|
PR INTRAVASCULAR US NONCORONARY RS&I ADDL VESSEL
|
Professional
|
Both
|
$424.00
|
|
|
Service Code
|
HCPCS 37253
|
| Min. Negotiated Rate |
$67.81 |
| Max. Negotiated Rate |
$275.60 |
| Rate for Payer: Aetna Commercial |
$90.87
|
| Rate for Payer: Aetna Medicare |
$70.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.65
|
| Rate for Payer: BCBS Complete |
$169.60
|
| Rate for Payer: BCBS MAPPO |
$67.81
|
| Rate for Payer: BCN Medicare Advantage |
$67.81
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cash Price |
$339.20
|
| Rate for Payer: Cofinity Commercial |
$90.87
|
| Rate for Payer: Cofinity Commercial |
$97.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.20
|
| Rate for Payer: Nomi Health Commercial |
$81.37
|
| Rate for Payer: PACE SWMI |
$67.81
|
| Rate for Payer: PHP Commercial |
$94.93
|
| Rate for Payer: PHP Medicare Advantage |
$67.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.60
|
| Rate for Payer: Priority Health Medicare |
$67.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.81
|
| Rate for Payer: UHC Medicare Advantage |
$67.81
|
| Rate for Payer: UMR Bronson Commercial |
$195.04
|
|
|
PR INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL
|
Professional
|
Both
|
$193.00
|
|
|
Service Code
|
HCPCS 37252
|
| Min. Negotiated Rate |
$77.20 |
| Max. Negotiated Rate |
$125.45 |
| Rate for Payer: Aetna Commercial |
$114.09
|
| Rate for Payer: Aetna Medicare |
$88.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.09
|
| Rate for Payer: BCBS Complete |
$77.20
|
| Rate for Payer: BCBS MAPPO |
$85.14
|
| Rate for Payer: BCN Medicare Advantage |
$85.14
|
| Rate for Payer: Cash Price |
$154.40
|
| Rate for Payer: Cash Price |
$154.40
|
| Rate for Payer: Cofinity Commercial |
$122.60
|
| Rate for Payer: Cofinity Commercial |
$114.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.40
|
| Rate for Payer: Nomi Health Commercial |
$102.17
|
| Rate for Payer: PACE SWMI |
$85.14
|
| Rate for Payer: PHP Commercial |
$119.20
|
| Rate for Payer: PHP Medicare Advantage |
$85.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.45
|
| Rate for Payer: Priority Health Medicare |
$85.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.14
|
| Rate for Payer: UHC Medicare Advantage |
$85.14
|
| Rate for Payer: UMR Bronson Commercial |
$88.78
|
|
|
PR INTRAVASC US DURING DX EVAL/ INTERVENTION,EA ADDN VESSEL
|
Professional
|
Both
|
$408.00
|
|
|
Service Code
|
HCPCS 37251
|
| Min. Negotiated Rate |
$163.20 |
| Max. Negotiated Rate |
$265.20 |
| Rate for Payer: Aetna Medicare |
$204.00
|
| Rate for Payer: BCBS Complete |
$163.20
|
| Rate for Payer: Cash Price |
$326.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.20
|
| Rate for Payer: UMR Bronson Commercial |
$187.68
|
|
|
PR INTRA-VNTR MAPG TACHYCARDIA SITES W/CATH MNPJ
|
Professional
|
Both
|
$584.00
|
|
|
Service Code
|
HCPCS 93609
|
| Min. Negotiated Rate |
$233.60 |
| Max. Negotiated Rate |
$379.60 |
| Rate for Payer: Aetna Medicare |
$292.00
|
| Rate for Payer: BCBS Complete |
$233.60
|
| Rate for Payer: Cash Price |
$467.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.60
|
| Rate for Payer: UMR Bronson Commercial |
$268.64
|
|
|
PR INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 57180
|
| Min. Negotiated Rate |
$88.40 |
| Max. Negotiated Rate |
$165.05 |
| Rate for Payer: Aetna Commercial |
$153.59
|
| Rate for Payer: Aetna Medicare |
$119.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.59
|
| Rate for Payer: BCBS Complete |
$88.40
|
| Rate for Payer: BCBS MAPPO |
$114.62
|
| Rate for Payer: BCN Medicare Advantage |
$114.62
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$165.05
|
| Rate for Payer: Cofinity Commercial |
$153.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.35
|
| Rate for Payer: Nomi Health Commercial |
$137.54
|
| Rate for Payer: PACE SWMI |
$114.62
|
| Rate for Payer: PHP Commercial |
$160.47
|
| Rate for Payer: PHP Medicare Advantage |
$114.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.65
|
| Rate for Payer: Priority Health Medicare |
$114.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.62
|
| Rate for Payer: UHC Medicare Advantage |
$114.62
|
| Rate for Payer: UMR Bronson Commercial |
$101.66
|
|
|
PR INTRO CATH DIALYSIS CIRCUIT DX ANGRPH FLUOR S&I
|
Professional
|
Both
|
$378.00
|
|
|
Service Code
|
HCPCS 36901
|
| Min. Negotiated Rate |
$151.20 |
| Max. Negotiated Rate |
$245.70 |
| Rate for Payer: Aetna Commercial |
$213.93
|
| Rate for Payer: Aetna Medicare |
$166.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.93
|
| Rate for Payer: BCBS Complete |
$151.20
|
| Rate for Payer: BCBS MAPPO |
$159.65
|
| Rate for Payer: BCN Medicare Advantage |
$159.65
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cofinity Commercial |
$229.90
|
| Rate for Payer: Cofinity Commercial |
$213.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.63
|
| Rate for Payer: Nomi Health Commercial |
$191.58
|
| Rate for Payer: PACE SWMI |
$159.65
|
| Rate for Payer: PHP Commercial |
$223.51
|
| Rate for Payer: PHP Medicare Advantage |
$159.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.70
|
| Rate for Payer: Priority Health Medicare |
$159.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.65
|
| Rate for Payer: UHC Medicare Advantage |
$159.65
|
| Rate for Payer: UMR Bronson Commercial |
$173.88
|
|
|
PR INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT IV STENT
|
Professional
|
Both
|
$771.00
|
|
|
Service Code
|
HCPCS 36903
|
| Min. Negotiated Rate |
$298.73 |
| Max. Negotiated Rate |
$501.15 |
| Rate for Payer: Aetna Commercial |
$400.30
|
| Rate for Payer: Aetna Medicare |
$310.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$400.30
|
| Rate for Payer: BCBS Complete |
$308.40
|
| Rate for Payer: BCBS MAPPO |
$298.73
|
| Rate for Payer: BCN Medicare Advantage |
$298.73
|
| Rate for Payer: Cash Price |
$616.80
|
| Rate for Payer: Cash Price |
$616.80
|
| Rate for Payer: Cofinity Commercial |
$430.17
|
| Rate for Payer: Cofinity Commercial |
$400.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.67
|
| Rate for Payer: Nomi Health Commercial |
$358.48
|
| Rate for Payer: PACE SWMI |
$298.73
|
| Rate for Payer: PHP Commercial |
$418.22
|
| Rate for Payer: PHP Medicare Advantage |
$298.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$501.15
|
| Rate for Payer: Priority Health Medicare |
$298.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.73
|
| Rate for Payer: UHC Medicare Advantage |
$298.73
|
| Rate for Payer: UMR Bronson Commercial |
$354.66
|
|
|
PR INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP
|
Professional
|
Both
|
$563.00
|
|
|
Service Code
|
HCPCS 36902
|
| Min. Negotiated Rate |
$225.20 |
| Max. Negotiated Rate |
$365.95 |
| Rate for Payer: Aetna Commercial |
$303.50
|
| Rate for Payer: Aetna Medicare |
$235.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.50
|
| Rate for Payer: BCBS Complete |
$225.20
|
| Rate for Payer: BCBS MAPPO |
$226.49
|
| Rate for Payer: BCN Medicare Advantage |
$226.49
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cofinity Commercial |
$326.15
|
| Rate for Payer: Cofinity Commercial |
$303.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.81
|
| Rate for Payer: Nomi Health Commercial |
$271.79
|
| Rate for Payer: PACE SWMI |
$226.49
|
| Rate for Payer: PHP Commercial |
$317.09
|
| Rate for Payer: PHP Medicare Advantage |
$226.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.95
|
| Rate for Payer: Priority Health Medicare |
$226.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.49
|
| Rate for Payer: UHC Medicare Advantage |
$226.49
|
| Rate for Payer: UMR Bronson Commercial |
$258.98
|
|
|
PR INTRO CATHETER RIGHT HEART/MAIN PULMONARY ARTERY
|
Professional
|
Both
|
$747.00
|
|
|
Service Code
|
HCPCS 36013
|
| Min. Negotiated Rate |
$119.25 |
| Max. Negotiated Rate |
$485.55 |
| Rate for Payer: Aetna Commercial |
$159.79
|
| Rate for Payer: Aetna Medicare |
$124.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.79
|
| Rate for Payer: BCBS Complete |
$298.80
|
| Rate for Payer: BCBS MAPPO |
$119.25
|
| Rate for Payer: BCN Medicare Advantage |
$119.25
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cofinity Commercial |
$171.72
|
| Rate for Payer: Cofinity Commercial |
$159.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.21
|
| Rate for Payer: Nomi Health Commercial |
$143.10
|
| Rate for Payer: PACE SWMI |
$119.25
|
| Rate for Payer: PHP Commercial |
$166.95
|
| Rate for Payer: PHP Medicare Advantage |
$119.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$485.55
|
| Rate for Payer: Priority Health Medicare |
$119.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.25
|
| Rate for Payer: UHC Medicare Advantage |
$119.25
|
| Rate for Payer: UMR Bronson Commercial |
$343.62
|
|
|
PR INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA
|
Professional
|
Both
|
$974.00
|
|
|
Service Code
|
HCPCS 36010
|
| Min. Negotiated Rate |
$102.70 |
| Max. Negotiated Rate |
$633.10 |
| Rate for Payer: Aetna Commercial |
$137.62
|
| Rate for Payer: Aetna Medicare |
$106.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.62
|
| Rate for Payer: BCBS Complete |
$389.60
|
| Rate for Payer: BCBS MAPPO |
$102.70
|
| Rate for Payer: BCN Medicare Advantage |
$102.70
|
| Rate for Payer: Cash Price |
$779.20
|
| Rate for Payer: Cash Price |
$779.20
|
| Rate for Payer: Cofinity Commercial |
$147.89
|
| Rate for Payer: Cofinity Commercial |
$137.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.83
|
| Rate for Payer: Nomi Health Commercial |
$123.24
|
| Rate for Payer: PACE SWMI |
$102.70
|
| Rate for Payer: PHP Commercial |
$143.78
|
| Rate for Payer: PHP Medicare Advantage |
$102.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$633.10
|
| Rate for Payer: Priority Health Medicare |
$102.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.70
|
| Rate for Payer: UHC Medicare Advantage |
$102.70
|
| Rate for Payer: UMR Bronson Commercial |
$448.04
|
|
|
PR INTRODUCTION CATHETER AORTA
|
Professional
|
Both
|
$576.00
|
|
|
Service Code
|
HCPCS 36200
|
| Min. Negotiated Rate |
$134.13 |
| Max. Negotiated Rate |
$374.40 |
| Rate for Payer: Aetna Commercial |
$179.73
|
| Rate for Payer: Aetna Medicare |
$139.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.73
|
| Rate for Payer: BCBS Complete |
$230.40
|
| Rate for Payer: BCBS MAPPO |
$134.13
|
| Rate for Payer: BCN Medicare Advantage |
$134.13
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cofinity Commercial |
$193.15
|
| Rate for Payer: Cofinity Commercial |
$179.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.84
|
| Rate for Payer: Nomi Health Commercial |
$160.96
|
| Rate for Payer: PACE SWMI |
$134.13
|
| Rate for Payer: PHP Commercial |
$187.78
|
| Rate for Payer: PHP Medicare Advantage |
$134.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.40
|
| Rate for Payer: Priority Health Medicare |
$134.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.13
|
| Rate for Payer: UHC Medicare Advantage |
$134.13
|
| Rate for Payer: UMR Bronson Commercial |
$264.96
|
|
|
PR INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE
|
Professional
|
Both
|
$139.00
|
|
|
Service Code
|
HCPCS 44500
|
| Min. Negotiated Rate |
$18.26 |
| Max. Negotiated Rate |
$90.35 |
| Rate for Payer: Aetna Commercial |
$24.47
|
| Rate for Payer: Aetna Medicare |
$18.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.47
|
| Rate for Payer: BCBS Complete |
$55.60
|
| Rate for Payer: BCBS MAPPO |
$18.26
|
| Rate for Payer: BCN Medicare Advantage |
$18.26
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cofinity Commercial |
$26.29
|
| Rate for Payer: Cofinity Commercial |
$24.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.17
|
| Rate for Payer: Nomi Health Commercial |
$21.91
|
| Rate for Payer: PACE SWMI |
$18.26
|
| Rate for Payer: PHP Commercial |
$25.56
|
| Rate for Payer: PHP Medicare Advantage |
$18.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.35
|
| Rate for Payer: Priority Health Medicare |
$18.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.26
|
| Rate for Payer: UHC Medicare Advantage |
$18.26
|
| Rate for Payer: UMR Bronson Commercial |
$63.94
|
|
|
PR INTRODUCTION NEEDLE/INTRACATHETER VEIN
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 36000
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$117.00 |
| Rate for Payer: Aetna Medicare |
$90.00
|
| Rate for Payer: BCBS Complete |
$72.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.00
|
| Rate for Payer: UMR Bronson Commercial |
$82.80
|
|
|
PR INTRO NEEDLE/INTRACATH CAROTID/VERTEBRAL ARTERY
|
Professional
|
Both
|
$735.00
|
|
|
Service Code
|
HCPCS 36100
|
| Min. Negotiated Rate |
$146.56 |
| Max. Negotiated Rate |
$477.75 |
| Rate for Payer: Aetna Commercial |
$196.39
|
| Rate for Payer: Aetna Medicare |
$152.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.05
|
| Rate for Payer: BCBS Complete |
$294.00
|
| Rate for Payer: BCBS MAPPO |
$146.56
|
| Rate for Payer: BCN Medicare Advantage |
$146.56
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cofinity Commercial |
$196.39
|
| Rate for Payer: Cofinity Commercial |
$211.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.89
|
| Rate for Payer: Nomi Health Commercial |
$175.87
|
| Rate for Payer: PACE SWMI |
$146.56
|
| Rate for Payer: PHP Commercial |
$205.18
|
| Rate for Payer: PHP Medicare Advantage |
$146.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.75
|
| Rate for Payer: Priority Health Medicare |
$146.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.56
|
| Rate for Payer: UHC Medicare Advantage |
$146.56
|
| Rate for Payer: UMR Bronson Commercial |
$338.10
|
|
|
PR INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY
|
Professional
|
Both
|
$942.00
|
|
|
Service Code
|
HCPCS 36140
|
| Min. Negotiated Rate |
$84.73 |
| Max. Negotiated Rate |
$612.30 |
| Rate for Payer: Aetna Commercial |
$113.54
|
| Rate for Payer: Aetna Medicare |
$88.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.54
|
| Rate for Payer: BCBS Complete |
$376.80
|
| Rate for Payer: BCBS MAPPO |
$84.73
|
| Rate for Payer: BCN Medicare Advantage |
$84.73
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cofinity Commercial |
$122.01
|
| Rate for Payer: Cofinity Commercial |
$113.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.97
|
| Rate for Payer: Nomi Health Commercial |
$101.68
|
| Rate for Payer: PACE SWMI |
$84.73
|
| Rate for Payer: PHP Commercial |
$118.62
|
| Rate for Payer: PHP Medicare Advantage |
$84.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.30
|
| Rate for Payer: Priority Health Medicare |
$84.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$84.73
|
| Rate for Payer: UHC Medicare Advantage |
$84.73
|
| Rate for Payer: UMR Bronson Commercial |
$433.32
|
|
|
PR INTSTINAL STRICTUROPLASTY W/WO DILAT OBSTRCJ
|
Professional
|
Both
|
$2,967.00
|
|
|
Service Code
|
HCPCS 44615
|
| Min. Negotiated Rate |
$1,037.74 |
| Max. Negotiated Rate |
$1,928.55 |
| Rate for Payer: Aetna Commercial |
$1,390.57
|
| Rate for Payer: Aetna Medicare |
$1,079.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,494.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,390.57
|
| Rate for Payer: BCBS Complete |
$1,186.80
|
| Rate for Payer: BCBS MAPPO |
$1,037.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,037.74
|
| Rate for Payer: Cash Price |
$2,373.60
|
| Rate for Payer: Cash Price |
$2,373.60
|
| Rate for Payer: Cofinity Commercial |
$1,494.35
|
| Rate for Payer: Cofinity Commercial |
$1,390.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,037.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,089.63
|
| Rate for Payer: Nomi Health Commercial |
$1,245.29
|
| Rate for Payer: PACE SWMI |
$1,037.74
|
| Rate for Payer: PHP Commercial |
$1,452.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,037.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,928.55
|
| Rate for Payer: Priority Health Medicare |
$1,037.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,037.74
|
| Rate for Payer: UHC Medicare Advantage |
$1,037.74
|
| Rate for Payer: UMR Bronson Commercial |
$1,364.82
|
|
|
PR INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE
|
Professional
|
Both
|
$364.00
|
|
|
Service Code
|
HCPCS 31500
|
| Min. Negotiated Rate |
$137.27 |
| Max. Negotiated Rate |
$236.60 |
| Rate for Payer: Aetna Commercial |
$183.94
|
| Rate for Payer: Aetna Medicare |
$142.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.94
|
| Rate for Payer: BCBS Complete |
$145.60
|
| Rate for Payer: BCBS MAPPO |
$137.27
|
| Rate for Payer: BCN Medicare Advantage |
$137.27
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Cofinity Commercial |
$197.67
|
| Rate for Payer: Cofinity Commercial |
$183.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.13
|
| Rate for Payer: Nomi Health Commercial |
$164.72
|
| Rate for Payer: PACE SWMI |
$137.27
|
| Rate for Payer: PHP Commercial |
$192.18
|
| Rate for Payer: PHP Medicare Advantage |
$137.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$236.60
|
| Rate for Payer: Priority Health Medicare |
$137.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.27
|
| Rate for Payer: UHC Medicare Advantage |
$137.27
|
| Rate for Payer: UMR Bronson Commercial |
$167.44
|
|
|
PR IONM 1 ON 1 IN OR W/ATTENDANCE EACH 15 MINUTES
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 95940
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$43.72 |
| Rate for Payer: Aetna Commercial |
$40.68
|
| Rate for Payer: Aetna Medicare |
$31.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.68
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS MAPPO |
$30.36
|
| Rate for Payer: BCN Medicare Advantage |
$30.36
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$43.72
|
| Rate for Payer: Cofinity Commercial |
$40.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.88
|
| Rate for Payer: Nomi Health Commercial |
$36.43
|
| Rate for Payer: PACE SWMI |
$30.36
|
| Rate for Payer: PHP Commercial |
$42.50
|
| Rate for Payer: PHP Medicare Advantage |
$30.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health Medicare |
$30.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.36
|
| Rate for Payer: UHC Medicare Advantage |
$30.36
|
| Rate for Payer: UMR Bronson Commercial |
$25.76
|
|
|
PR IONM REMOTE/NEARBY/>1 PATIENT IN OR PER HOUR
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 95941
|
| Min. Negotiated Rate |
$51.20 |
| Max. Negotiated Rate |
$83.20 |
| Rate for Payer: Aetna Medicare |
$64.00
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: UMR Bronson Commercial |
$58.88
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT HIGH MDM 80 MINUTES
|
Professional
|
Both
|
$348.00
|
|
|
Service Code
|
HCPCS 99255
|
| Min. Negotiated Rate |
$139.20 |
| Max. Negotiated Rate |
$226.20 |
| Rate for Payer: Aetna Medicare |
$174.00
|
| Rate for Payer: BCBS Complete |
$139.20
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$226.20
|
| Rate for Payer: UMR Bronson Commercial |
$160.08
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT LOW MDM 45 MINUTES
|
Professional
|
Both
|
$209.00
|
|
|
Service Code
|
HCPCS 99253
|
| Min. Negotiated Rate |
$83.60 |
| Max. Negotiated Rate |
$135.85 |
| Rate for Payer: Aetna Medicare |
$104.50
|
| Rate for Payer: BCBS Complete |
$83.60
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.85
|
| Rate for Payer: UMR Bronson Commercial |
$96.14
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT MOD MDM 60 MINUTES
|
Professional
|
Both
|
$266.00
|
|
|
Service Code
|
HCPCS 99254
|
| Min. Negotiated Rate |
$106.40 |
| Max. Negotiated Rate |
$172.90 |
| Rate for Payer: Aetna Medicare |
$133.00
|
| Rate for Payer: BCBS Complete |
$106.40
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.90
|
| Rate for Payer: UMR Bronson Commercial |
$122.36
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT SF MDM 35 MINUTES
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 99252
|
| Min. Negotiated Rate |
$67.20 |
| Max. Negotiated Rate |
$109.20 |
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
| Rate for Payer: UMR Bronson Commercial |
$77.28
|
|
|
PR IPRATROPIUM BROMIDE NON-COMP
|
Professional
|
Both
|
$4.00
|
|
|
Service Code
|
HCPCS J7644
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$2.60 |
| Rate for Payer: Aetna Commercial |
$0.52
|
| Rate for Payer: Aetna Medicare |
$0.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.52
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: BCBS MAPPO |
$0.39
|
| Rate for Payer: BCN Medicare Advantage |
$0.39
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cofinity Commercial |
$0.56
|
| Rate for Payer: Cofinity Commercial |
$0.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.41
|
| Rate for Payer: Nomi Health Commercial |
$0.47
|
| Rate for Payer: PACE SWMI |
$0.39
|
| Rate for Payer: PHP Commercial |
$0.55
|
| Rate for Payer: PHP Medicare Advantage |
$0.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.60
|
| Rate for Payer: Priority Health Medicare |
$0.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.39
|
| Rate for Payer: UHC Medicare Advantage |
$0.39
|
| Rate for Payer: UMR Bronson Commercial |
$1.84
|
|
|
PR IR DEEP HEAT PAIN RELIEF 15MIN
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 00099
|
|
Hospital Revenue Code
|
990
|
| 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
|
|
