|
PR FASCIOTOMY PALMAR PERCUTANEOUS
|
Professional
|
Both
|
$930.00
|
|
|
Service Code
|
HCPCS 26040
|
| Min. Negotiated Rate |
$139.24 |
| Max. Negotiated Rate |
$604.50 |
| Rate for Payer: Aetna Commercial |
$410.24
|
| Rate for Payer: Aetna Medicare |
$318.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$410.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$440.86
|
| Rate for Payer: BCBS Complete |
$220.74
|
| Rate for Payer: BCBS MAPPO |
$306.15
|
| Rate for Payer: BCBS Trust/PPO |
$139.24
|
| Rate for Payer: BCN Commercial |
$471.08
|
| Rate for Payer: BCN Medicare Advantage |
$306.15
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cofinity Commercial |
$410.24
|
| Rate for Payer: Cofinity Commercial |
$440.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.46
|
| Rate for Payer: Meridian Medicaid |
$220.74
|
| Rate for Payer: Nomi Health Commercial |
$367.38
|
| Rate for Payer: PACE SWMI |
$306.15
|
| Rate for Payer: PHP Commercial |
$428.61
|
| Rate for Payer: PHP Medicare Advantage |
$306.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$496.65
|
| Rate for Payer: Priority Health Medicare |
$306.15
|
| Rate for Payer: Priority Health Narrow Network |
$496.65
|
| Rate for Payer: Priority Health SBD |
$496.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.15
|
| Rate for Payer: UHC Medicare Advantage |
$306.15
|
| Rate for Payer: UHCCP Medicaid |
$210.23
|
| Rate for Payer: UMR Bronson Commercial |
$427.80
|
|
|
PR FASCT PALM W/WO Z-PLASTY TISSUE REARGMT/SKN GRFT
|
Professional
|
Both
|
$2,361.00
|
|
|
Service Code
|
HCPCS 26121
|
| Min. Negotiated Rate |
$250.03 |
| Max. Negotiated Rate |
$1,534.65 |
| Rate for Payer: Aetna Commercial |
$777.70
|
| Rate for Payer: Aetna Medicare |
$603.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$777.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$835.73
|
| Rate for Payer: BCBS Complete |
$414.20
|
| Rate for Payer: BCBS MAPPO |
$580.37
|
| Rate for Payer: BCBS Trust/PPO |
$250.03
|
| Rate for Payer: BCN Commercial |
$887.44
|
| Rate for Payer: BCN Medicare Advantage |
$580.37
|
| Rate for Payer: Cash Price |
$1,888.80
|
| Rate for Payer: Cash Price |
$1,888.80
|
| Rate for Payer: Cofinity Commercial |
$777.70
|
| Rate for Payer: Cofinity Commercial |
$835.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$580.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$609.39
|
| Rate for Payer: Meridian Medicaid |
$414.20
|
| Rate for Payer: Nomi Health Commercial |
$696.44
|
| Rate for Payer: PACE SWMI |
$580.37
|
| Rate for Payer: PHP Commercial |
$812.52
|
| Rate for Payer: PHP Medicare Advantage |
$580.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$394.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,534.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$932.74
|
| Rate for Payer: Priority Health Medicare |
$580.37
|
| Rate for Payer: Priority Health Narrow Network |
$932.74
|
| Rate for Payer: Priority Health SBD |
$932.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$580.37
|
| Rate for Payer: UHC Medicare Advantage |
$580.37
|
| Rate for Payer: UHCCP Medicaid |
$394.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,086.06
|
|
|
PR FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR
|
Professional
|
Both
|
$2,952.00
|
|
|
Service Code
|
HCPCS 26123
|
| Min. Negotiated Rate |
$337.48 |
| Max. Negotiated Rate |
$1,918.80 |
| Rate for Payer: Aetna Commercial |
$1,084.06
|
| Rate for Payer: Aetna Medicare |
$841.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,084.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,164.96
|
| Rate for Payer: BCBS Complete |
$577.24
|
| Rate for Payer: BCBS MAPPO |
$809.00
|
| Rate for Payer: BCBS Trust/PPO |
$337.48
|
| Rate for Payer: BCN Commercial |
$1,235.86
|
| Rate for Payer: BCN Medicare Advantage |
$809.00
|
| Rate for Payer: Cash Price |
$2,361.60
|
| Rate for Payer: Cash Price |
$2,361.60
|
| Rate for Payer: Cofinity Commercial |
$1,084.06
|
| Rate for Payer: Cofinity Commercial |
$1,164.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$809.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$849.45
|
| Rate for Payer: Meridian Medicaid |
$577.24
|
| Rate for Payer: Nomi Health Commercial |
$970.80
|
| Rate for Payer: PACE SWMI |
$809.00
|
| Rate for Payer: PHP Commercial |
$1,132.60
|
| Rate for Payer: PHP Medicare Advantage |
$809.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$549.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,918.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,299.63
|
| Rate for Payer: Priority Health Medicare |
$809.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,299.63
|
| Rate for Payer: Priority Health SBD |
$1,299.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$809.00
|
| Rate for Payer: UHC Medicare Advantage |
$809.00
|
| Rate for Payer: UHCCP Medicaid |
$549.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,357.92
|
|
|
PR FASCT PRTL PALMR ADDL DGT PROX IPHAL JT W/WO RPR
|
Professional
|
Both
|
$885.00
|
|
|
Service Code
|
HCPCS 26125
|
| Min. Negotiated Rate |
$171.68 |
| Max. Negotiated Rate |
$575.25 |
| Rate for Payer: Aetna Commercial |
$345.67
|
| Rate for Payer: Aetna Medicare |
$268.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$371.46
|
| Rate for Payer: BCBS Complete |
$180.26
|
| Rate for Payer: BCBS MAPPO |
$257.96
|
| Rate for Payer: BCBS Trust/PPO |
$555.24
|
| Rate for Payer: BCN Commercial |
$389.96
|
| Rate for Payer: BCN Medicare Advantage |
$257.96
|
| Rate for Payer: Cash Price |
$708.00
|
| Rate for Payer: Cash Price |
$708.00
|
| Rate for Payer: Cofinity Commercial |
$345.67
|
| Rate for Payer: Cofinity Commercial |
$371.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.86
|
| Rate for Payer: Meridian Medicaid |
$180.26
|
| Rate for Payer: Nomi Health Commercial |
$309.55
|
| Rate for Payer: PACE SWMI |
$257.96
|
| Rate for Payer: PHP Commercial |
$361.14
|
| Rate for Payer: PHP Medicare Advantage |
$257.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$575.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$407.09
|
| Rate for Payer: Priority Health Medicare |
$257.96
|
| Rate for Payer: Priority Health Narrow Network |
$407.09
|
| Rate for Payer: Priority Health SBD |
$407.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.96
|
| Rate for Payer: UHC Medicare Advantage |
$257.96
|
| Rate for Payer: UHCCP Medicaid |
$171.68
|
| Rate for Payer: UMR Bronson Commercial |
$407.10
|
|
|
PR FECAL BLOOD SCRN IMMUNOASSAY
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS G0328
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$1,270.03 |
| 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 Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,270.03
|
| Rate for Payer: BCN Commercial |
$18.05
|
| Rate for Payer: BCN Medicare Advantage |
$18.05
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cofinity Commercial |
$25.99
|
| Rate for Payer: Cofinity Commercial |
$24.19
|
| 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: Nomi Health Commercial |
$21.66
|
| 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 |
$24.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.98
|
| Rate for Payer: Priority Health Medicare |
$18.05
|
| Rate for Payer: Priority Health Narrow Network |
$17.98
|
| Rate for Payer: Priority Health SBD |
$17.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.05
|
| Rate for Payer: UHC Medicare Advantage |
$18.05
|
| Rate for Payer: UMR Bronson Commercial |
$17.48
|
|
|
PR FECAL MICROBIOTA PREP INSTIL
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS G0455
|
| Min. Negotiated Rate |
$44.73 |
| Max. Negotiated Rate |
$1,923.54 |
| Rate for Payer: Aetna Commercial |
$89.91
|
| Rate for Payer: Aetna Medicare |
$69.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.91
|
| Rate for Payer: BCBS Complete |
$46.97
|
| Rate for Payer: BCBS MAPPO |
$67.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,923.54
|
| Rate for Payer: BCN Commercial |
$190.10
|
| Rate for Payer: BCN Medicare Advantage |
$67.10
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$96.62
|
| Rate for Payer: Cofinity Commercial |
$89.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.46
|
| Rate for Payer: Meridian Medicaid |
$46.97
|
| Rate for Payer: Nomi Health Commercial |
$80.52
|
| Rate for Payer: PACE SWMI |
$67.10
|
| Rate for Payer: PHP Commercial |
$93.94
|
| Rate for Payer: PHP Medicare Advantage |
$67.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.69
|
| Rate for Payer: Priority Health Medicare |
$67.10
|
| Rate for Payer: Priority Health Narrow Network |
$124.69
|
| Rate for Payer: Priority Health SBD |
$124.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.10
|
| Rate for Payer: UHC Medicare Advantage |
$67.10
|
| Rate for Payer: UHCCP Medicaid |
$44.73
|
| Rate for Payer: UMR Bronson Commercial |
$93.84
|
|
|
PR FERN TEST
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS Q0114
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$126.79 |
| Rate for Payer: Aetna Commercial |
$13.05
|
| Rate for Payer: Aetna Medicare |
$10.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.03
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: BCBS MAPPO |
$9.74
|
| Rate for Payer: BCBS Trust/PPO |
$126.79
|
| Rate for Payer: BCN Commercial |
$6.80
|
| 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 |
$13.05
|
| Rate for Payer: Cofinity Commercial |
$14.03
|
| 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: Nomi Health Commercial |
$11.69
|
| 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 Cigna Priority Health |
$3.90
|
| Rate for Payer: Priority Health Medicare |
$9.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.74
|
| Rate for Payer: UHC Medicare Advantage |
$9.74
|
| Rate for Payer: UMR Bronson Commercial |
$2.76
|
|
|
PR FETAL CONTRACTION STRESS TEST
|
Professional
|
Both
|
$164.00
|
|
|
Service Code
|
HCPCS 59020
|
| Min. Negotiated Rate |
$23.22 |
| Max. Negotiated Rate |
$145.28 |
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: Aetna Medicare |
$68.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.69
|
| Rate for Payer: BCBS Complete |
$24.38
|
| Rate for Payer: BCBS MAPPO |
$66.19
|
| Rate for Payer: BCBS Trust/PPO |
$145.28
|
| Rate for Payer: BCN Commercial |
$103.11
|
| Rate for Payer: BCN Medicare Advantage |
$66.19
|
| Rate for Payer: Cash Price |
$131.20
|
| Rate for Payer: Cash Price |
$131.20
|
| Rate for Payer: Cofinity Commercial |
$88.69
|
| Rate for Payer: Cofinity Commercial |
$95.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.50
|
| Rate for Payer: Meridian Medicaid |
$24.38
|
| Rate for Payer: Nomi Health Commercial |
$79.43
|
| Rate for Payer: PACE SWMI |
$66.19
|
| Rate for Payer: PHP Commercial |
$92.67
|
| Rate for Payer: PHP Medicare Advantage |
$66.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.14
|
| Rate for Payer: Priority Health Medicare |
$66.19
|
| Rate for Payer: Priority Health Narrow Network |
$100.14
|
| Rate for Payer: Priority Health SBD |
$51.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.19
|
| Rate for Payer: UHC Medicare Advantage |
$66.19
|
| Rate for Payer: UHCCP Medicaid |
$23.22
|
| Rate for Payer: UMR Bronson Commercial |
$75.44
|
|
|
PR FETAL FLUID DRAINAGE W/ULTRASOUND GUIDANCE
|
Professional
|
Both
|
$842.00
|
|
|
Service Code
|
HCPCS 59074
|
| Min. Negotiated Rate |
$197.45 |
| Max. Negotiated Rate |
$561.98 |
| Rate for Payer: Aetna Commercial |
$404.32
|
| Rate for Payer: Aetna Medicare |
$313.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.49
|
| Rate for Payer: BCBS Complete |
$207.32
|
| Rate for Payer: BCBS MAPPO |
$301.73
|
| Rate for Payer: BCBS Trust/PPO |
$488.15
|
| Rate for Payer: BCN Commercial |
$561.98
|
| Rate for Payer: BCN Medicare Advantage |
$301.73
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cofinity Commercial |
$404.32
|
| Rate for Payer: Cofinity Commercial |
$434.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.82
|
| Rate for Payer: Meridian Medicaid |
$207.32
|
| Rate for Payer: Nomi Health Commercial |
$362.08
|
| Rate for Payer: PACE SWMI |
$301.73
|
| Rate for Payer: PHP Commercial |
$422.42
|
| Rate for Payer: PHP Medicare Advantage |
$301.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$547.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$431.29
|
| Rate for Payer: Priority Health Medicare |
$301.73
|
| Rate for Payer: Priority Health Narrow Network |
$431.29
|
| Rate for Payer: Priority Health SBD |
$431.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.73
|
| Rate for Payer: UHC Medicare Advantage |
$301.73
|
| Rate for Payer: UHCCP Medicaid |
$197.45
|
| Rate for Payer: UMR Bronson Commercial |
$387.32
|
|
|
PR FETAL NONSTRESS TEST
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 59025
|
| Min. Negotiated Rate |
$18.53 |
| Max. Negotiated Rate |
$522.49 |
| Rate for Payer: Aetna Commercial |
$62.07
|
| Rate for Payer: Aetna Medicare |
$48.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.70
|
| Rate for Payer: BCBS Complete |
$19.46
|
| Rate for Payer: BCBS MAPPO |
$46.32
|
| Rate for Payer: BCBS Trust/PPO |
$522.49
|
| Rate for Payer: BCN Commercial |
$71.35
|
| Rate for Payer: BCN Medicare Advantage |
$46.32
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$62.07
|
| Rate for Payer: Cofinity Commercial |
$66.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.64
|
| Rate for Payer: Meridian Medicaid |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$55.58
|
| Rate for Payer: PACE SWMI |
$46.32
|
| Rate for Payer: PHP Commercial |
$64.85
|
| Rate for Payer: PHP Medicare Advantage |
$46.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.94
|
| Rate for Payer: Priority Health Medicare |
$46.32
|
| Rate for Payer: Priority Health Narrow Network |
$68.94
|
| Rate for Payer: Priority Health SBD |
$40.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.32
|
| Rate for Payer: UHC Medicare Advantage |
$46.32
|
| Rate for Payer: UHCCP Medicaid |
$18.53
|
| Rate for Payer: UMR Bronson Commercial |
$46.92
|
|
|
PR FETAL SHUNT PLACEMENT W/ULTRASOUND GUIDANCE
|
Professional
|
Both
|
$1,066.00
|
|
|
Service Code
|
HCPCS 59076
|
| Min. Negotiated Rate |
$125.74 |
| Max. Negotiated Rate |
$759.41 |
| Rate for Payer: Aetna Commercial |
$682.58
|
| Rate for Payer: Aetna Medicare |
$529.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$682.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$733.52
|
| Rate for Payer: BCBS Complete |
$349.35
|
| Rate for Payer: BCBS MAPPO |
$509.39
|
| Rate for Payer: BCBS Trust/PPO |
$125.74
|
| Rate for Payer: BCN Commercial |
$759.41
|
| Rate for Payer: BCN Medicare Advantage |
$509.39
|
| Rate for Payer: Cash Price |
$852.80
|
| Rate for Payer: Cash Price |
$852.80
|
| Rate for Payer: Cofinity Commercial |
$682.58
|
| Rate for Payer: Cofinity Commercial |
$733.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$534.86
|
| Rate for Payer: Meridian Medicaid |
$349.35
|
| Rate for Payer: Nomi Health Commercial |
$611.27
|
| Rate for Payer: PACE SWMI |
$509.39
|
| Rate for Payer: PHP Commercial |
$713.15
|
| Rate for Payer: PHP Medicare Advantage |
$509.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$727.06
|
| Rate for Payer: Priority Health Medicare |
$509.39
|
| Rate for Payer: Priority Health Narrow Network |
$727.06
|
| Rate for Payer: Priority Health SBD |
$727.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.39
|
| Rate for Payer: UHC Medicare Advantage |
$509.39
|
| Rate for Payer: UHCCP Medicaid |
$332.71
|
| Rate for Payer: UMR Bronson Commercial |
$490.36
|
|
|
PR FILLETED FINGER/TOE FLAP W/PREPJ RECIPIENT SITE
|
Professional
|
Both
|
$1,293.00
|
|
|
Service Code
|
HCPCS 14350
|
| Min. Negotiated Rate |
$428.56 |
| Max. Negotiated Rate |
$5,240.72 |
| Rate for Payer: Aetna Commercial |
$848.90
|
| Rate for Payer: Aetna Medicare |
$658.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$848.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$912.25
|
| Rate for Payer: BCBS Complete |
$449.99
|
| Rate for Payer: BCBS MAPPO |
$633.51
|
| Rate for Payer: BCBS Trust/PPO |
$5,240.72
|
| Rate for Payer: BCN Commercial |
$982.24
|
| Rate for Payer: BCN Medicare Advantage |
$633.51
|
| Rate for Payer: Cash Price |
$1,034.40
|
| Rate for Payer: Cash Price |
$1,034.40
|
| Rate for Payer: Cofinity Commercial |
$848.90
|
| Rate for Payer: Cofinity Commercial |
$912.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$633.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$665.19
|
| Rate for Payer: Meridian Medicaid |
$449.99
|
| Rate for Payer: Nomi Health Commercial |
$760.21
|
| Rate for Payer: PACE SWMI |
$633.51
|
| Rate for Payer: PHP Commercial |
$886.91
|
| Rate for Payer: PHP Medicare Advantage |
$633.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$840.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$916.12
|
| Rate for Payer: Priority Health Medicare |
$633.51
|
| Rate for Payer: Priority Health Narrow Network |
$916.12
|
| Rate for Payer: Priority Health SBD |
$916.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$633.51
|
| Rate for Payer: UHC Medicare Advantage |
$633.51
|
| Rate for Payer: UHCCP Medicaid |
$428.56
|
| Rate for Payer: UMR Bronson Commercial |
$594.78
|
|
|
PR FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 10009
|
| Min. Negotiated Rate |
$68.37 |
| Max. Negotiated Rate |
$513.21 |
| Rate for Payer: Aetna Commercial |
$137.97
|
| Rate for Payer: Aetna Commercial |
$137.97
|
| Rate for Payer: Aetna Medicare |
$107.08
|
| Rate for Payer: Aetna Medicare |
$107.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.97
|
| Rate for Payer: BCBS Complete |
$71.79
|
| Rate for Payer: BCBS Complete |
$71.79
|
| Rate for Payer: BCBS MAPPO |
$102.96
|
| Rate for Payer: BCBS MAPPO |
$102.96
|
| Rate for Payer: BCBS Trust/PPO |
$405.74
|
| Rate for Payer: BCBS Trust/PPO |
$405.74
|
| Rate for Payer: BCN Commercial |
$513.21
|
| Rate for Payer: BCN Commercial |
$513.21
|
| Rate for Payer: BCN Medicare Advantage |
$102.96
|
| Rate for Payer: BCN Medicare Advantage |
$102.96
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$137.97
|
| Rate for Payer: Cofinity Commercial |
$148.26
|
| Rate for Payer: Cofinity Commercial |
$148.26
|
| Rate for Payer: Cofinity Commercial |
$137.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.11
|
| Rate for Payer: Meridian Medicaid |
$71.79
|
| Rate for Payer: Meridian Medicaid |
$71.79
|
| Rate for Payer: Nomi Health Commercial |
$123.55
|
| Rate for Payer: Nomi Health Commercial |
$123.55
|
| Rate for Payer: PACE SWMI |
$102.96
|
| Rate for Payer: PACE SWMI |
$102.96
|
| Rate for Payer: PHP Commercial |
$144.14
|
| Rate for Payer: PHP Commercial |
$144.14
|
| Rate for Payer: PHP Medicare Advantage |
$102.96
|
| Rate for Payer: PHP Medicare Advantage |
$102.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.49
|
| Rate for Payer: Priority Health Medicare |
$102.96
|
| Rate for Payer: Priority Health Medicare |
$102.96
|
| Rate for Payer: Priority Health Narrow Network |
$144.49
|
| Rate for Payer: Priority Health Narrow Network |
$144.49
|
| Rate for Payer: Priority Health SBD |
$144.49
|
| Rate for Payer: Priority Health SBD |
$144.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.96
|
| Rate for Payer: UHC Medicare Advantage |
$102.96
|
| Rate for Payer: UHC Medicare Advantage |
$102.96
|
| Rate for Payer: UHCCP Medicaid |
$68.37
|
| Rate for Payer: UHCCP Medicaid |
$68.37
|
| Rate for Payer: UMR Bronson Commercial |
$121.90
|
| Rate for Payer: UMR Bronson Commercial |
$338.56
|
|
|
PR FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION
|
Professional
|
Both
|
$238.00
|
|
|
Service Code
|
HCPCS 10021
|
| Min. Negotiated Rate |
$35.15 |
| Max. Negotiated Rate |
$3,585.00 |
| Rate for Payer: Aetna Commercial |
$70.83
|
| Rate for Payer: Aetna Medicare |
$54.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.12
|
| Rate for Payer: BCBS Complete |
$36.91
|
| Rate for Payer: BCBS MAPPO |
$52.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,585.00
|
| Rate for Payer: BCN Commercial |
$119.76
|
| Rate for Payer: BCN Medicare Advantage |
$52.86
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cofinity Commercial |
$70.83
|
| Rate for Payer: Cofinity Commercial |
$76.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.50
|
| Rate for Payer: Meridian Medicaid |
$36.91
|
| Rate for Payer: Nomi Health Commercial |
$63.43
|
| Rate for Payer: PACE SWMI |
$52.86
|
| Rate for Payer: PHP Commercial |
$74.00
|
| Rate for Payer: PHP Medicare Advantage |
$52.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.60
|
| Rate for Payer: Priority Health Medicare |
$52.86
|
| Rate for Payer: Priority Health Narrow Network |
$73.60
|
| Rate for Payer: Priority Health SBD |
$73.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.86
|
| Rate for Payer: UHC Medicare Advantage |
$52.86
|
| Rate for Payer: UHCCP Medicaid |
$35.15
|
| Rate for Payer: UMR Bronson Commercial |
$109.48
|
|
|
PR FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION
|
Professional
|
Both
|
$252.00
|
|
|
Service Code
|
HCPCS 10005
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$163.80 |
| Rate for Payer: Aetna Commercial |
$93.13
|
| Rate for Payer: Aetna Medicare |
$72.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.13
|
| Rate for Payer: BCBS Complete |
$48.53
|
| Rate for Payer: BCBS MAPPO |
$69.50
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$159.81
|
| Rate for Payer: BCN Medicare Advantage |
$69.50
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cofinity Commercial |
$100.08
|
| Rate for Payer: Cofinity Commercial |
$93.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.98
|
| Rate for Payer: Meridian Medicaid |
$48.53
|
| Rate for Payer: Nomi Health Commercial |
$83.40
|
| Rate for Payer: PACE SWMI |
$69.50
|
| Rate for Payer: PHP Commercial |
$97.30
|
| Rate for Payer: PHP Medicare Advantage |
$69.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.53
|
| Rate for Payer: Priority Health Medicare |
$69.50
|
| Rate for Payer: Priority Health Narrow Network |
$97.53
|
| Rate for Payer: Priority Health SBD |
$97.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.50
|
| Rate for Payer: UHC Medicare Advantage |
$69.50
|
| Rate for Payer: UHCCP Medicaid |
$46.22
|
| Rate for Payer: UMR Bronson Commercial |
$115.92
|
|
|
PR FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 10006
|
| Min. Negotiated Rate |
$31.52 |
| Max. Negotiated Rate |
$349.63 |
| Rate for Payer: Aetna Commercial |
$63.44
|
| Rate for Payer: Aetna Medicare |
$49.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.17
|
| Rate for Payer: BCBS Complete |
$33.10
|
| Rate for Payer: BCBS MAPPO |
$47.34
|
| Rate for Payer: BCBS Trust/PPO |
$349.63
|
| Rate for Payer: BCN Commercial |
$70.29
|
| Rate for Payer: BCN Medicare Advantage |
$47.34
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$63.44
|
| Rate for Payer: Cofinity Commercial |
$68.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.71
|
| Rate for Payer: Meridian Medicaid |
$33.10
|
| Rate for Payer: Nomi Health Commercial |
$56.81
|
| Rate for Payer: PACE SWMI |
$47.34
|
| Rate for Payer: PHP Commercial |
$66.28
|
| Rate for Payer: PHP Medicare Advantage |
$47.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.83
|
| Rate for Payer: Priority Health Medicare |
$47.34
|
| Rate for Payer: Priority Health Narrow Network |
$66.83
|
| Rate for Payer: Priority Health SBD |
$66.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.34
|
| Rate for Payer: UHC Medicare Advantage |
$47.34
|
| Rate for Payer: UHCCP Medicaid |
$31.52
|
| Rate for Payer: UMR Bronson Commercial |
$56.12
|
|
|
PR FINE NEEDLE ASP;W/IMAGING GUIDANCE
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 10022
|
| Min. Negotiated Rate |
$107.60 |
| Max. Negotiated Rate |
$174.85 |
| Rate for Payer: Aetna Medicare |
$134.50
|
| Rate for Payer: BCBS Complete |
$107.60
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: UMR Bronson Commercial |
$123.74
|
|
|
PR FINGER SPLINT, STATIC
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS Q4049
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.25 |
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: BCN Commercial |
$2.07
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.25
|
| Rate for Payer: UMR Bronson Commercial |
$2.30
|
|
|
PR FISSURECTOMY INCL SPHINCTEROTOMY WHEN PERFORMED
|
Professional
|
Both
|
$962.00
|
|
|
Service Code
|
HCPCS 46200
|
| Min. Negotiated Rate |
$220.67 |
| Max. Negotiated Rate |
$1,577.50 |
| Rate for Payer: Aetna Commercial |
$429.74
|
| Rate for Payer: Aetna Medicare |
$333.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.74
|
| Rate for Payer: BCBS Complete |
$231.70
|
| Rate for Payer: BCBS MAPPO |
$320.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,577.50
|
| Rate for Payer: BCN Commercial |
$699.79
|
| Rate for Payer: BCN Medicare Advantage |
$320.70
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Cofinity Commercial |
$429.74
|
| Rate for Payer: Cofinity Commercial |
$461.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.74
|
| Rate for Payer: Meridian Medicaid |
$231.70
|
| Rate for Payer: Nomi Health Commercial |
$384.84
|
| Rate for Payer: PACE SWMI |
$320.70
|
| Rate for Payer: PHP Commercial |
$448.98
|
| Rate for Payer: PHP Medicare Advantage |
$320.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$625.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$612.11
|
| Rate for Payer: Priority Health Medicare |
$320.70
|
| Rate for Payer: Priority Health Narrow Network |
$612.11
|
| Rate for Payer: Priority Health SBD |
$612.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.70
|
| Rate for Payer: UHC Medicare Advantage |
$320.70
|
| Rate for Payer: UHCCP Medicaid |
$220.67
|
| Rate for Payer: UMR Bronson Commercial |
$442.52
|
|
|
PR FIT CONTACT LENS TX OCULAR SURFACE DISEASE
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
HCPCS 92071
|
| Min. Negotiated Rate |
$20.24 |
| Max. Negotiated Rate |
$664.07 |
| Rate for Payer: Aetna Commercial |
$40.09
|
| Rate for Payer: Aetna Medicare |
$31.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.08
|
| Rate for Payer: BCBS Complete |
$21.25
|
| Rate for Payer: BCBS MAPPO |
$29.92
|
| Rate for Payer: BCBS Trust/PPO |
$664.07
|
| Rate for Payer: BCN Commercial |
$52.78
|
| Rate for Payer: BCN Medicare Advantage |
$29.92
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cofinity Commercial |
$40.09
|
| Rate for Payer: Cofinity Commercial |
$43.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.42
|
| Rate for Payer: Meridian Medicaid |
$21.25
|
| Rate for Payer: Nomi Health Commercial |
$35.90
|
| Rate for Payer: PACE SWMI |
$29.92
|
| Rate for Payer: PHP Commercial |
$41.89
|
| Rate for Payer: PHP Medicare Advantage |
$29.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.44
|
| Rate for Payer: Priority Health Medicare |
$29.92
|
| Rate for Payer: Priority Health Narrow Network |
$39.44
|
| Rate for Payer: Priority Health SBD |
$39.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.92
|
| Rate for Payer: UHC Medicare Advantage |
$29.92
|
| Rate for Payer: UHCCP Medicaid |
$20.24
|
| Rate for Payer: UMR Bronson Commercial |
$30.82
|
|
|
PR FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 57160
|
| Min. Negotiated Rate |
$29.39 |
| Max. Negotiated Rate |
$2,269.05 |
| Rate for Payer: Aetna Commercial |
$59.63
|
| Rate for Payer: Aetna Medicare |
$46.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.08
|
| Rate for Payer: BCBS Complete |
$30.86
|
| Rate for Payer: BCBS MAPPO |
$44.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,269.05
|
| Rate for Payer: BCN Commercial |
$109.46
|
| Rate for Payer: BCN Medicare Advantage |
$44.50
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$59.63
|
| Rate for Payer: Cofinity Commercial |
$64.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.72
|
| Rate for Payer: Meridian Medicaid |
$30.86
|
| Rate for Payer: Nomi Health Commercial |
$53.40
|
| Rate for Payer: PACE SWMI |
$44.50
|
| Rate for Payer: PHP Commercial |
$62.30
|
| Rate for Payer: PHP Medicare Advantage |
$44.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.95
|
| Rate for Payer: Priority Health Medicare |
$44.50
|
| Rate for Payer: Priority Health Narrow Network |
$67.95
|
| Rate for Payer: Priority Health SBD |
$67.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.50
|
| Rate for Payer: UHC Medicare Advantage |
$44.50
|
| Rate for Payer: UHCCP Medicaid |
$29.39
|
| Rate for Payer: UMR Bronson Commercial |
$58.88
|
|
|
PR FITTING CONTACT LENS FOR MGMT OF KERATOCONUS 1ST
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 92072
|
| Min. Negotiated Rate |
$58.36 |
| Max. Negotiated Rate |
$900.75 |
| Rate for Payer: Aetna Commercial |
$116.02
|
| Rate for Payer: Aetna Medicare |
$90.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.68
|
| Rate for Payer: BCBS Complete |
$61.28
|
| Rate for Payer: BCBS MAPPO |
$86.58
|
| Rate for Payer: BCBS Trust/PPO |
$900.75
|
| Rate for Payer: BCN Commercial |
$183.25
|
| Rate for Payer: BCN Medicare Advantage |
$86.58
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$116.02
|
| Rate for Payer: Cofinity Commercial |
$124.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.91
|
| Rate for Payer: Meridian Medicaid |
$61.28
|
| Rate for Payer: Nomi Health Commercial |
$103.90
|
| Rate for Payer: PACE SWMI |
$86.58
|
| Rate for Payer: PHP Commercial |
$121.21
|
| Rate for Payer: PHP Medicare Advantage |
$86.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.19
|
| Rate for Payer: Priority Health Medicare |
$86.58
|
| Rate for Payer: Priority Health Narrow Network |
$114.19
|
| Rate for Payer: Priority Health SBD |
$114.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.58
|
| Rate for Payer: UHC Medicare Advantage |
$86.58
|
| Rate for Payer: UHCCP Medicaid |
$58.36
|
| Rate for Payer: UMR Bronson Commercial |
$101.66
|
|
|
PR FIXATION CONTRALATERAL TESTIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$574.00
|
|
|
Service Code
|
HCPCS 54620
|
| Min. Negotiated Rate |
$191.49 |
| Max. Negotiated Rate |
$3,422.86 |
| Rate for Payer: Aetna Commercial |
$382.24
|
| Rate for Payer: Aetna Medicare |
$296.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$410.76
|
| Rate for Payer: BCBS Complete |
$201.06
|
| Rate for Payer: BCBS MAPPO |
$285.25
|
| Rate for Payer: BCBS Trust/PPO |
$3,422.86
|
| Rate for Payer: BCN Commercial |
$431.50
|
| Rate for Payer: BCN Medicare Advantage |
$285.25
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cofinity Commercial |
$382.24
|
| Rate for Payer: Cofinity Commercial |
$410.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$299.51
|
| Rate for Payer: Meridian Medicaid |
$201.06
|
| Rate for Payer: Nomi Health Commercial |
$342.30
|
| Rate for Payer: PACE SWMI |
$285.25
|
| Rate for Payer: PHP Commercial |
$399.35
|
| Rate for Payer: PHP Medicare Advantage |
$285.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$475.62
|
| Rate for Payer: Priority Health Medicare |
$285.25
|
| Rate for Payer: Priority Health Narrow Network |
$475.62
|
| Rate for Payer: Priority Health SBD |
$475.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$285.25
|
| Rate for Payer: UHC Medicare Advantage |
$285.25
|
| Rate for Payer: UHCCP Medicaid |
$191.49
|
| Rate for Payer: UMR Bronson Commercial |
$264.04
|
|
|
PR FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY
|
Professional
|
Both
|
$1,733.00
|
|
|
Service Code
|
HCPCS 15740
|
| Min. Negotiated Rate |
$543.58 |
| Max. Negotiated Rate |
$1,709.25 |
| Rate for Payer: Aetna Commercial |
$1,074.45
|
| Rate for Payer: Aetna Medicare |
$833.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,074.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,154.64
|
| Rate for Payer: BCBS Complete |
$570.76
|
| Rate for Payer: BCBS MAPPO |
$801.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,709.25
|
| Rate for Payer: BCN Commercial |
$1,478.74
|
| Rate for Payer: BCN Medicare Advantage |
$801.83
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cofinity Commercial |
$1,074.45
|
| Rate for Payer: Cofinity Commercial |
$1,154.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$801.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$841.92
|
| Rate for Payer: Meridian Medicaid |
$570.76
|
| Rate for Payer: Nomi Health Commercial |
$962.20
|
| Rate for Payer: PACE SWMI |
$801.83
|
| Rate for Payer: PHP Commercial |
$1,122.56
|
| Rate for Payer: PHP Medicare Advantage |
$801.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$543.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,126.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,142.33
|
| Rate for Payer: Priority Health Medicare |
$801.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,142.33
|
| Rate for Payer: Priority Health SBD |
$1,142.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$801.83
|
| Rate for Payer: UHC Medicare Advantage |
$801.83
|
| Rate for Payer: UHCCP Medicaid |
$543.58
|
| Rate for Payer: UMR Bronson Commercial |
$797.18
|
|
|
PR FLUORESCEIN ANGIOSCOPY INTERPRETATION & REPORT
|
Professional
|
Both
|
$118.00
|
|
|
Service Code
|
HCPCS 92230
|
| Min. Negotiated Rate |
$20.02 |
| Max. Negotiated Rate |
$1,393.66 |
| Rate for Payer: Aetna Commercial |
$39.89
|
| Rate for Payer: Aetna Medicare |
$30.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.87
|
| Rate for Payer: BCBS Complete |
$21.02
|
| Rate for Payer: BCBS MAPPO |
$29.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,393.66
|
| Rate for Payer: BCN Commercial |
$163.71
|
| Rate for Payer: BCN Medicare Advantage |
$29.77
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cofinity Commercial |
$39.89
|
| Rate for Payer: Cofinity Commercial |
$42.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.26
|
| Rate for Payer: Meridian Medicaid |
$21.02
|
| Rate for Payer: Nomi Health Commercial |
$35.72
|
| Rate for Payer: PACE SWMI |
$29.77
|
| Rate for Payer: PHP Commercial |
$41.68
|
| Rate for Payer: PHP Medicare Advantage |
$29.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.35
|
| Rate for Payer: Priority Health Medicare |
$29.77
|
| Rate for Payer: Priority Health Narrow Network |
$42.35
|
| Rate for Payer: Priority Health SBD |
$42.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.77
|
| Rate for Payer: UHC Medicare Advantage |
$29.77
|
| Rate for Payer: UHCCP Medicaid |
$20.02
|
| Rate for Payer: UMR Bronson Commercial |
$54.28
|
|
