate for Payer: UHC Exchange |
$1,851.78
|
| Rate for Payer: UHC Medicaid |
$617.06
|
| Rate for Payer: UHCCP Medicaid |
$617.06
|
| Rate for Payer: UMR Bronson Commercial |
$1,210.26
|
|
|
PR ILIAC ART ANGIO,CARDIAC CATH
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS G0278
|
| Min. Negotiated Rate |
$11.80 |
| Max. Negotiated Rate |
$27.75 |
| Rate for Payer: Aetna Commercial |
$15.81
|
| Rate for Payer: Aetna Medicare |
$12.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.99
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: BCBS MAPPO |
$11.80
|
| Rate for Payer: BCN Commercial |
$19.42
|
| Rate for Payer: BCN Medicare Advantage |
$11.80
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| 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: Molina Medicare/Medicaid |
$12.98
|
| Rate for Payer: Nomi Health Commercial |
$14.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.75
|
| 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/HMO/PPO/Narrow Network |
$19.58
|
| Rate for Payer: Priority Health Medicare |
$11.80
|
| Rate for Payer: Priority Health SBD |
$19.58
|
| Rate for Payer: Priority Health Tiered Network |
$19.58
|
| Rate for Payer: Railroad Medicare Medicare |
$11.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.08
|
| Rate for Payer: UHC Core |
$21.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.80
|
| Rate for Payer: UHC Exchange |
$21.08
|
| Rate for Payer: UMR Bronson Commercial |
$17.02
|
|
|
PR IM ADM INTRANSL/ORAL 1 VACCINE
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 90473
|
| Min. Negotiated Rate |
$13.76 |
| Max. Negotiated Rate |
$26.75 |
| Rate for Payer: Aetna Commercial |
$22.00
|
| Rate for Payer: Aetna Medicare |
$17.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.64
|
| Rate for Payer: BCBS MAPPO |
$16.42
|
| Rate for Payer: BCN Commercial |
$19.64
|
| Rate for Payer: BCN Medicare Advantage |
$16.42
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$22.00
|
| Rate for Payer: Cofinity Commercial |
$23.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.06
|
| Rate for Payer: Nomi Health Commercial |
$19.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
| Rate for Payer: PACE SWMI |
$16.42
|
| Rate for Payer: PHP Commercial |
$22.99
|
| Rate for Payer: PHP Medicare Advantage |
$16.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$26.75
|
| Rate for Payer: Priority Health Medicare |
$16.42
|
| Rate for Payer: Priority Health SBD |
$26.75
|
| Rate for Payer: Priority Health Tiered Network |
$26.75
|
| Rate for Payer: Railroad Medicare Medicare |
$16.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.76
|
| Rate for Payer: UHC Core |
$13.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.42
|
| Rate for Payer: UHC Exchange |
$13.76
|
| Rate for Payer: UMR Bronson Commercial |
$15.64
|
|
|
PR IM ADM INTRANSL/ORAL EA VACCINE
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS 90474
|
| Min. Negotiated Rate |
$11.04 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Aetna Commercial |
$15.80
|
| Rate for Payer: Aetna Medicare |
$12.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.98
|
| Rate for Payer: BCBS MAPPO |
$11.79
|
| Rate for Payer: BCN Commercial |
$14.14
|
| Rate for Payer: BCN Medicare Advantage |
$11.79
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$15.80
|
| Rate for Payer: Cofinity Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.97
|
| Rate for Payer: Nomi Health Commercial |
$14.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.00
|
| Rate for Payer: PACE SWMI |
$11.79
|
| Rate for Payer: PHP Commercial |
$16.51
|
| Rate for Payer: PHP Medicare Advantage |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.53
|
| Rate for Payer: Priority Health Medicare |
$11.79
|
| Rate for Payer: Priority Health SBD |
$16.53
|
| Rate for Payer: Priority Health Tiered Network |
$16.53
|
| Rate for Payer: Railroad Medicare Medicare |
$11.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.38
|
| Rate for Payer: UHC Core |
$12.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.79
|
| Rate for Payer: UHC Exchange |
$12.38
|
| Rate for Payer: UMR Bronson Commercial |
$11.04
|
|
|
PR IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 90471
|
| Min. Negotiated Rate |
$13.76 |
| Max. Negotiated Rate |
$29.79 |
| Rate for Payer: Aetna Commercial |
$27.72
|
| Rate for Payer: Aetna Medicare |
$21.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.79
|
| Rate for Payer: BCBS MAPPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$27.07
|
| Rate for Payer: BCN Medicare Advantage |
$20.69
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$29.79
|
| Rate for Payer: Cofinity Commercial |
$27.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.76
|
| Rate for Payer: Nomi Health Commercial |
$24.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
| Rate for Payer: PACE SWMI |
$20.69
|
| Rate for Payer: PHP Commercial |
$28.97
|
| Rate for Payer: PHP Medicare Advantage |
$20.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$26.75
|
| Rate for Payer: Priority Health Medicare |
$20.69
|
| Rate for Payer: Priority Health SBD |
$26.75
|
| Rate for Payer: Priority Health Tiered Network |
$26.75
|
| Rate for Payer: Railroad Medicare Medicare |
$20.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.76
|
| Rate for Payer: UHC Core |
$13.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.69
|
| Rate for Payer: UHC Exchange |
$13.76
|
| Rate for Payer: UMR Bronson Commercial |
$15.64
|
|
|
PR IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS 90472
|
| Min. Negotiated Rate |
$11.04 |
| Max. Negotiated Rate |
$21.82 |
| Rate for Payer: Aetna Commercial |
$20.30
|
| Rate for Payer: Aetna Medicare |
$15.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.82
|
| Rate for Payer: BCBS MAPPO |
$15.15
|
| Rate for Payer: BCN Commercial |
$17.28
|
| Rate for Payer: BCN Medicare Advantage |
$15.15
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$20.30
|
| Rate for Payer: Cofinity Commercial |
$21.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.66
|
| Rate for Payer: Nomi Health Commercial |
$18.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.00
|
| Rate for Payer: PACE SWMI |
$15.15
|
| Rate for Payer: PHP Commercial |
$21.21
|
| Rate for Payer: PHP Medicare Advantage |
$15.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20.20
|
| Rate for Payer: Priority Health Medicare |
$15.15
|
| Rate for Payer: Priority Health SBD |
$20.20
|
| Rate for Payer: Priority Health Tiered Network |
$20.20
|
| Rate for Payer: Railroad Medicare Medicare |
$15.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.38
|
| Rate for Payer: UHC Core |
$12.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.15
|
| Rate for Payer: UHC Exchange |
$12.38
|
| Rate for Payer: UMR Bronson Commercial |
$11.04
|
|
