|
PR MPSV4 VACCINE GROUPS ACYW-135 SUBQ USE
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 90733
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$147.65 |
| Rate for Payer: Aetna Commercial |
$125.50
|
| Rate for Payer: Aetna Medicare |
$66.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.50
|
| Rate for Payer: BCBS Complete |
$53.20
|
| Rate for Payer: BCBS Trust/PPO |
$125.49
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.65
|
| Rate for Payer: UHC Core |
$147.65
|
| Rate for Payer: UHC Exchange |
$147.65
|
| Rate for Payer: UMR Bronson Commercial |
$61.18
|
|
|
PR MULTIPLE FAM GROUP BHV TX GDN PHYS/QHP EA 15 MIN
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS 97157
|
| Min. Negotiated Rate |
$20.79 |
| Max. Negotiated Rate |
$47.25 |
| Rate for Payer: Aetna Commercial |
$20.79
|
| Rate for Payer: Aetna Medicare |
$31.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.79
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: BCN Commercial |
$23.79
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$45.93
|
| Rate for Payer: Priority Health SBD |
$45.93
|
| Rate for Payer: Priority Health Tiered Network |
$45.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.47
|
| Rate for Payer: UHC Core |
$33.47
|
| Rate for Payer: UHC Exchange |
$33.47
|
| Rate for Payer: UMR Bronson Commercial |
$28.98
|
|
|
PR MULTIPLE FAMILY GROUP PSYCHOTHERAPY
|
Professional
|
Both
|
$95.00
|
|
|
Service Code
|
HCPCS 90849
|
| Min. Negotiated Rate |
$29.54 |
| Max. Negotiated Rate |
$71.25 |
| Rate for Payer: Aetna Commercial |
$39.58
|
| Rate for Payer: Aetna Medicare |
$30.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.54
|
| Rate for Payer: BCBS Complete |
$38.00
|
| Rate for Payer: BCBS MAPPO |
$29.54
|
| Rate for Payer: BCN Commercial |
$45.32
|
| Rate for Payer: BCN Medicare Advantage |
$29.54
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Commercial |
$42.54
|
| Rate for Payer: Cofinity Commercial |
$39.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.49
|
| Rate for Payer: Nomi Health Commercial |
$35.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.25
|
| Rate for Payer: PACE SWMI |
$29.54
|
| Rate for Payer: PHP Commercial |
$41.36
|
| Rate for Payer: PHP Medicare Advantage |
$29.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$38.81
|
| Rate for Payer: Priority Health Medicare |
$29.54
|
| Rate for Payer: Priority Health SBD |
$38.81
|
| Rate for Payer: Priority Health Tiered Network |
$38.81
|
| Rate for Payer: Railroad Medicare Medicare |
$29.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.61
|
| Rate for Payer: UHC Core |
$46.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.54
|
| Rate for Payer: UHC Exchange |
$46.61
|
| Rate for Payer: UMR Bronson Commercial |
$43.70
|
|
|
PR MUSCLE-SKIN FLAP,HEAD/NECK
|
Professional
|
Both
|
$3,344.00
|
|
|
Service Code
|
HCPCS 15732
|
| Min. Negotiated Rate |
$1,337.60 |
| Max. Negotiated Rate |
$2,508.00 |
| Rate for Payer: Aetna Medicare |
$1,672.00
|
| Rate for Payer: BCBS Complete |
$1,337.60
|
| Rate for Payer: Cash Price |
$2,675.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,508.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,538.24
|
|
|
PR MUSCLE/TENDON TRANSFER UPPER ARM/ELBOW SINGLE
|
Professional
|
Both
|
$1,174.00
|
|
|
Service Code
|
HCPCS 24301
|
| Min. Negotiated Rate |
$446.87 |
| Max. Negotiated Rate |
$1,308.72 |
| Rate for Payer: Aetna Commercial |
$917.12
|
| Rate for Payer: Aetna Medicare |
$711.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$917.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$985.56
|
| Rate for Payer: BCBS Complete |
$469.21
|
| Rate for Payer: BCBS MAPPO |
$684.42
|
| Rate for Payer: BCN Commercial |
$1,145.85
|
| Rate for Payer: BCN Medicare Advantage |
$684.42
|
| Rate for Payer: Cash Price |
$939.20
|
| Rate for Payer: Cash Price |
$939.20
|
| Rate for Payer: Cofinity Commercial |
$985.56
|
| Rate for Payer: Cofinity Commercial |
$917.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$684.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$718.64
|
| Rate for Payer: Meridian Medicaid |
$469.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$752.86
|
| Rate for Payer: Nomi Health Commercial |
$821.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$880.50
|
| Rate for Payer: PACE SWMI |
$684.42
|
| Rate for Payer: PHP Commercial |
$958.19
|
| Rate for Payer: PHP Medicare Advantage |
$684.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$446.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,224.88
|
| Rate for Payer: Priority Health Medicare |
$684.42
|
| Rate for Payer: Priority Health SBD |
$1,224.88
|
| Rate for Payer: Priority Health Tiered Network |
$1,224.88
|
| Rate for Payer: Railroad Medicare Medicare |
$684.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,308.72
|
| Rate for Payer: UHC Core |
$1,308.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$684.42
|
| Rate for Payer: UHC Exchange |
$1,308.72
|
| Rate for Payer: UHC Medicaid |
$446.87
|
| Rate for Payer: UHCCP Medicaid |
$446.87
|
| Rate for Payer: UMR Bronson Commercial |
$540.04
|
|
|
PR MUSCLE TRANSFER SHOULDER/UPPER ARM MULTIPLE
|
Professional
|
Both
|
$3,157.00
|
|
|
Service Code
|
HCPCS 23397
|
| Min. Negotiated Rate |
$664.99 |
| Max. Negotiated Rate |
$2,367.75 |
| Rate for Payer: Aetna Commercial |
$1,373.02
|
| Rate for Payer: Aetna Medicare |
$1,065.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,373.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,475.48
|
| Rate for Payer: BCBS Complete |
$698.24
|
| Rate for Payer: BCBS MAPPO |
$1,024.64
|
| Rate for Payer: BCN Commercial |
$1,722.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,024.64
|
| Rate for Payer: Cash Price |
$2,525.60
|
| Rate for Payer: Cash Price |
$2,525.60
|
| Rate for Payer: Cofinity Commercial |
$1,373.02
|
| Rate for Payer: Cofinity Commercial |
$1,475.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,024.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,075.87
|
| Rate for Payer: Meridian Medicaid |
$698.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,127.10
|
| Rate for Payer: Nomi Health Commercial |
$1,229.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,367.75
|
| Rate for Payer: PACE SWMI |
$1,024.64
|
| Rate for Payer: PHP Commercial |
$1,434.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,024.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$664.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,841.33
|
| Rate for Payer: Priority Health Medicare |
$1,024.64
|
| Rate for Payer: Priority Health SBD |
$1,841.33
|
| Rate for Payer: Priority Health Tiered Network |
$1,841.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,024.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,002.31
|
| Rate for Payer: UHC Core |
$2,002.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,024.64
|
| Rate for Payer: UHC Exchange |
$2,002.31
|
| Rate for Payer: UHC Medicaid |
$664.99
|
| Rate for Payer: UHCCP Medicaid |
$664.99
|
| Rate for Payer: UMR Bronson Commercial |
$1,452.22
|
|
|
PR MUSCLE TRANSFER SHOULDER/UPPER ARM SINGLE
|
Professional
|
Both
|
$3,516.00
|
|
|
Service Code
|
HCPCS 23395
|
| Min. Negotiated Rate |
$751.04 |
| Max. Negotiated Rate |
$2,637.00 |
| Rate for Payer: Aetna Commercial |
$1,547.20
|
| Rate for Payer: Aetna Medicare |
$1,200.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,547.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,662.67
|
| Rate for Payer: BCBS Complete |
$788.59
|
| Rate for Payer: BCBS MAPPO |
$1,154.63
|
| Rate for Payer: BCN Commercial |
$1,946.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,154.63
|
| Rate for Payer: Cash Price |
$2,812.80
|
| Rate for Payer: Cash Price |
$2,812.80
|
| Rate for Payer: Cofinity Commercial |
$1,547.20
|
| Rate for Payer: Cofinity Commercial |
$1,662.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,154.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,212.36
|
| Rate for Payer: Meridian Medicaid |
$788.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,270.09
|
| Rate for Payer: Nomi Health Commercial |
$1,385.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,637.00
|
| Rate for Payer: PACE SWMI |
$1,154.63
|
| Rate for Payer: PHP Commercial |
$1,616.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,154.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$751.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,080.33
|
| Rate for Payer: Priority Health Medicare |
$1,154.63
|
| Rate for Payer: Priority Health SBD |
$2,080.33
|
| Rate for Payer: Priority Health Tiered Network |
$2,080.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,154.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,248.45
|
| Rate for Payer: UHC Core |
$2,248.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,154.63
|
| Rate for Payer: UHC Exchange |
$2,248.45
|
| Rate for Payer: UHC Medicaid |
$751.04
|
| Rate for Payer: UHCCP Medicaid |
$751.04
|
| Rate for Payer: UMR Bronson Commercial |
$1,617.36
|
|
|
PR MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP LXTR
|
Professional
|
Both
|
$2,549.00
|
|
|
Service Code
|
HCPCS 15738
|
| Min. Negotiated Rate |
$732.29 |
| Max. Negotiated Rate |
$2,270.86 |
| Rate for Payer: Aetna Commercial |
$1,512.15
|
| Rate for Payer: Aetna Medicare |
$1,173.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,512.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,625.00
|
| Rate for Payer: BCBS Complete |
$768.90
|
| Rate for Payer: BCBS MAPPO |
$1,128.47
|
| Rate for Payer: BCN Commercial |
$1,898.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,128.47
|
| Rate for Payer: Cash Price |
$2,039.20
|
| Rate for Payer: Cash Price |
$2,039.20
|
| Rate for Payer: Cofinity Commercial |
$1,512.15
|
| Rate for Payer: Cofinity Commercial |
$1,625.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,128.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,184.89
|
| Rate for Payer: Meridian Medicaid |
$768.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,241.32
|
| Rate for Payer: Nomi Health Commercial |
$1,354.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,911.75
|
| Rate for Payer: PACE SWMI |
$1,128.47
|
| Rate for Payer: PHP Commercial |
$1,579.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,128.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$732.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,737.44
|
| Rate for Payer: Priority Health Medicare |
$1,128.47
|
| Rate for Payer: Priority Health SBD |
$1,737.44
|
| Rate for Payer: Priority Health Tiered Network |
$1,737.44
|
| Rate for Payer: Railroad Medicare Medicare |
$1,128.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,270.86
|
| Rate for Payer: UHC Core |
$2,270.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,128.47
|
| Rate for Payer: UHC Exchange |
$2,270.86
|
| Rate for Payer: UHC Medicaid |
$732.29
|
| Rate for Payer: UHCCP Medicaid |
$732.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,172.54
|
|
|
PR MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP TRUNK
|
Professional
|
Both
|
$4,738.00
|
|
|
Service Code
|
HCPCS 15734
|
| Min. Negotiated Rate |
$884.38 |
| Max. Negotiated Rate |
$3,553.50 |
| Rate for Payer: Aetna Commercial |
$1,832.13
|
| Rate for Payer: Aetna Medicare |
$1,421.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,832.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,968.85
|
| Rate for Payer: BCBS Complete |
$928.60
|
| Rate for Payer: BCBS MAPPO |
$1,367.26
|
| Rate for Payer: BCN Commercial |
$2,257.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,367.26
|
| Rate for Payer: Cash Price |
$3,790.40
|
| Rate for Payer: Cash Price |
$3,790.40
|
| Rate for Payer: Cofinity Commercial |
$1,832.13
|
| Rate for Payer: Cofinity Commercial |
$1,968.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,367.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,435.62
|
| Rate for Payer: Meridian Medicaid |
$928.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,503.99
|
| Rate for Payer: Nomi Health Commercial |
$1,640.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,553.50
|
| Rate for Payer: PACE SWMI |
$1,367.26
|
| Rate for Payer: PHP Commercial |
$1,914.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,367.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$884.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,066.06
|
| Rate for Payer: Priority Health Medicare |
$1,367.26
|
| Rate for Payer: Priority Health SBD |
$2,066.06
|
| Rate for Payer: Priority Health Tiered Network |
$2,066.06
|
| Rate for Payer: Railroad Medicare Medicare |
$1,367.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,653.36
|
| Rate for Payer: UHC Core |
$2,653.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,367.26
|
| Rate for Payer: UHC Exchange |
$2,653.36
|
| Rate for Payer: UHC Medicaid |
$884.38
|
| Rate for Payer: UHCCP Medicaid |
$884.38
|
| Rate for Payer: UMR Bronson Commercial |
$2,179.48
|
|
|
PR MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP UXTR
|
Professional
|
Both
|
$2,375.00
|
|
|
Service Code
|
HCPCS 15736
|
| Min. Negotiated Rate |
$708.65 |
| Max. Negotiated Rate |
$2,136.01 |
| Rate for Payer: Aetna Commercial |
$1,456.20
|
| Rate for Payer: Aetna Medicare |
$1,130.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,456.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,564.88
|
| Rate for Payer: BCBS Complete |
$744.08
|
| Rate for Payer: BCBS MAPPO |
$1,086.72
|
| Rate for Payer: BCN Commercial |
$1,831.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,086.72
|
| Rate for Payer: Cash Price |
$1,900.00
|
| Rate for Payer: Cash Price |
$1,900.00
|
| Rate for Payer: Cofinity Commercial |
$1,456.20
|
| Rate for Payer: Cofinity Commercial |
$1,564.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,086.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,141.06
|
| Rate for Payer: Meridian Medicaid |
$744.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,195.39
|
| Rate for Payer: Nomi Health Commercial |
$1,304.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,781.25
|
| Rate for Payer: PACE SWMI |
$1,086.72
|
| Rate for Payer: PHP Commercial |
$1,521.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,086.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$708.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,676.36
|
| Rate for Payer: Priority Health Medicare |
$1,086.72
|
| Rate for Payer: Priority Health SBD |
$1,676.36
|
| Rate for Payer: Priority Health Tiered Network |
$1,676.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1,086.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,136.01
|
| Rate for Payer: UHC Core |
$2,136.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,086.72
|
| Rate for Payer: UHC Exchange |
$2,136.01
|
| Rate for Payer: UHC Medicaid |
$708.65
|
| Rate for Payer: UHCCP Medicaid |
$708.65
|
| Rate for Payer: UMR Bronson Commercial |
$1,092.50
|
|
|
PR MUSC MYOQ/FSCQ FLAP HEAD&NECK W/NAMED VASC PEDCL
|
Professional
|
Both
|
$3,257.00
|
|
|
Service Code
|
HCPCS 15733
|
| Min. Negotiated Rate |
$579.15 |
| Max. Negotiated Rate |
$2,442.75 |
| Rate for Payer: Aetna Commercial |
$1,195.55
|
| Rate for Payer: Aetna Medicare |
$927.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,195.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,284.77
|
| Rate for Payer: BCBS Complete |
$608.11
|
| Rate for Payer: BCBS MAPPO |
$892.20
|
| Rate for Payer: BCN Commercial |
$1,545.24
|
| Rate for Payer: BCN Medicare Advantage |
$892.20
|
| Rate for Payer: Cash Price |
$2,605.60
|
| Rate for Payer: Cash Price |
$2,605.60
|
| Rate for Payer: Cofinity Commercial |
$1,195.55
|
| Rate for Payer: Cofinity Commercial |
$1,284.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$892.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$936.81
|
| Rate for Payer: Meridian Medicaid |
$608.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$981.42
|
| Rate for Payer: Nomi Health Commercial |
$1,070.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,442.75
|
| Rate for Payer: PACE SWMI |
$892.20
|
| Rate for Payer: PHP Commercial |
$1,249.08
|
| Rate for Payer: PHP Medicare Advantage |
$892.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$579.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,414.29
|
| Rate for Payer: Priority Health Medicare |
$892.20
|
| Rate for Payer: Priority Health SBD |
$1,414.29
|
| Rate for Payer: Priority Health Tiered Network |
$1,414.29
|
| Rate for Payer: Railroad Medicare Medicare |
$892.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,815.97
|
| Rate for Payer: UHC Core |
$1,815.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$892.20
|
| Rate for Payer: UHC Exchange |
$1,815.97
|
| Rate for Payer: UHC Medicaid |
$579.15
|
| Rate for Payer: UHCCP Medicaid |
$579.15
|
| Rate for Payer: UMR Bronson Commercial |
$1,498.22
|
|
|
PR MYOCARDIAL RESECTION
|
Professional
|
Both
|
$6,456.00
|
|
|
Service Code
|
HCPCS 33542
|
| Min. Negotiated Rate |
$1,565.98 |
| Max. Negotiated Rate |
$4,842.00 |
| Rate for Payer: Aetna Commercial |
$3,299.62
|
| Rate for Payer: Aetna Medicare |
$2,560.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,299.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,545.86
|
| Rate for Payer: BCBS Complete |
$1,644.28
|
| Rate for Payer: BCBS MAPPO |
$2,462.40
|
| Rate for Payer: BCN Commercial |
$3,862.34
|
| Rate for Payer: BCN Medicare Advantage |
$2,462.40
|
| Rate for Payer: Cash Price |
$5,164.80
|
| Rate for Payer: Cash Price |
$5,164.80
|
| Rate for Payer: Cofinity Commercial |
$3,299.62
|
| Rate for Payer: Cofinity Commercial |
$3,545.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,462.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,585.52
|
| Rate for Payer: Meridian Medicaid |
$1,644.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,708.64
|
| Rate for Payer: Nomi Health Commercial |
$2,954.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,842.00
|
| Rate for Payer: PACE SWMI |
$2,462.40
|
| Rate for Payer: PHP Commercial |
$3,447.36
|
| Rate for Payer: PHP Medicare Advantage |
$2,462.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,565.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,153.45
|
| Rate for Payer: Priority Health Medicare |
$2,462.40
|
| Rate for Payer: Priority Health SBD |
$4,153.45
|
| Rate for Payer: Priority Health Tiered Network |
$4,153.45
|
| Rate for Payer: Railroad Medicare Medicare |
$2,462.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,690.69
|
| Rate for Payer: UHC Core |
$4,690.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,462.40
|
| Rate for Payer: UHC Exchange |
$4,690.69
|
| Rate for Payer: UHC Medicaid |
$1,565.98
|
| Rate for Payer: UHCCP Medicaid |
$1,565.98
|
| Rate for Payer: UMR Bronson Commercial |
$2,969.76
|
|
|
PR MYOMECTOMY 1-4 MYOMAS 250 GM/< VAGINAL APPR
|
Professional
|
Both
|
$2,020.00
|
|
|
Service Code
|
HCPCS 58145
|
| Min. Negotiated Rate |
$318.22 |
| Max. Negotiated Rate |
$1,515.00 |
| Rate for Payer: Aetna Commercial |
$658.93
|
| Rate for Payer: Aetna Medicare |
$511.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$658.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$708.11
|
| Rate for Payer: BCBS Complete |
$334.13
|
| Rate for Payer: BCBS MAPPO |
$491.74
|
| Rate for Payer: BCN Commercial |
$844.08
|
| Rate for Payer: BCN Medicare Advantage |
$491.74
|
| Rate for Payer: Cash Price |
$1,616.00
|
| Rate for Payer: Cash Price |
$1,616.00
|
| Rate for Payer: Cofinity Commercial |
$658.93
|
| Rate for Payer: Cofinity Commercial |
$708.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$491.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$516.33
|
| Rate for Payer: Meridian Medicaid |
$334.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$540.91
|
| Rate for Payer: Nomi Health Commercial |
$590.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,515.00
|
| Rate for Payer: PACE SWMI |
$491.74
|
| Rate for Payer: PHP Commercial |
$688.44
|
| Rate for Payer: PHP Medicare Advantage |
$491.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$318.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$854.86
|
| Rate for Payer: Priority Health Medicare |
$491.74
|
| Rate for Payer: Priority Health SBD |
$854.86
|
| Rate for Payer: Priority Health Tiered Network |
$854.86
|
| Rate for Payer: Railroad Medicare Medicare |
$491.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$988.01
|
| Rate for Payer: UHC Core |
$988.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$491.74
|
| Rate for Payer: UHC Exchange |
$988.01
|
| Rate for Payer: UHC Medicaid |
$318.22
|
| Rate for Payer: UHCCP Medicaid |
$318.22
|
| Rate for Payer: UMR Bronson Commercial |
$929.20
|
|
|
PR MYOMECTOMY 1-4 MYOMAS W/250 GM/< ABDOMINAL APPR
|
Professional
|
Both
|
$3,124.00
|
|
|
Service Code
|
HCPCS 58140
|
| Min. Negotiated Rate |
$518.44 |
| Max. Negotiated Rate |
$2,343.00 |
| Rate for Payer: Aetna Commercial |
$1,080.68
|
| Rate for Payer: Aetna Medicare |
$838.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,080.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,161.33
|
| Rate for Payer: BCBS Complete |
$544.36
|
| Rate for Payer: BCBS MAPPO |
$806.48
|
| Rate for Payer: BCN Commercial |
$1,379.90
|
| Rate for Payer: BCN Medicare Advantage |
$806.48
|
| Rate for Payer: Cash Price |
$2,499.20
|
| Rate for Payer: Cash Price |
$2,499.20
|
| Rate for Payer: Cofinity Commercial |
$1,080.68
|
| Rate for Payer: Cofinity Commercial |
$1,161.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$806.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$846.80
|
| Rate for Payer: Meridian Medicaid |
$544.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$887.13
|
| Rate for Payer: Nomi Health Commercial |
$967.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,343.00
|
| Rate for Payer: PACE SWMI |
$806.48
|
| Rate for Payer: PHP Commercial |
$1,129.07
|
| Rate for Payer: PHP Medicare Advantage |
$806.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$518.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,397.54
|
| Rate for Payer: Priority Health Medicare |
$806.48
|
| Rate for Payer: Priority Health SBD |
$1,397.54
|
| Rate for Payer: Priority Health Tiered Network |
$1,397.54
|
| Rate for Payer: Railroad Medicare Medicare |
$806.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,644.77
|
| Rate for Payer: UHC Core |
$1,644.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$806.48
|
| Rate for Payer: UHC Exchange |
$1,644.77
|
| Rate for Payer: UHC Medicaid |
$518.44
|
| Rate for Payer: UHCCP Medicaid |
$518.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,437.04
|
|
|
PR MYOMECTOMY 5/> MYOMAS &/>250 GM ABDOMINA
|
Professional
|
Both
|
$2,281.00
|
|
|
Service Code
|
HCPCS 58146
|
| Min. Negotiated Rate |
$647.09 |
| Max. Negotiated Rate |
$2,054.84 |
| Rate for Payer: Aetna Commercial |
$1,352.19
|
| Rate for Payer: Aetna Medicare |
$1,049.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,352.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,453.10
|
| Rate for Payer: BCBS Complete |
$679.44
|
| Rate for Payer: BCBS MAPPO |
$1,009.10
|
| Rate for Payer: BCN Commercial |
$1,727.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,009.10
|
| Rate for Payer: Cash Price |
$1,824.80
|
| Rate for Payer: Cash Price |
$1,824.80
|
| Rate for Payer: Cofinity Commercial |
$1,352.19
|
| Rate for Payer: Cofinity Commercial |
$1,453.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,009.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,059.56
|
| Rate for Payer: Meridian Medicaid |
$679.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,110.01
|
| Rate for Payer: Nomi Health Commercial |
$1,210.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,710.75
|
| Rate for Payer: PACE SWMI |
$1,009.10
|
| Rate for Payer: PHP Commercial |
$1,412.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,009.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$647.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,749.58
|
| Rate for Payer: Priority Health Medicare |
$1,009.10
|
| Rate for Payer: Priority Health SBD |
$1,749.58
|
| Rate for Payer: Priority Health Tiered Network |
$1,749.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,009.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,054.84
|
| Rate for Payer: UHC Core |
$2,054.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,009.10
|
| Rate for Payer: UHC Exchange |
$2,054.84
|
| Rate for Payer: UHC Medicaid |
$647.09
|
| Rate for Payer: UHCCP Medicaid |
$647.09
|
| Rate for Payer: UMR Bronson Commercial |
$1,049.26
|
|
|
PR MYRINGOPLASTY
|
Professional
|
Both
|
$1,202.00
|
|
|
Service Code
|
HCPCS 69620
|
| Min. Negotiated Rate |
$288.19 |
| Max. Negotiated Rate |
$901.50 |
| Rate for Payer: Aetna Commercial |
$584.19
|
| Rate for Payer: Aetna Medicare |
$453.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$584.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$627.78
|
| Rate for Payer: BCBS Complete |
$302.60
|
| Rate for Payer: BCBS MAPPO |
$435.96
|
| Rate for Payer: BCN Commercial |
$747.47
|
| Rate for Payer: BCN Medicare Advantage |
$435.96
|
| Rate for Payer: Cash Price |
$961.60
|
| Rate for Payer: Cash Price |
$961.60
|
| Rate for Payer: Cofinity Commercial |
$584.19
|
| Rate for Payer: Cofinity Commercial |
$627.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$435.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$457.76
|
| Rate for Payer: Meridian Medicaid |
$302.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$479.56
|
| Rate for Payer: Nomi Health Commercial |
$523.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$901.50
|
| Rate for Payer: PACE SWMI |
$435.96
|
| Rate for Payer: PHP Commercial |
$610.34
|
| Rate for Payer: PHP Medicare Advantage |
$435.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$738.57
|
| Rate for Payer: Priority Health Medicare |
$435.96
|
| Rate for Payer: Priority Health SBD |
$738.57
|
| Rate for Payer: Priority Health Tiered Network |
$738.57
|
| Rate for Payer: Railroad Medicare Medicare |
$435.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$835.18
|
| Rate for Payer: UHC Core |
$835.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$435.96
|
| Rate for Payer: UHC Exchange |
$835.18
|
| Rate for Payer: UHC Medicaid |
$288.19
|
| Rate for Payer: UHCCP Medicaid |
$288.19
|
| Rate for Payer: UMR Bronson Commercial |
$552.92
|
|
|
PR MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ
|
Professional
|
Both
|
$327.00
|
|
|
Service Code
|
HCPCS 69420
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$245.25 |
| Rate for Payer: Aetna Commercial |
$142.44
|
| Rate for Payer: Aetna Medicare |
$110.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.07
|
| Rate for Payer: BCBS Complete |
$74.03
|
| Rate for Payer: BCBS MAPPO |
$106.30
|
| Rate for Payer: BCN Commercial |
$182.76
|
| Rate for Payer: BCN Medicare Advantage |
$106.30
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cofinity Commercial |
$142.44
|
| Rate for Payer: Cofinity Commercial |
$153.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.61
|
| Rate for Payer: Meridian Medicaid |
$74.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$116.93
|
| Rate for Payer: Nomi Health Commercial |
$127.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.25
|
| Rate for Payer: PACE SWMI |
$106.30
|
| Rate for Payer: PHP Commercial |
$148.82
|
| Rate for Payer: PHP Medicare Advantage |
$106.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$180.58
|
| Rate for Payer: Priority Health Medicare |
$106.30
|
| Rate for Payer: Priority Health SBD |
$180.58
|
| Rate for Payer: Priority Health Tiered Network |
$180.58
|
| Rate for Payer: Railroad Medicare Medicare |
$106.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.15
|
| Rate for Payer: UHC Core |
$203.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$106.30
|
| Rate for Payer: UHC Exchange |
$203.15
|
| Rate for Payer: UHC Medicaid |
$70.50
|
| Rate for Payer: UHCCP Medicaid |
$70.50
|
| Rate for Payer: UMR Bronson Commercial |
$150.42
|
|
|
PR MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ ANES
|
Professional
|
Both
|
$486.00
|
|
|
Service Code
|
HCPCS 69421
|
| Min. Negotiated Rate |
$87.97 |
| Max. Negotiated Rate |
$364.50 |
| Rate for Payer: Aetna Commercial |
$177.95
|
| Rate for Payer: Aetna Medicare |
$138.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.23
|
| Rate for Payer: BCBS Complete |
$92.37
|
| Rate for Payer: BCBS MAPPO |
$132.80
|
| Rate for Payer: BCN Commercial |
$228.57
|
| Rate for Payer: BCN Medicare Advantage |
$132.80
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cofinity Commercial |
$177.95
|
| Rate for Payer: Cofinity Commercial |
$191.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.44
|
| Rate for Payer: Meridian Medicaid |
$92.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$146.08
|
| Rate for Payer: Nomi Health Commercial |
$159.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$364.50
|
| Rate for Payer: PACE SWMI |
$132.80
|
| Rate for Payer: PHP Commercial |
$185.92
|
| Rate for Payer: PHP Medicare Advantage |
$132.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$225.85
|
| Rate for Payer: Priority Health Medicare |
$132.80
|
| Rate for Payer: Priority Health SBD |
$225.85
|
| Rate for Payer: Priority Health Tiered Network |
$225.85
|
| Rate for Payer: Railroad Medicare Medicare |
$132.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.72
|
| Rate for Payer: UHC Core |
$252.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.80
|
| Rate for Payer: UHC Exchange |
$252.72
|
| Rate for Payer: UHC Medicaid |
$87.97
|
| Rate for Payer: UHCCP Medicaid |
$87.97
|
| Rate for Payer: UMR Bronson Commercial |
$223.56
|
|
|
PR NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX
|
Professional
|
Both
|
$323.00
|
|
|
Service Code
|
HCPCS 31231
|
| Min. Negotiated Rate |
$34.93 |
| Max. Negotiated Rate |
$242.25 |
| Rate for Payer: Aetna Commercial |
$72.74
|
| Rate for Payer: Aetna Medicare |
$56.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.16
|
| Rate for Payer: BCBS Complete |
$36.68
|
| Rate for Payer: BCBS MAPPO |
$54.28
|
| Rate for Payer: BCN Commercial |
$75.79
|
| Rate for Payer: BCN Medicare Advantage |
$54.28
|
| Rate for Payer: Cash Price |
$258.40
|
| Rate for Payer: Cash Price |
$258.40
|
| Rate for Payer: Cofinity Commercial |
$72.74
|
| Rate for Payer: Cofinity Commercial |
$78.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.99
|
| Rate for Payer: Meridian Medicaid |
$36.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.71
|
| Rate for Payer: Nomi Health Commercial |
$65.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$242.25
|
| Rate for Payer: PACE SWMI |
$54.28
|
| Rate for Payer: PHP Commercial |
$75.99
|
| Rate for Payer: PHP Medicare Advantage |
$54.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$86.12
|
| Rate for Payer: Priority Health Medicare |
$54.28
|
| Rate for Payer: Priority Health SBD |
$86.12
|
| Rate for Payer: Priority Health Tiered Network |
$86.12
|
| Rate for Payer: Railroad Medicare Medicare |
$54.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.13
|
| Rate for Payer: UHC Core |
$111.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$54.28
|
| Rate for Payer: UHC Exchange |
$111.13
|
| Rate for Payer: UHC Medicaid |
$34.93
|
| Rate for Payer: UHCCP Medicaid |
$34.93
|
| Rate for Payer: UMR Bronson Commercial |
$148.58
|
|
|
PR NASAL/SINUS ENDOSCOPY DX MAXILLARY SINUSOSCOPY
|
Professional
|
Both
|
$533.00
|
|
|
Service Code
|
HCPCS 31233
|
| Min. Negotiated Rate |
$74.76 |
| Max. Negotiated Rate |
$399.75 |
| Rate for Payer: Aetna Commercial |
$154.62
|
| Rate for Payer: Aetna Medicare |
$120.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.16
|
| Rate for Payer: BCBS Complete |
$78.50
|
| Rate for Payer: BCBS MAPPO |
$115.39
|
| Rate for Payer: BCN Commercial |
$202.18
|
| Rate for Payer: BCN Medicare Advantage |
$115.39
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cofinity Commercial |
$154.62
|
| Rate for Payer: Cofinity Commercial |
$166.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.16
|
| Rate for Payer: Meridian Medicaid |
$78.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$126.93
|
| Rate for Payer: Nomi Health Commercial |
$138.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$399.75
|
| Rate for Payer: PACE SWMI |
$115.39
|
| Rate for Payer: PHP Commercial |
$161.55
|
| Rate for Payer: PHP Medicare Advantage |
$115.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$190.40
|
| Rate for Payer: Priority Health Medicare |
$115.39
|
| Rate for Payer: Priority Health SBD |
$190.40
|
| Rate for Payer: Priority Health Tiered Network |
$190.40
|
| Rate for Payer: Railroad Medicare Medicare |
$115.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.86
|
| Rate for Payer: UHC Core |
$233.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$115.39
|
| Rate for Payer: UHC Exchange |
$233.86
|
| Rate for Payer: UHC Medicaid |
$74.76
|
| Rate for Payer: UHCCP Medicaid |
$74.76
|
| Rate for Payer: UMR Bronson Commercial |
$245.18
|
|
|
PR NASAL/SINUS ENDOSCOPY DX SPHENOID SINUSOSCOPY
|
Professional
|
Both
|
$522.00
|
|
|
Service Code
|
HCPCS 31235
|
| Min. Negotiated Rate |
$87.97 |
| Max. Negotiated Rate |
$391.50 |
| Rate for Payer: Aetna Commercial |
$182.35
|
| Rate for Payer: Aetna Medicare |
$141.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.96
|
| Rate for Payer: BCBS Complete |
$92.37
|
| Rate for Payer: BCBS MAPPO |
$136.08
|
| Rate for Payer: BCN Commercial |
$240.53
|
| Rate for Payer: BCN Medicare Advantage |
$136.08
|
| Rate for Payer: Cash Price |
$417.60
|
| Rate for Payer: Cash Price |
$417.60
|
| Rate for Payer: Cofinity Commercial |
$182.35
|
| Rate for Payer: Cofinity Commercial |
$195.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.88
|
| Rate for Payer: Meridian Medicaid |
$92.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$149.69
|
| Rate for Payer: Nomi Health Commercial |
$163.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$391.50
|
| Rate for Payer: PACE SWMI |
$136.08
|
| Rate for Payer: PHP Commercial |
$190.51
|
| Rate for Payer: PHP Medicare Advantage |
$136.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$226.50
|
| Rate for Payer: Priority Health Medicare |
$136.08
|
| Rate for Payer: Priority Health SBD |
$226.50
|
| Rate for Payer: Priority Health Tiered Network |
$226.50
|
| Rate for Payer: Railroad Medicare Medicare |
$136.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$276.64
|
| Rate for Payer: UHC Core |
$276.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$136.08
|
| Rate for Payer: UHC Exchange |
$276.64
|
| Rate for Payer: UHC Medicaid |
$87.97
|
| Rate for Payer: UHCCP Medicaid |
$87.97
|
| Rate for Payer: UMR Bronson Commercial |
$240.12
|
|
|
PR NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY
|
Professional
|
Both
|
$557.00
|
|
|
Service Code
|
HCPCS 31256
|
| Min. Negotiated Rate |
$97.34 |
| Max. Negotiated Rate |
$417.75 |
| Rate for Payer: Aetna Commercial |
$202.70
|
| Rate for Payer: Aetna Medicare |
$157.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.83
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$151.27
|
| Rate for Payer: BCN Commercial |
$270.40
|
| Rate for Payer: BCN Medicare Advantage |
$151.27
|
| Rate for Payer: Cash Price |
$445.60
|
| Rate for Payer: Cash Price |
$445.60
|
| Rate for Payer: Cofinity Commercial |
$202.70
|
| Rate for Payer: Cofinity Commercial |
$217.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.83
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$166.40
|
| Rate for Payer: Nomi Health Commercial |
$181.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$417.75
|
| Rate for Payer: PACE SWMI |
$151.27
|
| Rate for Payer: PHP Commercial |
$211.78
|
| Rate for Payer: PHP Medicare Advantage |
$151.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$254.64
|
| Rate for Payer: Priority Health Medicare |
$151.27
|
| Rate for Payer: Priority Health SBD |
$254.64
|
| Rate for Payer: Priority Health Tiered Network |
$254.64
|
| Rate for Payer: Railroad Medicare Medicare |
$151.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.93
|
| Rate for Payer: UHC Core |
$315.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$151.27
|
| Rate for Payer: UHC Exchange |
$315.93
|
| Rate for Payer: UHC Medicaid |
$97.34
|
| Rate for Payer: UHCCP Medicaid |
$97.34
|
| Rate for Payer: UMR Bronson Commercial |
$256.22
|
|
|
PR NASAL/SINUS ENDOSCOPY W/SPHENOIDOTOMY
|
Professional
|
Both
|
$916.00
|
|
|
Service Code
|
HCPCS 31287
|
| Min. Negotiated Rate |
$108.63 |
| Max. Negotiated Rate |
$687.00 |
| Rate for Payer: Aetna Commercial |
$226.33
|
| Rate for Payer: Aetna Medicare |
$175.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$226.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.22
|
| Rate for Payer: BCBS Complete |
$114.06
|
| Rate for Payer: BCBS MAPPO |
$168.90
|
| Rate for Payer: BCN Commercial |
$300.28
|
| Rate for Payer: BCN Medicare Advantage |
$168.90
|
| Rate for Payer: Cash Price |
$732.80
|
| Rate for Payer: Cash Price |
$732.80
|
| Rate for Payer: Cofinity Commercial |
$226.33
|
| Rate for Payer: Cofinity Commercial |
$243.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$177.34
|
| Rate for Payer: Meridian Medicaid |
$114.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$185.79
|
| Rate for Payer: Nomi Health Commercial |
$202.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$687.00
|
| Rate for Payer: PACE SWMI |
$168.90
|
| Rate for Payer: PHP Commercial |
$236.46
|
| Rate for Payer: PHP Medicare Advantage |
$168.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$282.78
|
| Rate for Payer: Priority Health Medicare |
$168.90
|
| Rate for Payer: Priority Health SBD |
$282.78
|
| Rate for Payer: Priority Health Tiered Network |
$282.78
|
| Rate for Payer: Railroad Medicare Medicare |
$168.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.32
|
| Rate for Payer: UHC Core |
$353.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$168.90
|
| Rate for Payer: UHC Exchange |
$353.32
|
| Rate for Payer: UHC Medicaid |
$108.63
|
| Rate for Payer: UHCCP Medicaid |
$108.63
|
| Rate for Payer: UMR Bronson Commercial |
$421.36
|
|
|
PR NASAL/SINUS NDSC DSTRJ CRYOABLATION PST NSL NRV
|
Professional
|
Both
|
$4,591.00
|
|
|
Service Code
|
HCPCS 31243
|
| Min. Negotiated Rate |
$86.05 |
| Max. Negotiated Rate |
$3,443.25 |
| Rate for Payer: Aetna Commercial |
$179.10
|
| Rate for Payer: Aetna Medicare |
$139.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.47
|
| Rate for Payer: BCBS Complete |
$90.35
|
| Rate for Payer: BCBS MAPPO |
$133.66
|
| Rate for Payer: BCN Commercial |
$235.55
|
| Rate for Payer: BCN Medicare Advantage |
$133.66
|
| Rate for Payer: Cash Price |
$3,672.80
|
| Rate for Payer: Cash Price |
$3,672.80
|
| Rate for Payer: Cofinity Commercial |
$179.10
|
| Rate for Payer: Cofinity Commercial |
$192.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.34
|
| Rate for Payer: Meridian Medicaid |
$90.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.03
|
| Rate for Payer: Nomi Health Commercial |
$160.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,443.25
|
| Rate for Payer: PACE SWMI |
$133.66
|
| Rate for Payer: PHP Commercial |
$187.12
|
| Rate for Payer: PHP Medicare Advantage |
$133.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$221.82
|
| Rate for Payer: Priority Health Medicare |
$133.66
|
| Rate for Payer: Priority Health SBD |
$221.82
|
| Rate for Payer: Priority Health Tiered Network |
$221.82
|
| Rate for Payer: Railroad Medicare Medicare |
$133.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.73
|
| Rate for Payer: UHC Core |
$287.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$133.66
|
| Rate for Payer: UHC Exchange |
$287.73
|
| Rate for Payer: UHC Medicaid |
$86.05
|
| Rate for Payer: UHCCP Medicaid |
$86.05
|
| Rate for Payer: UMR Bronson Commercial |
$2,111.86
|
|
|
PR NASAL/SINUS NDSC RPR CEREBRSP FLUID LEAK ETHMOID
|
Professional
|
Both
|
$2,173.00
|
|
|
Service Code
|
HCPCS 31290
|
| Min. Negotiated Rate |
$632.82 |
| Max. Negotiated Rate |
$1,992.72 |
| Rate for Payer: Aetna Commercial |
$1,312.14
|
| Rate for Payer: Aetna Medicare |
$1,018.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,312.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,410.06
|
| Rate for Payer: BCBS Complete |
$664.46
|
| Rate for Payer: BCBS MAPPO |
$979.21
|
| Rate for Payer: BCN Commercial |
$1,715.55
|
| Rate for Payer: BCN Medicare Advantage |
$979.21
|
| Rate for Payer: Cash Price |
$1,738.40
|
| Rate for Payer: Cash Price |
$1,738.40
|
| Rate for Payer: Cofinity Commercial |
$1,312.14
|
| Rate for Payer: Cofinity Commercial |
$1,410.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$979.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,028.17
|
| Rate for Payer: Meridian Medicaid |
$664.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,077.13
|
| Rate for Payer: Nomi Health Commercial |
$1,175.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,629.75
|
| Rate for Payer: PACE SWMI |
$979.21
|
| Rate for Payer: PHP Commercial |
$1,370.89
|
| Rate for Payer: PHP Medicare Advantage |
$979.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$632.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,615.54
|
| Rate for Payer: Priority Health Medicare |
$979.21
|
| Rate for Payer: Priority Health SBD |
$1,615.54
|
| Rate for Payer: Priority Health Tiered Network |
$1,615.54
|
| Rate for Payer: Railroad Medicare Medicare |
$979.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,992.72
|
| Rate for Payer: UHC Core |
$1,992.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$979.21
|
| Rate for Payer: UHC Exchange |
$1,992.72
|
| Rate for Payer: UHC Medicaid |
$632.82
|
| Rate for Payer: UHCCP Medicaid |
$632.82
|
| Rate for Payer: UMR Bronson Commercial |
$999.58
|
|
