|
PR HOME/RES VISIT EST PATIENT SF MDM 20 MINUTES
|
Professional
|
Both
|
$101.00
|
|
|
Service Code
|
HCPCS 99347
|
| Min. Negotiated Rate |
$40.40 |
| Max. Negotiated Rate |
$728.53 |
| Rate for Payer: Aetna Commercial |
$57.23
|
| Rate for Payer: Aetna Medicare |
$44.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.50
|
| Rate for Payer: BCBS Complete |
$40.40
|
| Rate for Payer: BCBS MAPPO |
$42.71
|
| Rate for Payer: BCBS Trust/PPO |
$728.53
|
| Rate for Payer: BCN Commercial |
$64.51
|
| Rate for Payer: BCN Medicare Advantage |
$42.71
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cofinity Commercial |
$61.50
|
| Rate for Payer: Cofinity Commercial |
$57.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.85
|
| Rate for Payer: Nomi Health Commercial |
$51.25
|
| Rate for Payer: PACE SWMI |
$42.71
|
| Rate for Payer: PHP Commercial |
$59.79
|
| Rate for Payer: PHP Medicare Advantage |
$42.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.57
|
| Rate for Payer: Priority Health Medicare |
$42.71
|
| Rate for Payer: Priority Health Narrow Network |
$60.57
|
| Rate for Payer: Priority Health SBD |
$60.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.71
|
| Rate for Payer: UHC Medicare Advantage |
$42.71
|
| Rate for Payer: UMR Bronson Commercial |
$46.46
|
|
|
PR HOME/RES VISIT NEW PATIENT HIGH MDM 75 MINUTES
|
Professional
|
Both
|
$404.00
|
|
|
Service Code
|
HCPCS 99345
|
| Min. Negotiated Rate |
$161.60 |
| Max. Negotiated Rate |
$321.73 |
| Rate for Payer: Aetna Commercial |
$254.33
|
| Rate for Payer: Aetna Medicare |
$197.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.31
|
| Rate for Payer: BCBS Complete |
$161.60
|
| Rate for Payer: BCBS MAPPO |
$189.80
|
| Rate for Payer: BCBS Trust/PPO |
$321.73
|
| Rate for Payer: BCN Commercial |
$292.23
|
| Rate for Payer: BCN Medicare Advantage |
$189.80
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cash Price |
$323.20
|
| Rate for Payer: Cofinity Commercial |
$254.33
|
| Rate for Payer: Cofinity Commercial |
$273.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.29
|
| Rate for Payer: Nomi Health Commercial |
$227.76
|
| Rate for Payer: PACE SWMI |
$189.80
|
| Rate for Payer: PHP Commercial |
$265.72
|
| Rate for Payer: PHP Medicare Advantage |
$189.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$269.68
|
| Rate for Payer: Priority Health Medicare |
$189.80
|
| Rate for Payer: Priority Health Narrow Network |
$269.68
|
| Rate for Payer: Priority Health SBD |
$269.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.80
|
| Rate for Payer: UHC Medicare Advantage |
$189.80
|
| Rate for Payer: UMR Bronson Commercial |
$185.84
|
|
|
PR HOME/RES VISIT NEW PATIENT LOW MDM 30 MINUTES
|
Professional
|
Both
|
$162.00
|
|
|
Service Code
|
HCPCS 99342
|
| Min. Negotiated Rate |
$64.80 |
| Max. Negotiated Rate |
$133.13 |
| Rate for Payer: Aetna Commercial |
$99.56
|
| Rate for Payer: Aetna Medicare |
$77.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.56
|
| Rate for Payer: BCBS Complete |
$64.80
|
| Rate for Payer: BCBS MAPPO |
$74.30
|
| Rate for Payer: BCBS Trust/PPO |
$133.13
|
| Rate for Payer: BCN Commercial |
$112.40
|
| Rate for Payer: BCN Medicare Advantage |
$74.30
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cofinity Commercial |
$99.56
|
| Rate for Payer: Cofinity Commercial |
$106.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.02
|
| Rate for Payer: Nomi Health Commercial |
$89.16
|
| Rate for Payer: PACE SWMI |
$74.30
|
| Rate for Payer: PHP Commercial |
$104.02
|
| Rate for Payer: PHP Medicare Advantage |
$74.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.55
|
| Rate for Payer: Priority Health Medicare |
$74.30
|
| Rate for Payer: Priority Health Narrow Network |
$104.55
|
| Rate for Payer: Priority Health SBD |
$104.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.30
|
| Rate for Payer: UHC Medicare Advantage |
$74.30
|
| Rate for Payer: UMR Bronson Commercial |
$74.52
|
|
|
PR HOME/RES VISIT NEW PATIENT MOD MDM 60 MINUTES
|
Professional
|
Both
|
$315.00
|
|
|
Service Code
|
HCPCS 99344
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$207.69 |
| Rate for Payer: Priority Health SBD |
$189.81
|
| Rate for Payer: Aetna Commercial |
$179.92
|
| Rate for Payer: Aetna Medicare |
$139.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.35
|
| Rate for Payer: BCBS Complete |
$126.00
|
| Rate for Payer: BCBS MAPPO |
$134.27
|
| Rate for Payer: BCBS Trust/PPO |
$178.57
|
| Rate for Payer: BCN Commercial |
$207.69
|
| Rate for Payer: BCN Medicare Advantage |
$134.27
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cofinity Commercial |
$179.92
|
| Rate for Payer: Cofinity Commercial |
$193.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.98
|
| Rate for Payer: Nomi Health Commercial |
$161.12
|
| Rate for Payer: PACE SWMI |
$134.27
|
| Rate for Payer: PHP Commercial |
$187.98
|
| Rate for Payer: PHP Medicare Advantage |
$134.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$204.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.81
|
| Rate for Payer: Priority Health Medicare |
$134.27
|
| Rate for Payer: Priority Health Narrow Network |
$189.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.27
|
| Rate for Payer: UHC Medicare Advantage |
$134.27
|
| Rate for Payer: UMR Bronson Commercial |
$144.90
|
|
|
PR HOME/RES VISIT NEW PATIENT SF MDM 15 MINUTES
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS 99341
|
| Min. Negotiated Rate |
$46.54 |
| Max. Negotiated Rate |
$431.62 |
| Rate for Payer: Aetna Commercial |
$62.36
|
| Rate for Payer: Aetna Medicare |
$48.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.02
|
| Rate for Payer: BCBS Complete |
$52.00
|
| Rate for Payer: BCBS MAPPO |
$46.54
|
| Rate for Payer: BCBS Trust/PPO |
$431.62
|
| Rate for Payer: BCN Commercial |
$70.37
|
| Rate for Payer: BCN Medicare Advantage |
$46.54
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cofinity Commercial |
$67.02
|
| Rate for Payer: Cofinity Commercial |
$62.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.87
|
| Rate for Payer: Nomi Health Commercial |
$55.85
|
| Rate for Payer: PACE SWMI |
$46.54
|
| Rate for Payer: PHP Commercial |
$65.16
|
| Rate for Payer: PHP Medicare Advantage |
$46.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.96
|
| Rate for Payer: Priority Health Medicare |
$46.54
|
| Rate for Payer: Priority Health Narrow Network |
$65.96
|
| Rate for Payer: Priority Health SBD |
$65.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.54
|
| Rate for Payer: UHC Medicare Advantage |
$46.54
|
| Rate for Payer: UMR Bronson Commercial |
$59.80
|
|
|
PR HOME SLEEP TEST/TYPE 3 PORTA
|
Professional
|
Both
|
$355.00
|
|
|
Service Code
|
HCPCS G0399
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$1,157.51 |
| Rate for Payer: Aetna Commercial |
$187.42
|
| Rate for Payer: Aetna Medicare |
$177.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.42
|
| Rate for Payer: BCBS Complete |
$142.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,157.51
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.05
|
| Rate for Payer: Priority Health Narrow Network |
$137.05
|
| Rate for Payer: Priority Health SBD |
$58.80
|
| Rate for Payer: UMR Bronson Commercial |
$163.30
|
|
|
PR HOME SLEEP TEST/TYPE 4 PORTA
|
Professional
|
Both
|
$355.00
|
|
|
Service Code
|
HCPCS G0400
|
| Min. Negotiated Rate |
$64.23 |
| Max. Negotiated Rate |
$1,317.05 |
| 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 |
$73.00
|
| Rate for Payer: Aetna Medicare |
$104.50
|
| Rate for Payer: Aetna Medicare |
$177.50
|
| 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 |
$83.60
|
| Rate for Payer: BCBS Complete |
$58.40
|
| Rate for Payer: BCBS Complete |
$142.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,317.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,317.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,317.05
|
| 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 |
$167.20
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.65
|
| Rate for Payer: Priority Health Narrow Network |
$145.65
|
| Rate for Payer: Priority Health Narrow Network |
$145.65
|
| Rate for Payer: Priority Health Narrow Network |
$145.65
|
| Rate for Payer: Priority Health SBD |
$64.23
|
| Rate for Payer: Priority Health SBD |
$64.23
|
| Rate for Payer: Priority Health SBD |
$64.23
|
| Rate for Payer: UMR Bronson Commercial |
$96.14
|
| Rate for Payer: UMR Bronson Commercial |
$67.16
|
| Rate for Payer: UMR Bronson Commercial |
$163.30
|
|
|
PR HOME VENTILATOR MGMT CARE OVERSIGHT 30 MIN/>
|
Professional
|
Both
|
$191.00
|
|
|
Service Code
|
HCPCS 94005
|
| Min. Negotiated Rate |
$76.40 |
| Max. Negotiated Rate |
$130.48 |
| Rate for Payer: Aetna Commercial |
$100.62
|
| Rate for Payer: Aetna Medicare |
$95.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.62
|
| Rate for Payer: BCBS Complete |
$76.40
|
| Rate for Payer: BCN Commercial |
$130.48
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$124.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$122.13
|
| Rate for Payer: Priority Health Narrow Network |
$122.13
|
| Rate for Payer: Priority Health SBD |
$122.13
|
| Rate for Payer: UMR Bronson Commercial |
$87.86
|
|
|
PR HOME VST NEW PATIENT MOD-HI SEVERITY 45 MINUTES
|
Professional
|
Both
|
$239.00
|
|
|
Service Code
|
HCPCS 99343
|
| Min. Negotiated Rate |
$95.60 |
| Max. Negotiated Rate |
$155.35 |
| Rate for Payer: Aetna Medicare |
$119.50
|
| Rate for Payer: BCBS Complete |
$95.60
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.35
|
| Rate for Payer: UMR Bronson Commercial |
$109.94
|
|
|
PR HOPD MNTL HLT, 15-29 MIN
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS C7900
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: UMR Bronson Commercial |
$23.46
|
|
|
PR HOPD MNTL HLT, 30-60 MIN
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS C7901
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: UMR Bronson Commercial |
$23.46
|
|
|
PR HOPD MNTL HLT, EA ADDL
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS C7902
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: UMR Bronson Commercial |
$23.46
|
|
|
PR HOSPICE CARE SUPERVISION
|
Professional
|
Both
|
$191.00
|
|
|
Service Code
|
HCPCS G0182
|
| Min. Negotiated Rate |
$19.02 |
| Max. Negotiated Rate |
$151.49 |
| Rate for Payer: Aetna Commercial |
$131.24
|
| Rate for Payer: Aetna Medicare |
$101.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.03
|
| Rate for Payer: BCBS Complete |
$76.40
|
| Rate for Payer: BCBS MAPPO |
$97.94
|
| Rate for Payer: BCBS Trust/PPO |
$19.02
|
| Rate for Payer: BCN Commercial |
$151.49
|
| Rate for Payer: BCN Medicare Advantage |
$97.94
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cofinity Commercial |
$141.03
|
| Rate for Payer: Cofinity Commercial |
$131.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.84
|
| Rate for Payer: Nomi Health Commercial |
$117.53
|
| Rate for Payer: PACE SWMI |
$97.94
|
| Rate for Payer: PHP Commercial |
$137.12
|
| Rate for Payer: PHP Medicare Advantage |
$97.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$124.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.57
|
| Rate for Payer: Priority Health Medicare |
$97.94
|
| Rate for Payer: Priority Health Narrow Network |
$141.57
|
| Rate for Payer: Priority Health SBD |
$141.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.94
|
| Rate for Payer: UHC Medicare Advantage |
$97.94
|
| Rate for Payer: UMR Bronson Commercial |
$87.86
|
|
|
PR HOSPITAL IP/OBS CARE SAME DATE HIGH MDM 85 MIN
|
Professional
|
Both
|
$392.00
|
|
|
Service Code
|
HCPCS 99236
|
| Min. Negotiated Rate |
$131.42 |
| Max. Negotiated Rate |
$1,191.84 |
| Rate for Payer: Aetna Commercial |
$263.97
|
| Rate for Payer: Aetna Medicare |
$204.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.97
|
| Rate for Payer: BCBS Complete |
$137.99
|
| Rate for Payer: BCBS MAPPO |
$196.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,191.84
|
| Rate for Payer: BCN Commercial |
$301.51
|
| Rate for Payer: BCN Medicare Advantage |
$196.99
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cofinity Commercial |
$283.67
|
| Rate for Payer: Cofinity Commercial |
$263.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.84
|
| Rate for Payer: Meridian Medicaid |
$137.99
|
| Rate for Payer: Nomi Health Commercial |
$236.39
|
| Rate for Payer: PACE SWMI |
$196.99
|
| Rate for Payer: PHP Commercial |
$275.79
|
| Rate for Payer: PHP Medicare Advantage |
$196.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$277.31
|
| Rate for Payer: Priority Health Medicare |
$196.99
|
| Rate for Payer: Priority Health Narrow Network |
$277.31
|
| Rate for Payer: Priority Health SBD |
$277.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.99
|
| Rate for Payer: UHC Medicare Advantage |
$196.99
|
| Rate for Payer: UHCCP Medicaid |
$131.42
|
| Rate for Payer: UMR Bronson Commercial |
$180.32
|
|
|
PR HOSPITAL IP/OBS CARE SAME DATE MOD MDM 70 MIN
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 99235
|
| Min. Negotiated Rate |
$100.54 |
| Max. Negotiated Rate |
$230.17 |
| Rate for Payer: Aetna Commercial |
$201.60
|
| Rate for Payer: Aetna Medicare |
$156.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.65
|
| Rate for Payer: BCBS Complete |
$105.57
|
| Rate for Payer: BCBS MAPPO |
$150.45
|
| Rate for Payer: BCBS Trust/PPO |
$218.72
|
| Rate for Payer: BCN Commercial |
$230.17
|
| Rate for Payer: BCN Medicare Advantage |
$150.45
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cofinity Commercial |
$201.60
|
| Rate for Payer: Cofinity Commercial |
$216.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.97
|
| Rate for Payer: Meridian Medicaid |
$105.57
|
| Rate for Payer: Nomi Health Commercial |
$180.54
|
| Rate for Payer: PACE SWMI |
$150.45
|
| Rate for Payer: PHP Commercial |
$210.63
|
| Rate for Payer: PHP Medicare Advantage |
$150.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.24
|
| Rate for Payer: Priority Health Medicare |
$150.45
|
| Rate for Payer: Priority Health Narrow Network |
$212.24
|
| Rate for Payer: Priority Health SBD |
$212.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.45
|
| Rate for Payer: UHC Medicare Advantage |
$150.45
|
| Rate for Payer: UHCCP Medicaid |
$100.54
|
| Rate for Payer: UMR Bronson Commercial |
$145.36
|
|
|
PR HOSPITAL IP/OBS CARE SAME DATE SF/LOW MDM 45 MIN
|
Professional
|
Both
|
$241.00
|
|
|
Service Code
|
HCPCS 99234
|
| Min. Negotiated Rate |
$61.77 |
| Max. Negotiated Rate |
$1,631.92 |
| Rate for Payer: Aetna Commercial |
$124.04
|
| Rate for Payer: Aetna Medicare |
$96.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.30
|
| Rate for Payer: BCBS Complete |
$64.86
|
| Rate for Payer: BCBS MAPPO |
$92.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,631.92
|
| Rate for Payer: BCN Commercial |
$142.69
|
| Rate for Payer: BCN Medicare Advantage |
$92.57
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cofinity Commercial |
$124.04
|
| Rate for Payer: Cofinity Commercial |
$133.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.20
|
| Rate for Payer: Meridian Medicaid |
$64.86
|
| Rate for Payer: Nomi Health Commercial |
$111.08
|
| Rate for Payer: PACE SWMI |
$92.57
|
| Rate for Payer: PHP Commercial |
$129.60
|
| Rate for Payer: PHP Medicare Advantage |
$92.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.13
|
| Rate for Payer: Priority Health Medicare |
$92.57
|
| Rate for Payer: Priority Health Narrow Network |
$130.13
|
| Rate for Payer: Priority Health SBD |
$130.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.57
|
| Rate for Payer: UHC Medicare Advantage |
$92.57
|
| Rate for Payer: UHCCP Medicaid |
$61.77
|
| Rate for Payer: UMR Bronson Commercial |
$110.86
|
|
|
PR HOSPITAL IP/OBS DISCHARGE DAY MGMT > 30 MIN
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 99239
|
| Min. Negotiated Rate |
$72.85 |
| Max. Negotiated Rate |
$1,216.15 |
| Rate for Payer: Aetna Commercial |
$145.15
|
| Rate for Payer: Aetna Medicare |
$112.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.98
|
| Rate for Payer: BCBS Complete |
$76.49
|
| Rate for Payer: BCBS MAPPO |
$108.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,216.15
|
| Rate for Payer: BCN Commercial |
$165.66
|
| Rate for Payer: BCN Medicare Advantage |
$108.32
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$145.15
|
| Rate for Payer: Cofinity Commercial |
$155.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.74
|
| Rate for Payer: Meridian Medicaid |
$76.49
|
| Rate for Payer: Nomi Health Commercial |
$129.98
|
| Rate for Payer: PACE SWMI |
$108.32
|
| Rate for Payer: PHP Commercial |
$151.65
|
| Rate for Payer: PHP Medicare Advantage |
$108.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$152.57
|
| Rate for Payer: Priority Health Medicare |
$108.32
|
| Rate for Payer: Priority Health Narrow Network |
$152.57
|
| Rate for Payer: Priority Health SBD |
$152.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.32
|
| Rate for Payer: UHC Medicare Advantage |
$108.32
|
| Rate for Payer: UHCCP Medicaid |
$72.85
|
| Rate for Payer: UMR Bronson Commercial |
$117.30
|
|
|
PR HOSPITAL IP/OBS DISCHARGE DAY MGMT 30 MIN/<
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 99238
|
| Min. Negotiated Rate |
$51.55 |
| Max. Negotiated Rate |
$255.17 |
| Rate for Payer: Aetna Commercial |
$102.71
|
| Rate for Payer: Aetna Medicare |
$79.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.38
|
| Rate for Payer: BCBS Complete |
$54.13
|
| Rate for Payer: BCBS MAPPO |
$76.65
|
| Rate for Payer: BCBS Trust/PPO |
$255.17
|
| Rate for Payer: BCN Commercial |
$116.79
|
| Rate for Payer: BCN Medicare Advantage |
$76.65
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$102.71
|
| Rate for Payer: Cofinity Commercial |
$110.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.48
|
| Rate for Payer: Meridian Medicaid |
$54.13
|
| Rate for Payer: Nomi Health Commercial |
$91.98
|
| Rate for Payer: PACE SWMI |
$76.65
|
| Rate for Payer: PHP Commercial |
$107.31
|
| Rate for Payer: PHP Medicare Advantage |
$76.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.14
|
| Rate for Payer: Priority Health Medicare |
$76.65
|
| Rate for Payer: Priority Health Narrow Network |
$108.14
|
| Rate for Payer: Priority Health SBD |
$108.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.65
|
| Rate for Payer: UHC Medicare Advantage |
$76.65
|
| Rate for Payer: UHCCP Medicaid |
$51.55
|
| Rate for Payer: UMR Bronson Commercial |
$57.50
|
|
|
PR HO W/O JOINTS CF
|
Professional
|
Both
|
$253.00
|
|
|
Service Code
|
HCPCS L3919
|
| Min. Negotiated Rate |
$101.20 |
| Max. Negotiated Rate |
$234.03 |
| Rate for Payer: BCBS Complete |
$101.20
|
| Rate for Payer: BCN Commercial |
$234.03
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.45
|
| Rate for Payer: UMR Bronson Commercial |
$116.38
|
|
|
PR HRHC 1 COL/GRP W/FSTULECTMY INCL FSSRECTOMY
|
Professional
|
Both
|
$1,182.00
|
|
|
Service Code
|
HCPCS 46258
|
| Min. Negotiated Rate |
$313.96 |
| Max. Negotiated Rate |
$1,432.75 |
| Rate for Payer: Aetna Commercial |
$625.39
|
| Rate for Payer: Aetna Medicare |
$485.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$672.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$625.39
|
| Rate for Payer: BCBS Complete |
$329.66
|
| Rate for Payer: BCBS MAPPO |
$466.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,432.75
|
| Rate for Payer: BCN Commercial |
$707.61
|
| Rate for Payer: BCN Medicare Advantage |
$466.71
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cofinity Commercial |
$625.39
|
| Rate for Payer: Cofinity Commercial |
$672.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$466.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$490.05
|
| Rate for Payer: Meridian Medicaid |
$329.66
|
| Rate for Payer: Nomi Health Commercial |
$560.05
|
| Rate for Payer: PACE SWMI |
$466.71
|
| Rate for Payer: PHP Commercial |
$653.39
|
| Rate for Payer: PHP Medicare Advantage |
$466.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$872.82
|
| Rate for Payer: Priority Health Medicare |
$466.71
|
| Rate for Payer: Priority Health Narrow Network |
$872.82
|
| Rate for Payer: Priority Health SBD |
$872.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$466.71
|
| Rate for Payer: UHC Medicare Advantage |
$466.71
|
| Rate for Payer: UHCCP Medicaid |
$313.96
|
| Rate for Payer: UMR Bronson Commercial |
$543.72
|
|
|
PR HRHC 2/> COL/GRP W/FSTULECTMY INCL FSSRECTMY
|
Professional
|
Both
|
$1,775.00
|
|
|
Service Code
|
HCPCS 46262
|
| Min. Negotiated Rate |
$236.15 |
| Max. Negotiated Rate |
$1,153.75 |
| Rate for Payer: Aetna Commercial |
$761.05
|
| Rate for Payer: Aetna Medicare |
$590.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$761.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$817.85
|
| Rate for Payer: BCBS Complete |
$400.78
|
| Rate for Payer: BCBS MAPPO |
$567.95
|
| Rate for Payer: BCBS Trust/PPO |
$236.15
|
| Rate for Payer: BCN Commercial |
$862.52
|
| Rate for Payer: BCN Medicare Advantage |
$567.95
|
| Rate for Payer: Cash Price |
$1,420.00
|
| Rate for Payer: Cash Price |
$1,420.00
|
| Rate for Payer: Cofinity Commercial |
$761.05
|
| Rate for Payer: Cofinity Commercial |
$817.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$567.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$596.35
|
| Rate for Payer: Meridian Medicaid |
$400.78
|
| Rate for Payer: Nomi Health Commercial |
$681.54
|
| Rate for Payer: PACE SWMI |
$567.95
|
| Rate for Payer: PHP Commercial |
$795.13
|
| Rate for Payer: PHP Medicare Advantage |
$567.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$381.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,153.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,057.77
|
| Rate for Payer: Priority Health Medicare |
$567.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,057.77
|
| Rate for Payer: Priority Health SBD |
$1,057.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$567.95
|
| Rate for Payer: UHC Medicare Advantage |
$567.95
|
| Rate for Payer: UHCCP Medicaid |
$381.70
|
| Rate for Payer: UMR Bronson Commercial |
$816.50
|
|
|
PR HRHC NTRNL & XTRNL 2/> COLUMN/GROUP W/FISSU
|
Professional
|
Both
|
$1,732.00
|
|
|
Service Code
|
HCPCS 46261
|
| Min. Negotiated Rate |
$131.02 |
| Max. Negotiated Rate |
$1,125.80 |
| Rate for Payer: Aetna Commercial |
$686.08
|
| Rate for Payer: Aetna Medicare |
$532.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$686.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$737.28
|
| Rate for Payer: BCBS Complete |
$362.31
|
| Rate for Payer: BCBS MAPPO |
$512.00
|
| Rate for Payer: BCBS Trust/PPO |
$131.02
|
| Rate for Payer: BCN Commercial |
$776.51
|
| Rate for Payer: BCN Medicare Advantage |
$512.00
|
| Rate for Payer: Cash Price |
$1,385.60
|
| Rate for Payer: Cash Price |
$1,385.60
|
| Rate for Payer: Cofinity Commercial |
$686.08
|
| Rate for Payer: Cofinity Commercial |
$737.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$512.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$537.60
|
| Rate for Payer: Meridian Medicaid |
$362.31
|
| Rate for Payer: Nomi Health Commercial |
$614.40
|
| Rate for Payer: PACE SWMI |
$512.00
|
| Rate for Payer: PHP Commercial |
$716.80
|
| Rate for Payer: PHP Medicare Advantage |
$512.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,125.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$961.11
|
| Rate for Payer: Priority Health Medicare |
$512.00
|
| Rate for Payer: Priority Health Narrow Network |
$961.11
|
| Rate for Payer: Priority Health SBD |
$961.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$512.00
|
| Rate for Payer: UHC Medicare Advantage |
$512.00
|
| Rate for Payer: UHCCP Medicaid |
$345.06
|
| Rate for Payer: UMR Bronson Commercial |
$796.72
|
|
|
PR HYALGAN SUPARTZ VISCO-3 DOSE
|
Professional
|
Both
|
$303.00
|
|
|
Service Code
|
HCPCS J7321
|
| Min. Negotiated Rate |
$64.00 |
| Max. Negotiated Rate |
$196.95 |
| Rate for Payer: Aetna Commercial |
$98.34
|
| Rate for Payer: Aetna Medicare |
$76.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.34
|
| Rate for Payer: BCBS Complete |
$121.20
|
| Rate for Payer: BCBS MAPPO |
$73.39
|
| Rate for Payer: BCBS Trust/PPO |
$64.00
|
| Rate for Payer: BCN Commercial |
$76.58
|
| Rate for Payer: BCN Medicare Advantage |
$73.39
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cofinity Commercial |
$105.68
|
| Rate for Payer: Cofinity Commercial |
$98.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.06
|
| Rate for Payer: Nomi Health Commercial |
$88.06
|
| Rate for Payer: PACE SWMI |
$73.39
|
| Rate for Payer: PHP Commercial |
$102.74
|
| Rate for Payer: PHP Medicare Advantage |
$73.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.95
|
| Rate for Payer: Priority Health Medicare |
$73.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.39
|
| Rate for Payer: UHC Medicare Advantage |
$73.39
|
| Rate for Payer: UMR Bronson Commercial |
$139.38
|
|
|
PR HYDROCORTISONE SODIUM SUCC I
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J1720
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$30.53 |
| Rate for Payer: Aetna Commercial |
$28.41
|
| Rate for Payer: Aetna Medicare |
$22.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.53
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$21.20
|
| Rate for Payer: BCBS Trust/PPO |
$16.18
|
| Rate for Payer: BCN Commercial |
$16.11
|
| Rate for Payer: BCN Medicare Advantage |
$21.20
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$28.41
|
| Rate for Payer: Cofinity Commercial |
$30.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.26
|
| Rate for Payer: Nomi Health Commercial |
$25.44
|
| Rate for Payer: PACE SWMI |
$21.20
|
| Rate for Payer: PHP Commercial |
$29.68
|
| Rate for Payer: PHP Medicare Advantage |
$21.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: Priority Health Medicare |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.20
|
| Rate for Payer: UHC Medicare Advantage |
$21.20
|
| Rate for Payer: UMR Bronson Commercial |
$4.60
|
|
|
PR HYDROMORPHONE INJECTION
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS J1170
|
| Min. Negotiated Rate |
$0.24 |
| 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: BCBS Trust/PPO |
$0.40
|
| Rate for Payer: BCN Commercial |
$0.24
|
| 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
|
|
