|
PR INJECTION AA&/STRD ILIOINGUINAL IH NERVES
|
Professional
|
Both
|
$669.00
|
|
|
Service Code
|
HCPCS 64425
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$1,001.13 |
| Rate for Payer: Aetna Commercial |
$69.36
|
| Rate for Payer: Aetna Medicare |
$53.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.53
|
| Rate for Payer: BCBS Complete |
$36.46
|
| Rate for Payer: BCBS MAPPO |
$51.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,001.13
|
| Rate for Payer: BCN Commercial |
$161.75
|
| Rate for Payer: BCN Medicare Advantage |
$51.76
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cofinity Commercial |
$69.36
|
| Rate for Payer: Cofinity Commercial |
$74.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.35
|
| Rate for Payer: Meridian Medicaid |
$36.46
|
| Rate for Payer: Nomi Health Commercial |
$62.11
|
| Rate for Payer: PACE SWMI |
$51.76
|
| Rate for Payer: PHP Commercial |
$72.46
|
| Rate for Payer: PHP Medicare Advantage |
$51.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$434.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.14
|
| Rate for Payer: Priority Health Medicare |
$51.76
|
| Rate for Payer: Priority Health Narrow Network |
$92.14
|
| Rate for Payer: Priority Health SBD |
$92.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.76
|
| Rate for Payer: UHC Medicare Advantage |
$51.76
|
| Rate for Payer: UHCCP Medicaid |
$34.72
|
| Rate for Payer: UMR Bronson Commercial |
$307.74
|
|
|
PR INJECTION AA&/STRD INTERCOSTAL NRV EA ADDL LVL
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 64421
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$368.75 |
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna Medicare |
$24.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.54
|
| Rate for Payer: BCBS Complete |
$16.33
|
| Rate for Payer: BCBS MAPPO |
$23.29
|
| Rate for Payer: BCBS Trust/PPO |
$368.75
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: BCN Medicare Advantage |
$23.29
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$31.21
|
| Rate for Payer: Cofinity Commercial |
$33.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.45
|
| Rate for Payer: Meridian Medicaid |
$16.33
|
| Rate for Payer: Nomi Health Commercial |
$27.95
|
| Rate for Payer: PACE SWMI |
$23.29
|
| Rate for Payer: PHP Commercial |
$32.61
|
| Rate for Payer: PHP Medicare Advantage |
$23.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.08
|
| Rate for Payer: Priority Health Medicare |
$23.29
|
| Rate for Payer: Priority Health Narrow Network |
$42.08
|
| Rate for Payer: Priority Health SBD |
$42.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.29
|
| Rate for Payer: UHC Medicare Advantage |
$23.29
|
| Rate for Payer: UHCCP Medicaid |
$15.55
|
| Rate for Payer: UMR Bronson Commercial |
$93.84
|
|
|
PR INJECTION AA&/STRD INTERCOSTAL NRV SINGLE LVL
|
Professional
|
Both
|
$219.00
|
|
|
Service Code
|
HCPCS 64420
|
| Min. Negotiated Rate |
$37.49 |
| Max. Negotiated Rate |
$551.55 |
| Rate for Payer: Aetna Commercial |
$75.03
|
| Rate for Payer: Aetna Medicare |
$58.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.63
|
| Rate for Payer: BCBS Complete |
$39.36
|
| Rate for Payer: BCBS MAPPO |
$55.99
|
| Rate for Payer: BCBS Trust/PPO |
$551.55
|
| Rate for Payer: BCN Commercial |
$142.21
|
| Rate for Payer: BCN Medicare Advantage |
$55.99
|
| Rate for Payer: Cash Price |
$175.20
|
| Rate for Payer: Cash Price |
$175.20
|
| Rate for Payer: Cofinity Commercial |
$75.03
|
| Rate for Payer: Cofinity Commercial |
$80.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.79
|
| Rate for Payer: Meridian Medicaid |
$39.36
|
| Rate for Payer: Nomi Health Commercial |
$67.19
|
| Rate for Payer: PACE SWMI |
$55.99
|
| Rate for Payer: PHP Commercial |
$78.39
|
| Rate for Payer: PHP Medicare Advantage |
$55.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.39
|
| Rate for Payer: Priority Health Medicare |
$55.99
|
| Rate for Payer: Priority Health Narrow Network |
$98.39
|
| Rate for Payer: Priority Health SBD |
$98.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.99
|
| Rate for Payer: UHC Medicare Advantage |
$55.99
|
| Rate for Payer: UHCCP Medicaid |
$37.49
|
| Rate for Payer: UMR Bronson Commercial |
$100.74
|
|
|
PR INJECTION AA&/STRD NERVES NRVTG SI JOINT W/IMG
|
Professional
|
Both
|
$414.00
|
|
|
Service Code
|
HCPCS 64451
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$580.60 |
| Rate for Payer: Aetna Commercial |
$104.71
|
| Rate for Payer: Aetna Medicare |
$81.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.52
|
| Rate for Payer: BCBS Complete |
$55.02
|
| Rate for Payer: BCBS MAPPO |
$78.14
|
| Rate for Payer: BCBS Trust/PPO |
$580.60
|
| Rate for Payer: BCN Commercial |
$333.28
|
| Rate for Payer: BCN Medicare Advantage |
$78.14
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cofinity Commercial |
$104.71
|
| Rate for Payer: Cofinity Commercial |
$112.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.05
|
| Rate for Payer: Meridian Medicaid |
$55.02
|
| Rate for Payer: Nomi Health Commercial |
$93.77
|
| Rate for Payer: PACE SWMI |
$78.14
|
| Rate for Payer: PHP Commercial |
$109.40
|
| Rate for Payer: PHP Medicare Advantage |
$78.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.20
|
| Rate for Payer: Priority Health Medicare |
$78.14
|
| Rate for Payer: Priority Health Narrow Network |
$138.20
|
| Rate for Payer: Priority Health SBD |
$138.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.14
|
| Rate for Payer: UHC Medicare Advantage |
$78.14
|
| Rate for Payer: UHCCP Medicaid |
$52.40
|
| Rate for Payer: UMR Bronson Commercial |
$190.44
|
|
|
PR INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH
|
Facility
|
IP
|
$259.00
|
|
|
Service Code
|
CPT 64450
|
| Hospital Charge Code |
64450
|
| Min. Negotiated Rate |
$113.96 |
| Max. Negotiated Rate |
$233.10 |
| Rate for Payer: Aetna American Axle |
$168.35
|
| Rate for Payer: Aetna Commercial |
$220.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.35
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$181.30
|
| Rate for Payer: Cofinity Commercial |
$222.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$181.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.20
|
| Rate for Payer: Healthscope Commercial |
$233.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$181.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.15
|
| Rate for Payer: PHP Commercial |
$220.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health SBD |
$163.17
|
| Rate for Payer: UMR Bronson Commercial |
$113.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.25
|
|
|
PR INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 64450
|
| Hospital Charge Code |
64450
|
| Min. Negotiated Rate |
$26.41 |
| Max. Negotiated Rate |
$661.43 |
| Rate for Payer: Aetna Commercial |
$52.65
|
| Rate for Payer: Aetna Medicare |
$40.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.58
|
| Rate for Payer: BCBS Complete |
$27.73
|
| Rate for Payer: BCBS MAPPO |
$39.29
|
| Rate for Payer: BCBS Trust/PPO |
$661.43
|
| Rate for Payer: BCN Commercial |
$87.96
|
| Rate for Payer: BCN Medicare Advantage |
$39.29
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$56.58
|
| Rate for Payer: Cofinity Commercial |
$52.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.25
|
| Rate for Payer: Meridian Medicaid |
$27.73
|
| Rate for Payer: Nomi Health Commercial |
$47.15
|
| Rate for Payer: PACE SWMI |
$39.29
|
| Rate for Payer: PHP Commercial |
$55.01
|
| Rate for Payer: PHP Medicare Advantage |
$39.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.09
|
| Rate for Payer: Priority Health Medicare |
$39.29
|
| Rate for Payer: Priority Health Narrow Network |
$71.09
|
| Rate for Payer: Priority Health SBD |
$71.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.29
|
| Rate for Payer: UHC Medicare Advantage |
$39.29
|
| Rate for Payer: UHCCP Medicaid |
$26.41
|
| Rate for Payer: UMR Bronson Commercial |
$119.14
|
|
|
PR INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 64450
|
| Min. Negotiated Rate |
$26.41 |
| Max. Negotiated Rate |
$661.43 |
| Rate for Payer: Aetna Commercial |
$52.65
|
| Rate for Payer: Aetna Medicare |
$40.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.58
|
| Rate for Payer: BCBS Complete |
$27.73
|
| Rate for Payer: BCBS MAPPO |
$39.29
|
| Rate for Payer: BCBS Trust/PPO |
$661.43
|
| Rate for Payer: BCN Commercial |
$87.96
|
| Rate for Payer: BCN Medicare Advantage |
$39.29
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$52.65
|
| Rate for Payer: Cofinity Commercial |
$56.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.25
|
| Rate for Payer: Meridian Medicaid |
$27.73
|
| Rate for Payer: Nomi Health Commercial |
$47.15
|
| Rate for Payer: PACE SWMI |
$39.29
|
| Rate for Payer: PHP Commercial |
$55.01
|
| Rate for Payer: PHP Medicare Advantage |
$39.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.09
|
| Rate for Payer: Priority Health Medicare |
$39.29
|
| Rate for Payer: Priority Health Narrow Network |
$71.09
|
| Rate for Payer: Priority Health SBD |
$71.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.29
|
| Rate for Payer: UHC Medicare Advantage |
$39.29
|
| Rate for Payer: UHCCP Medicaid |
$26.41
|
| Rate for Payer: UMR Bronson Commercial |
$119.14
|
|
|
PR INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH
|
Facility
|
OP
|
$259.00
|
|
|
Service Code
|
CPT 64450
|
| Hospital Charge Code |
64450
|
| Min. Negotiated Rate |
$40.25 |
| Max. Negotiated Rate |
$2,132.58 |
| Rate for Payer: Aetna American Axle |
$168.35
|
| Rate for Payer: Aetna Commercial |
$220.15
|
| Rate for Payer: Aetna Medicare |
$705.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$848.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$848.15
|
| Rate for Payer: BCBS Complete |
$381.87
|
| Rate for Payer: BCBS MAPPO |
$678.52
|
| Rate for Payer: BCBS Trust/PPO |
$722.69
|
| Rate for Payer: BCN Commercial |
$722.69
|
| Rate for Payer: BCN Medicare Advantage |
$678.52
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$222.74
|
| Rate for Payer: Cofinity Commercial |
$181.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$181.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$678.52
|
| Rate for Payer: Healthscope Commercial |
$233.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$181.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.25
|
| Rate for Payer: Mclaren Medicaid |
$363.69
|
| Rate for Payer: Mclaren Medicare |
$678.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$712.45
|
| Rate for Payer: Meridian Medicaid |
$381.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$780.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.15
|
| Rate for Payer: Nomi Health Commercial |
$1,424.89
|
| Rate for Payer: PACE Medicare |
$644.59
|
| Rate for Payer: PACE SWMI |
$678.52
|
| Rate for Payer: PHP Commercial |
$220.15
|
| Rate for Payer: PHP Medicare Advantage |
$678.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,132.58
|
| Rate for Payer: Priority Health Medicare |
$678.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,706.06
|
| Rate for Payer: Priority Health SBD |
$163.17
|
| Rate for Payer: Railroad Medicare Medicare |
$678.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.28
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$678.52
|
| Rate for Payer: UHC Exchange |
$40.25
|
| Rate for Payer: UHC Medicare Advantage |
$678.52
|
| Rate for Payer: UHCCP Medicaid |
$363.69
|
| Rate for Payer: UMR Bronson Commercial |
$95.83
|
| Rate for Payer: VA VA |
$678.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.25
|
|
|
PR INJECTION AA&/STRD PARACERVICAL NERVE
|
Professional
|
Both
|
$291.00
|
|
|
Service Code
|
HCPCS 64435
|
| Min. Negotiated Rate |
$27.90 |
| Max. Negotiated Rate |
$1,878.11 |
| Rate for Payer: Aetna Commercial |
$56.09
|
| Rate for Payer: Aetna Medicare |
$43.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.28
|
| Rate for Payer: BCBS Complete |
$29.30
|
| Rate for Payer: BCBS MAPPO |
$41.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,878.11
|
| Rate for Payer: BCN Commercial |
$118.75
|
| Rate for Payer: BCN Medicare Advantage |
$41.86
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$56.09
|
| Rate for Payer: Cofinity Commercial |
$60.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.95
|
| Rate for Payer: Meridian Medicaid |
$29.30
|
| Rate for Payer: Nomi Health Commercial |
$50.23
|
| Rate for Payer: PACE SWMI |
$41.86
|
| Rate for Payer: PHP Commercial |
$58.60
|
| Rate for Payer: PHP Medicare Advantage |
$41.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.51
|
| Rate for Payer: Priority Health Medicare |
$41.86
|
| Rate for Payer: Priority Health Narrow Network |
$74.51
|
| Rate for Payer: Priority Health SBD |
$74.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.86
|
| Rate for Payer: UHC Medicare Advantage |
$41.86
|
| Rate for Payer: UHCCP Medicaid |
$27.90
|
| Rate for Payer: UMR Bronson Commercial |
$133.86
|
|
|
PR INJECTION AA&/STRD PUDENDAL NERVE
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 64430
|
| Min. Negotiated Rate |
$35.15 |
| Max. Negotiated Rate |
$1,676.82 |
| Rate for Payer: Aetna Commercial |
$70.48
|
| Rate for Payer: Aetna Medicare |
$54.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.74
|
| Rate for Payer: BCBS Complete |
$36.91
|
| Rate for Payer: BCBS MAPPO |
$52.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,676.82
|
| Rate for Payer: BCN Commercial |
$144.16
|
| Rate for Payer: BCN Medicare Advantage |
$52.60
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$70.48
|
| Rate for Payer: Cofinity Commercial |
$75.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.23
|
| Rate for Payer: Meridian Medicaid |
$36.91
|
| Rate for Payer: Nomi Health Commercial |
$63.12
|
| Rate for Payer: PACE SWMI |
$52.60
|
| Rate for Payer: PHP Commercial |
$73.64
|
| Rate for Payer: PHP Medicare Advantage |
$52.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.70
|
| Rate for Payer: Priority Health Medicare |
$52.60
|
| Rate for Payer: Priority Health Narrow Network |
$92.70
|
| Rate for Payer: Priority Health SBD |
$92.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.60
|
| Rate for Payer: UHC Medicare Advantage |
$52.60
|
| Rate for Payer: UHCCP Medicaid |
$35.15
|
| Rate for Payer: UMR Bronson Commercial |
$117.30
|
|
|
PR INJECTION AA&/STRD SCIATIC NERVE W/IMG GDN
|
Professional
|
Both
|
$271.00
|
|
|
Service Code
|
HCPCS 64445
|
| Min. Negotiated Rate |
$46.01 |
| Max. Negotiated Rate |
$1,332.90 |
| Rate for Payer: Aetna Commercial |
$92.47
|
| Rate for Payer: Aetna Medicare |
$71.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.37
|
| Rate for Payer: BCBS Complete |
$48.31
|
| Rate for Payer: BCBS MAPPO |
$69.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,332.90
|
| Rate for Payer: BCN Commercial |
$189.26
|
| Rate for Payer: BCN Medicare Advantage |
$69.01
|
| Rate for Payer: Cash Price |
$216.80
|
| Rate for Payer: Cash Price |
$216.80
|
| Rate for Payer: Cofinity Commercial |
$92.47
|
| Rate for Payer: Cofinity Commercial |
$99.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.46
|
| Rate for Payer: Meridian Medicaid |
$48.31
|
| Rate for Payer: Nomi Health Commercial |
$82.81
|
| Rate for Payer: PACE SWMI |
$69.01
|
| Rate for Payer: PHP Commercial |
$96.61
|
| Rate for Payer: PHP Medicare Advantage |
$69.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.71
|
| Rate for Payer: Priority Health Medicare |
$69.01
|
| Rate for Payer: Priority Health Narrow Network |
$121.71
|
| Rate for Payer: Priority Health SBD |
$121.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.01
|
| Rate for Payer: UHC Medicare Advantage |
$69.01
|
| Rate for Payer: UHCCP Medicaid |
$46.01
|
| Rate for Payer: UMR Bronson Commercial |
$124.66
|
|
|
PR INJECTION AA&/STRD SUPRASCAPULAR NERVE
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 64418
|
| Min. Negotiated Rate |
$35.36 |
| Max. Negotiated Rate |
$359.77 |
| Rate for Payer: Aetna Commercial |
$71.26
|
| Rate for Payer: Aetna Medicare |
$55.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.58
|
| Rate for Payer: BCBS Complete |
$37.13
|
| Rate for Payer: BCBS MAPPO |
$53.18
|
| Rate for Payer: BCBS Trust/PPO |
$359.77
|
| Rate for Payer: BCN Commercial |
$127.06
|
| Rate for Payer: BCN Medicare Advantage |
$53.18
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cofinity Commercial |
$71.26
|
| Rate for Payer: Cofinity Commercial |
$76.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.84
|
| Rate for Payer: Meridian Medicaid |
$37.13
|
| Rate for Payer: Nomi Health Commercial |
$63.82
|
| Rate for Payer: PACE SWMI |
$53.18
|
| Rate for Payer: PHP Commercial |
$74.45
|
| Rate for Payer: PHP Medicare Advantage |
$53.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.83
|
| Rate for Payer: Priority Health Medicare |
$53.18
|
| Rate for Payer: Priority Health Narrow Network |
$93.83
|
| Rate for Payer: Priority Health SBD |
$93.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.18
|
| Rate for Payer: UHC Medicare Advantage |
$53.18
|
| Rate for Payer: UHCCP Medicaid |
$35.36
|
| Rate for Payer: UMR Bronson Commercial |
$83.26
|
|
|
PR INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 64400
|
| Min. Negotiated Rate |
$33.44 |
| Max. Negotiated Rate |
$285.28 |
| Rate for Payer: Aetna Commercial |
$67.27
|
| Rate for Payer: Aetna Medicare |
$52.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.29
|
| Rate for Payer: BCBS Complete |
$35.11
|
| Rate for Payer: BCBS MAPPO |
$50.20
|
| Rate for Payer: BCBS Trust/PPO |
$285.28
|
| Rate for Payer: BCN Commercial |
$164.20
|
| Rate for Payer: BCN Medicare Advantage |
$50.20
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cofinity Commercial |
$67.27
|
| Rate for Payer: Cofinity Commercial |
$72.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.71
|
| Rate for Payer: Meridian Medicaid |
$35.11
|
| Rate for Payer: Nomi Health Commercial |
$60.24
|
| Rate for Payer: PACE SWMI |
$50.20
|
| Rate for Payer: PHP Commercial |
$70.28
|
| Rate for Payer: PHP Medicare Advantage |
$50.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.16
|
| Rate for Payer: Priority Health Medicare |
$50.20
|
| Rate for Payer: Priority Health Narrow Network |
$88.16
|
| Rate for Payer: Priority Health SBD |
$88.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.20
|
| Rate for Payer: UHC Medicare Advantage |
$50.20
|
| Rate for Payer: UHCCP Medicaid |
$33.44
|
| Rate for Payer: UMR Bronson Commercial |
$120.06
|
|
|
PR INJECTION AA&/STRD VAGUS NERVE
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 64408
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$416.83 |
| Rate for Payer: Aetna Commercial |
$57.96
|
| Rate for Payer: Aetna Medicare |
$44.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.28
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS MAPPO |
$43.25
|
| Rate for Payer: BCBS Trust/PPO |
$416.83
|
| Rate for Payer: BCN Commercial |
$120.21
|
| Rate for Payer: BCN Medicare Advantage |
$43.25
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$57.96
|
| Rate for Payer: Cofinity Commercial |
$62.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.41
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Nomi Health Commercial |
$51.90
|
| Rate for Payer: PACE SWMI |
$43.25
|
| Rate for Payer: PHP Commercial |
$60.55
|
| Rate for Payer: PHP Medicare Advantage |
$43.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.22
|
| Rate for Payer: Priority Health Medicare |
$43.25
|
| Rate for Payer: Priority Health Narrow Network |
$76.22
|
| Rate for Payer: Priority Health SBD |
$76.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.25
|
| Rate for Payer: UHC Medicare Advantage |
$43.25
|
| Rate for Payer: UHCCP Medicaid |
$28.97
|
| Rate for Payer: UMR Bronson Commercial |
$77.28
|
|
|
PR INJECTION AIR/CONTRAST PERITONEAL CAVITY SPX
|
Professional
|
Both
|
$307.00
|
|
|
Service Code
|
HCPCS 49400
|
| Min. Negotiated Rate |
$56.87 |
| Max. Negotiated Rate |
$2,526.86 |
| Rate for Payer: Aetna Commercial |
$115.07
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.65
|
| Rate for Payer: BCBS Complete |
$59.71
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,526.86
|
| Rate for Payer: BCN Commercial |
$219.42
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$245.60
|
| Rate for Payer: Cash Price |
$245.60
|
| Rate for Payer: Cofinity Commercial |
$115.07
|
| Rate for Payer: Cofinity Commercial |
$123.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$59.71
|
| Rate for Payer: Nomi Health Commercial |
$103.04
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$120.22
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$157.50
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health Narrow Network |
$157.50
|
| Rate for Payer: Priority Health SBD |
$157.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$56.87
|
| Rate for Payer: UMR Bronson Commercial |
$141.22
|
|
|
PR INJECTION ANES AGENT SPHENOPALATINE GANGLION
|
Professional
|
Both
|
$179.00
|
|
|
Service Code
|
HCPCS 64505
|
| Min. Negotiated Rate |
$68.37 |
| Max. Negotiated Rate |
$210.13 |
| Rate for Payer: Aetna Commercial |
$136.43
|
| Rate for Payer: Aetna Medicare |
$105.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.61
|
| Rate for Payer: BCBS Complete |
$71.79
|
| Rate for Payer: BCBS MAPPO |
$101.81
|
| Rate for Payer: BCBS Trust/PPO |
$195.47
|
| Rate for Payer: BCN Commercial |
$210.13
|
| Rate for Payer: BCN Medicare Advantage |
$101.81
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cofinity Commercial |
$136.43
|
| Rate for Payer: Cofinity Commercial |
$146.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.90
|
| Rate for Payer: Meridian Medicaid |
$71.79
|
| Rate for Payer: Nomi Health Commercial |
$122.17
|
| Rate for Payer: PACE SWMI |
$101.81
|
| Rate for Payer: PHP Commercial |
$142.53
|
| Rate for Payer: PHP Medicare Advantage |
$101.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.28
|
| Rate for Payer: Priority Health Medicare |
$101.81
|
| Rate for Payer: Priority Health Narrow Network |
$180.28
|
| Rate for Payer: Priority Health SBD |
$180.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.81
|
| Rate for Payer: UHC Medicare Advantage |
$101.81
|
| Rate for Payer: UHCCP Medicaid |
$68.37
|
| Rate for Payer: UMR Bronson Commercial |
$82.34
|
|
|
PR INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 64520
|
| Min. Negotiated Rate |
$54.32 |
| Max. Negotiated Rate |
$335.72 |
| Rate for Payer: Aetna Commercial |
$107.37
|
| Rate for Payer: Aetna Commercial |
$107.37
|
| Rate for Payer: Aetna Medicare |
$83.34
|
| Rate for Payer: Aetna Medicare |
$83.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.37
|
| Rate for Payer: BCBS Complete |
$57.04
|
| Rate for Payer: BCBS Complete |
$57.04
|
| Rate for Payer: BCBS MAPPO |
$80.13
|
| Rate for Payer: BCBS MAPPO |
$80.13
|
| Rate for Payer: BCBS Trust/PPO |
$224.53
|
| Rate for Payer: BCBS Trust/PPO |
$224.53
|
| Rate for Payer: BCN Commercial |
$335.72
|
| Rate for Payer: BCN Commercial |
$335.72
|
| Rate for Payer: BCN Medicare Advantage |
$80.13
|
| Rate for Payer: BCN Medicare Advantage |
$80.13
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$107.37
|
| Rate for Payer: Cofinity Commercial |
$115.39
|
| Rate for Payer: Cofinity Commercial |
$115.39
|
| Rate for Payer: Cofinity Commercial |
$107.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.14
|
| Rate for Payer: Meridian Medicaid |
$57.04
|
| Rate for Payer: Meridian Medicaid |
$57.04
|
| Rate for Payer: Nomi Health Commercial |
$96.16
|
| Rate for Payer: Nomi Health Commercial |
$96.16
|
| Rate for Payer: PACE SWMI |
$80.13
|
| Rate for Payer: PACE SWMI |
$80.13
|
| Rate for Payer: PHP Commercial |
$112.18
|
| Rate for Payer: PHP Commercial |
$112.18
|
| Rate for Payer: PHP Medicare Advantage |
$80.13
|
| Rate for Payer: PHP Medicare Advantage |
$80.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.45
|
| Rate for Payer: Priority Health Medicare |
$80.13
|
| Rate for Payer: Priority Health Medicare |
$80.13
|
| Rate for Payer: Priority Health Narrow Network |
$144.45
|
| Rate for Payer: Priority Health Narrow Network |
$144.45
|
| Rate for Payer: Priority Health SBD |
$144.45
|
| Rate for Payer: Priority Health SBD |
$144.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.13
|
| Rate for Payer: UHC Medicare Advantage |
$80.13
|
| Rate for Payer: UHC Medicare Advantage |
$80.13
|
| Rate for Payer: UHCCP Medicaid |
$54.32
|
| Rate for Payer: UHCCP Medicaid |
$54.32
|
| Rate for Payer: UMR Bronson Commercial |
$94.76
|
| Rate for Payer: UMR Bronson Commercial |
$164.22
|
|
|
PR INJECTION, BUPIVICAINE HYDRO
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS S0020
|
| Min. Negotiated Rate |
$1.19 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Aetna Medicare |
$5.00
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCN Commercial |
$1.19
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: UMR Bronson Commercial |
$4.60
|
|
|
PR INJECTION CORPORA CAVERNOSA PHARMACOLOGIC AGENT
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 54235
|
| Min. Negotiated Rate |
$47.71 |
| Max. Negotiated Rate |
$573.21 |
| Rate for Payer: Aetna Commercial |
$94.86
|
| Rate for Payer: Aetna Medicare |
$73.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.86
|
| Rate for Payer: BCBS Complete |
$50.10
|
| Rate for Payer: BCBS MAPPO |
$70.79
|
| Rate for Payer: BCBS Trust/PPO |
$573.21
|
| Rate for Payer: BCN Commercial |
$130.96
|
| Rate for Payer: BCN Medicare Advantage |
$70.79
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$94.86
|
| Rate for Payer: Cofinity Commercial |
$101.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.33
|
| Rate for Payer: Meridian Medicaid |
$50.10
|
| Rate for Payer: Nomi Health Commercial |
$84.95
|
| Rate for Payer: PACE SWMI |
$70.79
|
| Rate for Payer: PHP Commercial |
$99.11
|
| Rate for Payer: PHP Medicare Advantage |
$70.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.71
|
| Rate for Payer: Priority Health Medicare |
$70.79
|
| Rate for Payer: Priority Health Narrow Network |
$117.71
|
| Rate for Payer: Priority Health SBD |
$117.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.79
|
| Rate for Payer: UHC Medicare Advantage |
$70.79
|
| Rate for Payer: UHCCP Medicaid |
$47.71
|
| Rate for Payer: UMR Bronson Commercial |
$80.50
|
|
|
PR INJECTION ENZYME PALMAR FASCIAL CORD
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 20527
|
| Min. Negotiated Rate |
$42.39 |
| Max. Negotiated Rate |
$128.52 |
| Rate for Payer: Aetna Commercial |
$84.47
|
| Rate for Payer: Aetna Medicare |
$65.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.78
|
| Rate for Payer: BCBS Complete |
$44.51
|
| Rate for Payer: BCBS MAPPO |
$63.04
|
| Rate for Payer: BCBS Trust/PPO |
$52.64
|
| Rate for Payer: BCN Commercial |
$128.52
|
| Rate for Payer: BCN Medicare Advantage |
$63.04
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cofinity Commercial |
$84.47
|
| Rate for Payer: Cofinity Commercial |
$90.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.19
|
| Rate for Payer: Meridian Medicaid |
$44.51
|
| Rate for Payer: Nomi Health Commercial |
$75.65
|
| Rate for Payer: PACE SWMI |
$63.04
|
| Rate for Payer: PHP Commercial |
$88.26
|
| Rate for Payer: PHP Medicare Advantage |
$63.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.25
|
| Rate for Payer: Priority Health Medicare |
$63.04
|
| Rate for Payer: Priority Health Narrow Network |
$100.25
|
| Rate for Payer: Priority Health SBD |
$100.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.04
|
| Rate for Payer: UHC Medicare Advantage |
$63.04
|
| Rate for Payer: UHCCP Medicaid |
$42.39
|
| Rate for Payer: UMR Bronson Commercial |
$76.36
|
|
|
PR INJECTION EPIDURAL BLOOD/CLOT PATCH
|
Professional
|
Both
|
$471.00
|
|
|
Service Code
|
HCPCS 62273
|
| Min. Negotiated Rate |
$72.21 |
| Max. Negotiated Rate |
$645.05 |
| Rate for Payer: Aetna Commercial |
$144.53
|
| Rate for Payer: Aetna Medicare |
$112.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.32
|
| Rate for Payer: BCBS Complete |
$75.82
|
| Rate for Payer: BCBS MAPPO |
$107.86
|
| Rate for Payer: BCBS Trust/PPO |
$645.05
|
| Rate for Payer: BCN Commercial |
$271.19
|
| Rate for Payer: BCN Medicare Advantage |
$107.86
|
| Rate for Payer: Cash Price |
$376.80
|
| Rate for Payer: Cash Price |
$376.80
|
| Rate for Payer: Cofinity Commercial |
$144.53
|
| Rate for Payer: Cofinity Commercial |
$155.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.25
|
| Rate for Payer: Meridian Medicaid |
$75.82
|
| Rate for Payer: Nomi Health Commercial |
$129.43
|
| Rate for Payer: PACE SWMI |
$107.86
|
| Rate for Payer: PHP Commercial |
$151.00
|
| Rate for Payer: PHP Medicare Advantage |
$107.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$306.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$191.66
|
| Rate for Payer: Priority Health Medicare |
$107.86
|
| Rate for Payer: Priority Health Narrow Network |
$191.66
|
| Rate for Payer: Priority Health SBD |
$191.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.86
|
| Rate for Payer: UHC Medicare Advantage |
$107.86
|
| Rate for Payer: UHCCP Medicaid |
$72.21
|
| Rate for Payer: UMR Bronson Commercial |
$216.66
|
|
|
PR INJECTION INTRALESIONAL >7 LESIONS
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 11901
|
| Min. Negotiated Rate |
$28.76 |
| Max. Negotiated Rate |
$185.19 |
| Rate for Payer: Aetna Commercial |
$57.19
|
| Rate for Payer: Aetna Medicare |
$44.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.46
|
| Rate for Payer: BCBS Complete |
$30.20
|
| Rate for Payer: BCBS MAPPO |
$42.68
|
| Rate for Payer: BCBS Trust/PPO |
$185.19
|
| Rate for Payer: BCN Commercial |
$82.07
|
| Rate for Payer: BCN Medicare Advantage |
$42.68
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$57.19
|
| Rate for Payer: Cofinity Commercial |
$61.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.81
|
| Rate for Payer: Meridian Medicaid |
$30.20
|
| Rate for Payer: Nomi Health Commercial |
$51.22
|
| Rate for Payer: PACE SWMI |
$42.68
|
| Rate for Payer: PHP Commercial |
$59.75
|
| Rate for Payer: PHP Medicare Advantage |
$42.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.96
|
| Rate for Payer: Priority Health Medicare |
$42.68
|
| Rate for Payer: Priority Health Narrow Network |
$60.96
|
| Rate for Payer: Priority Health SBD |
$60.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.68
|
| Rate for Payer: UHC Medicare Advantage |
$42.68
|
| Rate for Payer: UHCCP Medicaid |
$28.76
|
| Rate for Payer: UMR Bronson Commercial |
$56.12
|
|
|
PR INJECTION INTRALESIONAL UP TO & INCLUD 7 LESIONS
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 11900
|
| Min. Negotiated Rate |
$18.74 |
| Max. Negotiated Rate |
$206.51 |
| Rate for Payer: Aetna Commercial |
$37.32
|
| Rate for Payer: Aetna Medicare |
$28.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.10
|
| Rate for Payer: BCBS Complete |
$19.68
|
| Rate for Payer: BCBS MAPPO |
$27.85
|
| Rate for Payer: BCBS Trust/PPO |
$206.51
|
| Rate for Payer: BCN Commercial |
$67.15
|
| Rate for Payer: BCN Medicare Advantage |
$27.85
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cofinity Commercial |
$37.32
|
| Rate for Payer: Cofinity Commercial |
$40.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.24
|
| Rate for Payer: Meridian Medicaid |
$19.68
|
| Rate for Payer: Nomi Health Commercial |
$33.42
|
| Rate for Payer: PACE SWMI |
$27.85
|
| Rate for Payer: PHP Commercial |
$38.99
|
| Rate for Payer: PHP Medicare Advantage |
$27.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.19
|
| Rate for Payer: Priority Health Medicare |
$27.85
|
| Rate for Payer: Priority Health Narrow Network |
$40.19
|
| Rate for Payer: Priority Health SBD |
$40.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.85
|
| Rate for Payer: UHC Medicare Advantage |
$27.85
|
| Rate for Payer: UHCCP Medicaid |
$18.74
|
| Rate for Payer: UMR Bronson Commercial |
$42.32
|
|
|
PR INJECTION KNEE ARTHROGRAPHY
|
Professional
|
Both
|
$286.00
|
|
|
Service Code
|
HCPCS 27370
|
| Min. Negotiated Rate |
$114.40 |
| Max. Negotiated Rate |
$185.90 |
| Rate for Payer: Aetna Medicare |
$143.00
|
| Rate for Payer: BCBS Complete |
$114.40
|
| Rate for Payer: Cash Price |
$228.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.90
|
| Rate for Payer: UMR Bronson Commercial |
$131.56
|
|
|
PR INJECTION,ONABOTULINUMTOXINA
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS J0585
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$9.36 |
| Rate for Payer: Aetna Commercial |
$8.71
|
| Rate for Payer: Aetna Medicare |
$6.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.36
|
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: BCBS MAPPO |
$6.50
|
| Rate for Payer: BCBS Trust/PPO |
$6.35
|
| Rate for Payer: BCN Commercial |
$6.27
|
| Rate for Payer: BCN Medicare Advantage |
$6.50
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cofinity Commercial |
$9.36
|
| Rate for Payer: Cofinity Commercial |
$8.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.83
|
| Rate for Payer: Nomi Health Commercial |
$7.80
|
| Rate for Payer: PACE SWMI |
$6.50
|
| Rate for Payer: PHP Commercial |
$9.10
|
| Rate for Payer: PHP Medicare Advantage |
$6.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.20
|
| Rate for Payer: Priority Health Medicare |
$6.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.50
|
| Rate for Payer: UHC Medicare Advantage |
$6.50
|
| Rate for Payer: UMR Bronson Commercial |
$3.68
|
|
