|
PR NJX INFUS/BOLUS DX/SBST EDRL/SUBARACH LUM/SACRAL
|
Professional
|
Both
|
$898.00
|
|
|
Service Code
|
HCPCS 62319
|
| Min. Negotiated Rate |
$359.20 |
| Max. Negotiated Rate |
$673.50 |
| Rate for Payer: Aetna Medicare |
$449.00
|
| Rate for Payer: BCBS Complete |
$359.20
|
| Rate for Payer: Cash Price |
$718.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$673.50
|
| Rate for Payer: UMR Bronson Commercial |
$413.08
|
|
|
PR NJX NONCMPND SCLEROSANT MULTIPLE INCMPTNT VEINS
|
Professional
|
Both
|
$2,936.00
|
|
|
Service Code
|
HCPCS 36466
|
| Min. Negotiated Rate |
$84.99 |
| Max. Negotiated Rate |
$2,202.00 |
| Rate for Payer: Aetna Commercial |
$180.16
|
| Rate for Payer: Aetna Medicare |
$139.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.61
|
| Rate for Payer: BCBS Complete |
$89.24
|
| Rate for Payer: BCBS MAPPO |
$134.45
|
| Rate for Payer: BCN Commercial |
$222.60
|
| Rate for Payer: BCN Medicare Advantage |
$134.45
|
| Rate for Payer: Cash Price |
$2,348.80
|
| Rate for Payer: Cash Price |
$2,348.80
|
| Rate for Payer: Cofinity Commercial |
$193.61
|
| Rate for Payer: Cofinity Commercial |
$180.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.17
|
| Rate for Payer: Meridian Medicaid |
$89.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.90
|
| Rate for Payer: Nomi Health Commercial |
$161.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,202.00
|
| Rate for Payer: PACE SWMI |
$134.45
|
| Rate for Payer: PHP Commercial |
$188.23
|
| Rate for Payer: PHP Medicare Advantage |
$134.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$239.38
|
| Rate for Payer: Priority Health Medicare |
$134.45
|
| Rate for Payer: Priority Health SBD |
$239.38
|
| Rate for Payer: Priority Health Tiered Network |
$239.38
|
| Rate for Payer: Railroad Medicare Medicare |
$134.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$275.08
|
| Rate for Payer: UHC Core |
$275.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$134.45
|
| Rate for Payer: UHC Exchange |
$275.08
|
| Rate for Payer: UHC Medicaid |
$84.99
|
| Rate for Payer: UHCCP Medicaid |
$84.99
|
| Rate for Payer: UMR Bronson Commercial |
$1,350.56
|
|
|
PR NJX NONCMPND SCLEROSANT SINGLE INCMPTNT VEIN
|
Professional
|
Both
|
$2,780.00
|
|
|
Service Code
|
HCPCS 36465
|
| Min. Negotiated Rate |
$67.31 |
| Max. Negotiated Rate |
$2,085.00 |
| Rate for Payer: Aetna Commercial |
$142.68
|
| Rate for Payer: Aetna Medicare |
$110.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.33
|
| Rate for Payer: BCBS Complete |
$70.68
|
| Rate for Payer: BCBS MAPPO |
$106.48
|
| Rate for Payer: BCN Commercial |
$176.28
|
| Rate for Payer: BCN Medicare Advantage |
$106.48
|
| Rate for Payer: Cash Price |
$2,224.00
|
| Rate for Payer: Cash Price |
$2,224.00
|
| Rate for Payer: Cofinity Commercial |
$142.68
|
| Rate for Payer: Cofinity Commercial |
$153.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.80
|
| Rate for Payer: Meridian Medicaid |
$70.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$117.13
|
| Rate for Payer: Nomi Health Commercial |
$127.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,085.00
|
| Rate for Payer: PACE SWMI |
$106.48
|
| Rate for Payer: PHP Commercial |
$149.07
|
| Rate for Payer: PHP Medicare Advantage |
$106.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$189.58
|
| Rate for Payer: Priority Health Medicare |
$106.48
|
| Rate for Payer: Priority Health SBD |
$189.58
|
| Rate for Payer: Priority Health Tiered Network |
$189.58
|
| Rate for Payer: Railroad Medicare Medicare |
$106.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.92
|
| Rate for Payer: UHC Core |
$214.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$106.48
|
| Rate for Payer: UHC Exchange |
$214.92
|
| Rate for Payer: UHC Medicaid |
$67.31
|
| Rate for Payer: UHCCP Medicaid |
$67.31
|
| Rate for Payer: UMR Bronson Commercial |
$1,278.80
|
|
|
PR NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION
|
Professional
|
Both
|
$946.00
|
|
|
Service Code
|
HCPCS 0232T
|
| Min. Negotiated Rate |
$78.68 |
| Max. Negotiated Rate |
$709.50 |
| Rate for Payer: Aetna Commercial |
$128.61
|
| Rate for Payer: Aetna Commercial |
$128.61
|
| Rate for Payer: Aetna Medicare |
$315.00
|
| Rate for Payer: Aetna Medicare |
$473.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.61
|
| Rate for Payer: BCBS Complete |
$252.00
|
| Rate for Payer: BCBS Complete |
$378.40
|
| Rate for Payer: BCN Commercial |
$373.10
|
| Rate for Payer: BCN Commercial |
$373.10
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$472.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$709.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$271.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$271.50
|
| Rate for Payer: Priority Health SBD |
$271.50
|
| Rate for Payer: Priority Health SBD |
$271.50
|
| Rate for Payer: Priority Health Tiered Network |
$271.50
|
| Rate for Payer: Priority Health Tiered Network |
$271.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.68
|
| Rate for Payer: UHC Core |
$78.68
|
| Rate for Payer: UHC Core |
$78.68
|
| Rate for Payer: UHC Exchange |
$78.68
|
| Rate for Payer: UHC Exchange |
$78.68
|
| Rate for Payer: UMR Bronson Commercial |
$289.80
|
| Rate for Payer: UMR Bronson Commercial |
$435.16
|
|
|
PR NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS
|
Professional
|
Both
|
$213.00
|
|
|
Service Code
|
HCPCS 50431
|
| Min. Negotiated Rate |
$37.70 |
| Max. Negotiated Rate |
$159.75 |
| Rate for Payer: Aetna Commercial |
$77.65
|
| Rate for Payer: Aetna Medicare |
$60.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.45
|
| Rate for Payer: BCBS Complete |
$39.59
|
| Rate for Payer: BCBS MAPPO |
$57.95
|
| Rate for Payer: BCN Commercial |
$98.60
|
| Rate for Payer: BCN Medicare Advantage |
$57.95
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$83.45
|
| Rate for Payer: Cofinity Commercial |
$77.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.85
|
| Rate for Payer: Meridian Medicaid |
$39.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.74
|
| Rate for Payer: Nomi Health Commercial |
$69.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.75
|
| Rate for Payer: PACE SWMI |
$57.95
|
| Rate for Payer: PHP Commercial |
$81.13
|
| Rate for Payer: PHP Medicare Advantage |
$57.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$107.41
|
| Rate for Payer: Priority Health Medicare |
$57.95
|
| Rate for Payer: Priority Health SBD |
$107.41
|
| Rate for Payer: Priority Health Tiered Network |
$107.41
|
| Rate for Payer: Railroad Medicare Medicare |
$57.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.37
|
| Rate for Payer: UHC Core |
$114.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$57.95
|
| Rate for Payer: UHC Exchange |
$114.37
|
| Rate for Payer: UHC Medicaid |
$37.70
|
| Rate for Payer: UHCCP Medicaid |
$37.70
|
| Rate for Payer: UMR Bronson Commercial |
$97.98
|
|
|
PR NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS
|
Professional
|
Both
|
$247.00
|
|
|
Service Code
|
HCPCS 50430
|
| Min. Negotiated Rate |
$86.48 |
| Max. Negotiated Rate |
$273.16 |
| Rate for Payer: Aetna Commercial |
$180.22
|
| Rate for Payer: Aetna Medicare |
$139.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.67
|
| Rate for Payer: BCBS Complete |
$90.80
|
| Rate for Payer: BCBS MAPPO |
$134.49
|
| Rate for Payer: BCN Commercial |
$226.08
|
| Rate for Payer: BCN Medicare Advantage |
$134.49
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cofinity Commercial |
$180.22
|
| Rate for Payer: Cofinity Commercial |
$193.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.21
|
| Rate for Payer: Meridian Medicaid |
$90.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.94
|
| Rate for Payer: Nomi Health Commercial |
$161.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.25
|
| Rate for Payer: PACE SWMI |
$134.49
|
| Rate for Payer: PHP Commercial |
$188.29
|
| Rate for Payer: PHP Medicare Advantage |
$134.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$246.27
|
| Rate for Payer: Priority Health Medicare |
$134.49
|
| Rate for Payer: Priority Health SBD |
$246.27
|
| Rate for Payer: Priority Health Tiered Network |
$246.27
|
| Rate for Payer: Railroad Medicare Medicare |
$134.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.16
|
| Rate for Payer: UHC Core |
$273.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$134.49
|
| Rate for Payer: UHC Exchange |
$273.16
|
| Rate for Payer: UHC Medicaid |
$86.48
|
| Rate for Payer: UHCCP Medicaid |
$86.48
|
| Rate for Payer: UMR Bronson Commercial |
$113.62
|
|
|
PR NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH
|
Professional
|
Both
|
$592.00
|
|
|
Service Code
|
HCPCS 36005
|
| Min. Negotiated Rate |
$26.63 |
| Max. Negotiated Rate |
$444.00 |
| Rate for Payer: Aetna Commercial |
$56.25
|
| Rate for Payer: Aetna Medicare |
$43.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.45
|
| Rate for Payer: BCBS Complete |
$27.96
|
| Rate for Payer: BCBS MAPPO |
$41.98
|
| Rate for Payer: BCN Commercial |
$76.59
|
| Rate for Payer: BCN Medicare Advantage |
$41.98
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Cofinity Commercial |
$56.25
|
| Rate for Payer: Cofinity Commercial |
$60.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.08
|
| Rate for Payer: Meridian Medicaid |
$27.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.18
|
| Rate for Payer: Nomi Health Commercial |
$50.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$444.00
|
| Rate for Payer: PACE SWMI |
$41.98
|
| Rate for Payer: PHP Commercial |
$58.77
|
| Rate for Payer: PHP Medicare Advantage |
$41.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$74.98
|
| Rate for Payer: Priority Health Medicare |
$41.98
|
| Rate for Payer: Priority Health SBD |
$74.98
|
| Rate for Payer: Priority Health Tiered Network |
$74.98
|
| Rate for Payer: Railroad Medicare Medicare |
$41.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.05
|
| Rate for Payer: UHC Core |
$85.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.98
|
| Rate for Payer: UHC Exchange |
$85.05
|
| Rate for Payer: UHC Medicaid |
$26.63
|
| Rate for Payer: UHCCP Medicaid |
$26.63
|
| Rate for Payer: UMR Bronson Commercial |
$272.32
|
|
|
PR NJX RETROGRADE URETHROCSTOGRAPY
|
Professional
|
Both
|
$739.00
|
|
|
Service Code
|
HCPCS 51610
|
| Min. Negotiated Rate |
$36.85 |
| Max. Negotiated Rate |
$554.25 |
| Rate for Payer: Aetna Commercial |
$75.83
|
| Rate for Payer: Aetna Medicare |
$58.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.49
|
| Rate for Payer: BCBS Complete |
$38.69
|
| Rate for Payer: BCBS MAPPO |
$56.59
|
| Rate for Payer: BCN Commercial |
$97.11
|
| Rate for Payer: BCN Medicare Advantage |
$56.59
|
| Rate for Payer: Cash Price |
$591.20
|
| Rate for Payer: Cash Price |
$591.20
|
| Rate for Payer: Cofinity Commercial |
$75.83
|
| Rate for Payer: Cofinity Commercial |
$81.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.42
|
| Rate for Payer: Meridian Medicaid |
$38.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.25
|
| Rate for Payer: Nomi Health Commercial |
$67.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$554.25
|
| Rate for Payer: PACE SWMI |
$56.59
|
| Rate for Payer: PHP Commercial |
$79.23
|
| Rate for Payer: PHP Medicare Advantage |
$56.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$105.79
|
| Rate for Payer: Priority Health Medicare |
$56.59
|
| Rate for Payer: Priority Health SBD |
$105.79
|
| Rate for Payer: Priority Health Tiered Network |
$105.79
|
| Rate for Payer: Railroad Medicare Medicare |
$56.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.49
|
| Rate for Payer: UHC Core |
$112.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$56.59
|
| Rate for Payer: UHC Exchange |
$112.49
|
| Rate for Payer: UHC Medicaid |
$36.85
|
| Rate for Payer: UHCCP Medicaid |
$36.85
|
| Rate for Payer: UMR Bronson Commercial |
$339.94
|
|
|
PR NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG
|
Professional
|
Both
|
$219.00
|
|
|
Service Code
|
HCPCS 50690
|
| Min. Negotiated Rate |
$39.62 |
| Max. Negotiated Rate |
$164.25 |
| Rate for Payer: Aetna Commercial |
$81.57
|
| Rate for Payer: Aetna Medicare |
$63.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.65
|
| Rate for Payer: BCBS Complete |
$41.60
|
| Rate for Payer: BCBS MAPPO |
$60.87
|
| Rate for Payer: BCN Commercial |
$105.08
|
| Rate for Payer: BCN Medicare Advantage |
$60.87
|
| Rate for Payer: Cash Price |
$175.20
|
| Rate for Payer: Cash Price |
$175.20
|
| Rate for Payer: Cofinity Commercial |
$81.57
|
| Rate for Payer: Cofinity Commercial |
$87.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.91
|
| Rate for Payer: Meridian Medicaid |
$41.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$66.96
|
| Rate for Payer: Nomi Health Commercial |
$73.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.25
|
| Rate for Payer: PACE SWMI |
$60.87
|
| Rate for Payer: PHP Commercial |
$85.22
|
| Rate for Payer: PHP Medicare Advantage |
$60.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$114.46
|
| Rate for Payer: Priority Health Medicare |
$60.87
|
| Rate for Payer: Priority Health SBD |
$114.46
|
| Rate for Payer: Priority Health Tiered Network |
$114.46
|
| Rate for Payer: Railroad Medicare Medicare |
$60.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.84
|
| Rate for Payer: UHC Core |
$122.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$60.87
|
| Rate for Payer: UHC Exchange |
$122.84
|
| Rate for Payer: UHC Medicaid |
$39.62
|
| Rate for Payer: UHCCP Medicaid |
$39.62
|
| Rate for Payer: UMR Bronson Commercial |
$100.74
|
|
|
PR NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 54250
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$214.52 |
| Rate for Payer: Aetna Commercial |
$161.63
|
| Rate for Payer: Aetna Medicare |
$125.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.69
|
| Rate for Payer: BCBS Complete |
$96.80
|
| Rate for Payer: BCBS MAPPO |
$120.62
|
| Rate for Payer: BCN Commercial |
$181.27
|
| Rate for Payer: BCN Medicare Advantage |
$120.62
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cofinity Commercial |
$173.69
|
| Rate for Payer: Cofinity Commercial |
$161.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$132.68
|
| Rate for Payer: Nomi Health Commercial |
$144.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$181.50
|
| Rate for Payer: PACE SWMI |
$120.62
|
| Rate for Payer: PHP Commercial |
$168.87
|
| Rate for Payer: PHP Medicare Advantage |
$120.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$197.45
|
| Rate for Payer: Priority Health Medicare |
$120.62
|
| Rate for Payer: Priority Health SBD |
$197.45
|
| Rate for Payer: Priority Health Tiered Network |
$197.45
|
| Rate for Payer: Railroad Medicare Medicare |
$120.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.52
|
| Rate for Payer: UHC Core |
$214.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$120.62
|
| Rate for Payer: UHC Exchange |
$214.52
|
| Rate for Payer: UMR Bronson Commercial |
$111.32
|
|
|
PR NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 94761
|
| Min. Negotiated Rate |
$4.04 |
| Max. Negotiated Rate |
$36.75 |
| Rate for Payer: Aetna Commercial |
$5.41
|
| Rate for Payer: Aetna Medicare |
$4.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.82
|
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: BCBS MAPPO |
$4.04
|
| Rate for Payer: BCN Commercial |
$5.97
|
| Rate for Payer: BCN Medicare Advantage |
$4.04
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$5.82
|
| Rate for Payer: Cofinity Commercial |
$5.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.44
|
| Rate for Payer: Nomi Health Commercial |
$4.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.75
|
| Rate for Payer: PACE SWMI |
$4.04
|
| Rate for Payer: PHP Commercial |
$5.66
|
| Rate for Payer: PHP Medicare Advantage |
$4.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.51
|
| Rate for Payer: Priority Health Medicare |
$4.04
|
| Rate for Payer: Priority Health SBD |
$5.51
|
| Rate for Payer: Priority Health Tiered Network |
$5.51
|
| Rate for Payer: Railroad Medicare Medicare |
$4.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.89
|
| Rate for Payer: UHC Core |
$5.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.04
|
| Rate for Payer: UHC Exchange |
$5.89
|
| Rate for Payer: UMR Bronson Commercial |
$22.54
|
|
|
PR NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 94762
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$39.40 |
| Rate for Payer: Aetna Commercial |
$29.52
|
| Rate for Payer: Aetna Medicare |
$22.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.72
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS MAPPO |
$22.03
|
| Rate for Payer: BCN Commercial |
$36.85
|
| Rate for Payer: BCN Medicare Advantage |
$22.03
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$31.72
|
| Rate for Payer: Cofinity Commercial |
$29.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.23
|
| Rate for Payer: Nomi Health Commercial |
$26.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.25
|
| Rate for Payer: PACE SWMI |
$22.03
|
| Rate for Payer: PHP Commercial |
$30.84
|
| Rate for Payer: PHP Medicare Advantage |
$22.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$33.99
|
| Rate for Payer: Priority Health Medicare |
$22.03
|
| Rate for Payer: Priority Health SBD |
$33.99
|
| Rate for Payer: Priority Health Tiered Network |
$33.99
|
| Rate for Payer: Railroad Medicare Medicare |
$22.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.40
|
| Rate for Payer: UHC Core |
$39.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.03
|
| Rate for Payer: UHC Exchange |
$39.40
|
| Rate for Payer: UMR Bronson Commercial |
$19.78
|
|
|
PR NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 94760
|
| Min. Negotiated Rate |
$3.73 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Aetna Commercial |
$5.00
|
| Rate for Payer: Aetna Medicare |
$3.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.37
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: BCBS MAPPO |
$3.73
|
| Rate for Payer: BCN Commercial |
$5.48
|
| Rate for Payer: BCN Medicare Advantage |
$3.73
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$5.37
|
| Rate for Payer: Cofinity Commercial |
$5.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.10
|
| Rate for Payer: Nomi Health Commercial |
$4.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.50
|
| Rate for Payer: PACE SWMI |
$3.73
|
| Rate for Payer: PHP Commercial |
$5.22
|
| Rate for Payer: PHP Medicare Advantage |
$3.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.05
|
| Rate for Payer: Priority Health Medicare |
$3.73
|
| Rate for Payer: Priority Health SBD |
$5.05
|
| Rate for Payer: Priority Health Tiered Network |
$5.05
|
| Rate for Payer: Railroad Medicare Medicare |
$3.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.77
|
| Rate for Payer: UHC Core |
$3.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.73
|
| Rate for Payer: UHC Exchange |
$3.77
|
| Rate for Payer: UMR Bronson Commercial |
$21.16
|
|
|
PR NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 93923
|
| Min. Negotiated Rate |
$21.16 |
| Max. Negotiated Rate |
$201.39 |
| Rate for Payer: Aetna Commercial |
$166.04
|
| Rate for Payer: Aetna Commercial |
$166.04
|
| Rate for Payer: Aetna Medicare |
$128.87
|
| Rate for Payer: Aetna Medicare |
$128.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.04
|
| Rate for Payer: BCBS MAPPO |
$123.91
|
| Rate for Payer: BCBS MAPPO |
$123.91
|
| Rate for Payer: BCN Commercial |
$193.71
|
| Rate for Payer: BCN Commercial |
$193.71
|
| Rate for Payer: BCN Medicare Advantage |
$123.91
|
| Rate for Payer: BCN Medicare Advantage |
$123.91
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$178.43
|
| Rate for Payer: Cofinity Commercial |
$178.43
|
| Rate for Payer: Cofinity Commercial |
$166.04
|
| Rate for Payer: Cofinity Commercial |
$166.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.30
|
| Rate for Payer: Nomi Health Commercial |
$148.69
|
| Rate for Payer: Nomi Health Commercial |
$148.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.00
|
| Rate for Payer: PACE SWMI |
$123.91
|
| Rate for Payer: PACE SWMI |
$123.91
|
| Rate for Payer: PHP Commercial |
$173.47
|
| Rate for Payer: PHP Commercial |
$173.47
|
| Rate for Payer: PHP Medicare Advantage |
$123.91
|
| Rate for Payer: PHP Medicare Advantage |
$123.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$178.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$178.65
|
| Rate for Payer: Priority Health Medicare |
$123.91
|
| Rate for Payer: Priority Health Medicare |
$123.91
|
| Rate for Payer: Priority Health SBD |
$178.65
|
| Rate for Payer: Priority Health SBD |
$178.65
|
| Rate for Payer: Priority Health Tiered Network |
$178.65
|
| Rate for Payer: Priority Health Tiered Network |
$178.65
|
| Rate for Payer: Railroad Medicare Medicare |
$123.91
|
| Rate for Payer: Railroad Medicare Medicare |
$123.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.39
|
| Rate for Payer: UHC Core |
$201.39
|
| Rate for Payer: UHC Core |
$201.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$123.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$123.91
|
| Rate for Payer: UHC Exchange |
$201.39
|
| Rate for Payer: UHC Exchange |
$201.39
|
| Rate for Payer: UMR Bronson Commercial |
$149.04
|
| Rate for Payer: UMR Bronson Commercial |
$21.16
|
|
|
PR NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 93922
|
| Min. Negotiated Rate |
$12.88 |
| Max. Negotiated Rate |
$129.03 |
| Rate for Payer: Aetna Commercial |
$103.17
|
| Rate for Payer: Aetna Commercial |
$103.17
|
| Rate for Payer: Aetna Medicare |
$80.07
|
| Rate for Payer: Aetna Medicare |
$80.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.17
|
| Rate for Payer: BCBS MAPPO |
$76.99
|
| Rate for Payer: BCBS MAPPO |
$76.99
|
| Rate for Payer: BCN Commercial |
$122.01
|
| Rate for Payer: BCN Commercial |
$122.01
|
| Rate for Payer: BCN Medicare Advantage |
$76.99
|
| Rate for Payer: BCN Medicare Advantage |
$76.99
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cofinity Commercial |
$110.87
|
| Rate for Payer: Cofinity Commercial |
$110.87
|
| Rate for Payer: Cofinity Commercial |
$103.17
|
| Rate for Payer: Cofinity Commercial |
$103.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$84.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$84.69
|
| Rate for Payer: Nomi Health Commercial |
$92.39
|
| Rate for Payer: Nomi Health Commercial |
$92.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$158.25
|
| Rate for Payer: PACE SWMI |
$76.99
|
| Rate for Payer: PACE SWMI |
$76.99
|
| Rate for Payer: PHP Commercial |
$107.79
|
| Rate for Payer: PHP Commercial |
$107.79
|
| Rate for Payer: PHP Medicare Advantage |
$76.99
|
| Rate for Payer: PHP Medicare Advantage |
$76.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$112.52
|
| Rate for Payer: Priority Health Medicare |
$76.99
|
| Rate for Payer: Priority Health Medicare |
$76.99
|
| Rate for Payer: Priority Health SBD |
$112.52
|
| Rate for Payer: Priority Health SBD |
$112.52
|
| Rate for Payer: Priority Health Tiered Network |
$112.52
|
| Rate for Payer: Priority Health Tiered Network |
$112.52
|
| Rate for Payer: Railroad Medicare Medicare |
$76.99
|
| Rate for Payer: Railroad Medicare Medicare |
$76.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.03
|
| Rate for Payer: UHC Core |
$129.03
|
| Rate for Payer: UHC Core |
$129.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$76.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$76.99
|
| Rate for Payer: UHC Exchange |
$129.03
|
| Rate for Payer: UHC Exchange |
$129.03
|
| Rate for Payer: UMR Bronson Commercial |
$97.06
|
| Rate for Payer: UMR Bronson Commercial |
$12.88
|
|
|
PR NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART
|
Professional
|
Both
|
$1,174.00
|
|
|
Service Code
|
HCPCS 36221
|
| Min. Negotiated Rate |
$113.53 |
| Max. Negotiated Rate |
$880.50 |
| Rate for Payer: Aetna Commercial |
$241.37
|
| Rate for Payer: Aetna Medicare |
$187.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.39
|
| Rate for Payer: BCBS Complete |
$119.21
|
| Rate for Payer: BCBS MAPPO |
$180.13
|
| Rate for Payer: BCN Commercial |
$292.32
|
| Rate for Payer: BCN Medicare Advantage |
$180.13
|
| Rate for Payer: Cash Price |
$939.20
|
| Rate for Payer: Cash Price |
$939.20
|
| Rate for Payer: Cofinity Commercial |
$241.37
|
| Rate for Payer: Cofinity Commercial |
$259.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.14
|
| Rate for Payer: Meridian Medicaid |
$119.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$198.14
|
| Rate for Payer: Nomi Health Commercial |
$216.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$880.50
|
| Rate for Payer: PACE SWMI |
$180.13
|
| Rate for Payer: PHP Commercial |
$252.18
|
| Rate for Payer: PHP Medicare Advantage |
$180.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$314.34
|
| Rate for Payer: Priority Health Medicare |
$180.13
|
| Rate for Payer: Priority Health SBD |
$314.34
|
| Rate for Payer: Priority Health Tiered Network |
$314.34
|
| Rate for Payer: Railroad Medicare Medicare |
$180.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$360.23
|
| Rate for Payer: UHC Core |
$360.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$180.13
|
| Rate for Payer: UHC Exchange |
$360.23
|
| Rate for Payer: UHC Medicaid |
$113.53
|
| Rate for Payer: UHCCP Medicaid |
$113.53
|
| Rate for Payer: UMR Bronson Commercial |
$540.04
|
|
|
PR NORMAL SALINE SOLUTION INFUS
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS J7050
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$3.75 |
| Rate for Payer: Aetna Commercial |
$0.94
|
| Rate for Payer: Aetna Medicare |
$0.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.01
|
| Rate for Payer: BCBS MAPPO |
$0.70
|
| Rate for Payer: BCBS Trust/PPO |
$0.41
|
| Rate for Payer: BCN Commercial |
$0.38
|
| Rate for Payer: BCN Medicare Advantage |
$0.70
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cofinity Commercial |
$0.94
|
| Rate for Payer: Cofinity Commercial |
$1.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.77
|
| Rate for Payer: Nomi Health Commercial |
$0.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.75
|
| Rate for Payer: PACE SWMI |
$0.70
|
| Rate for Payer: PHP Commercial |
$0.98
|
| Rate for Payer: PHP Medicare Advantage |
$0.70
|
| Rate for Payer: Priority Health Medicare |
$0.70
|
| Rate for Payer: Railroad Medicare Medicare |
$0.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.66
|
| Rate for Payer: UHC Core |
$0.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.70
|
| Rate for Payer: UHC Exchange |
$0.66
|
| Rate for Payer: UMR Bronson Commercial |
$2.30
|
|
|
PR NORMAL SALINE SOLUTION INFUS
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS J7040
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$6.00 |
| Rate for Payer: Aetna Commercial |
$1.82
|
| Rate for Payer: Aetna Medicare |
$1.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.96
|
| Rate for Payer: BCBS MAPPO |
$1.36
|
| Rate for Payer: BCBS Trust/PPO |
$0.62
|
| Rate for Payer: BCN Commercial |
$0.35
|
| Rate for Payer: BCN Medicare Advantage |
$1.36
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cofinity Commercial |
$1.96
|
| Rate for Payer: Cofinity Commercial |
$1.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.50
|
| Rate for Payer: Nomi Health Commercial |
$1.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.00
|
| Rate for Payer: PACE SWMI |
$1.36
|
| Rate for Payer: PHP Commercial |
$1.90
|
| Rate for Payer: PHP Medicare Advantage |
$1.36
|
| Rate for Payer: Priority Health Medicare |
$1.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.29
|
| Rate for Payer: UHC Core |
$1.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1.36
|
| Rate for Payer: UHC Exchange |
$1.29
|
| Rate for Payer: UMR Bronson Commercial |
$3.68
|
|
|
PR NORMAL SALINE SOLUTION INFUS
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J7030
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: Aetna Commercial |
$2.93
|
| Rate for Payer: Aetna Medicare |
$2.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.15
|
| Rate for Payer: BCBS MAPPO |
$2.19
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.58
|
| Rate for Payer: BCN Medicare Advantage |
$2.19
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$2.93
|
| Rate for Payer: Cofinity Commercial |
$3.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.41
|
| Rate for Payer: Nomi Health Commercial |
$2.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.50
|
| Rate for Payer: PACE SWMI |
$2.19
|
| Rate for Payer: PHP Commercial |
$3.07
|
| Rate for Payer: PHP Medicare Advantage |
$2.19
|
| Rate for Payer: Priority Health Medicare |
$2.19
|
| Rate for Payer: Railroad Medicare Medicare |
$2.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.99
|
| Rate for Payer: UHC Core |
$1.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.19
|
| Rate for Payer: UHC Exchange |
$1.99
|
| Rate for Payer: UMR Bronson Commercial |
$4.60
|
|
|
PR NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 11-20 MIN
|
Professional
|
Both
|
$69.00
|
|
|
Service Code
|
HCPCS 98971
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$51.75 |
| Rate for Payer: Aetna Commercial |
$25.21
|
| Rate for Payer: Aetna Medicare |
$19.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.09
|
| Rate for Payer: BCBS Complete |
$27.60
|
| Rate for Payer: BCBS MAPPO |
$18.81
|
| Rate for Payer: BCN Commercial |
$32.87
|
| Rate for Payer: BCN Medicare Advantage |
$18.81
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$27.09
|
| Rate for Payer: Cofinity Commercial |
$25.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.69
|
| Rate for Payer: Nomi Health Commercial |
$22.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.75
|
| Rate for Payer: PACE SWMI |
$18.81
|
| Rate for Payer: PHP Commercial |
$26.33
|
| Rate for Payer: PHP Medicare Advantage |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$30.31
|
| Rate for Payer: Priority Health Medicare |
$18.81
|
| Rate for Payer: Priority Health SBD |
$30.31
|
| Rate for Payer: Priority Health Tiered Network |
$30.31
|
| Rate for Payer: Railroad Medicare Medicare |
$18.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.13
|
| Rate for Payer: UHC Core |
$30.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.81
|
| Rate for Payer: UHC Exchange |
$30.13
|
| Rate for Payer: UMR Bronson Commercial |
$31.74
|
|
|
PR NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 21+ MIN
|
Professional
|
Both
|
$96.00
|
|
|
Service Code
|
HCPCS 98972
|
| Min. Negotiated Rate |
$28.75 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Aetna Commercial |
$38.52
|
| Rate for Payer: Aetna Medicare |
$29.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.40
|
| Rate for Payer: BCBS Complete |
$38.40
|
| Rate for Payer: BCBS MAPPO |
$28.75
|
| Rate for Payer: BCN Commercial |
$49.30
|
| Rate for Payer: BCN Medicare Advantage |
$28.75
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cofinity Commercial |
$41.40
|
| Rate for Payer: Cofinity Commercial |
$38.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.62
|
| Rate for Payer: Nomi Health Commercial |
$34.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.00
|
| Rate for Payer: PACE SWMI |
$28.75
|
| Rate for Payer: PHP Commercial |
$40.25
|
| Rate for Payer: PHP Medicare Advantage |
$28.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$45.46
|
| Rate for Payer: Priority Health Medicare |
$28.75
|
| Rate for Payer: Priority Health SBD |
$45.46
|
| Rate for Payer: Priority Health Tiered Network |
$45.46
|
| Rate for Payer: Railroad Medicare Medicare |
$28.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.75
|
| Rate for Payer: UHC Core |
$46.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.75
|
| Rate for Payer: UHC Exchange |
$46.75
|
| Rate for Payer: UMR Bronson Commercial |
$44.16
|
|
|
PR NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 5-10 MIN
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 98970
|
| Min. Negotiated Rate |
$10.25 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna Commercial |
$13.73
|
| Rate for Payer: Aetna Medicare |
$10.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.76
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: BCBS MAPPO |
$10.25
|
| Rate for Payer: BCN Commercial |
$17.43
|
| Rate for Payer: BCN Medicare Advantage |
$10.25
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cofinity Commercial |
$14.76
|
| Rate for Payer: Cofinity Commercial |
$13.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.28
|
| Rate for Payer: Nomi Health Commercial |
$12.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.00
|
| Rate for Payer: PACE SWMI |
$10.25
|
| Rate for Payer: PHP Commercial |
$14.35
|
| Rate for Payer: PHP Medicare Advantage |
$10.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.07
|
| Rate for Payer: Priority Health Medicare |
$10.25
|
| Rate for Payer: Priority Health SBD |
$16.07
|
| Rate for Payer: Priority Health Tiered Network |
$16.07
|
| Rate for Payer: Railroad Medicare Medicare |
$10.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.07
|
| Rate for Payer: UHC Core |
$17.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.25
|
| Rate for Payer: UHC Exchange |
$17.07
|
| Rate for Payer: UMR Bronson Commercial |
$16.56
|
|
|
PR NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS
|
Professional
|
Both
|
$833.00
|
|
|
Service Code
|
HCPCS 31267
|
| Min. Negotiated Rate |
$142.92 |
| Max. Negotiated Rate |
$624.75 |
| Rate for Payer: Aetna Commercial |
$298.32
|
| Rate for Payer: Aetna Medicare |
$231.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.59
|
| Rate for Payer: BCBS Complete |
$150.07
|
| Rate for Payer: BCBS MAPPO |
$222.63
|
| Rate for Payer: BCN Commercial |
$394.90
|
| Rate for Payer: BCN Medicare Advantage |
$222.63
|
| Rate for Payer: Cash Price |
$666.40
|
| Rate for Payer: Cash Price |
$666.40
|
| Rate for Payer: Cofinity Commercial |
$298.32
|
| Rate for Payer: Cofinity Commercial |
$320.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$233.76
|
| Rate for Payer: Meridian Medicaid |
$150.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$244.89
|
| Rate for Payer: Nomi Health Commercial |
$267.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.75
|
| Rate for Payer: PACE SWMI |
$222.63
|
| Rate for Payer: PHP Commercial |
$311.68
|
| Rate for Payer: PHP Medicare Advantage |
$222.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$142.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$371.88
|
| Rate for Payer: Priority Health Medicare |
$222.63
|
| Rate for Payer: Priority Health SBD |
$371.88
|
| Rate for Payer: Priority Health Tiered Network |
$371.88
|
| Rate for Payer: Railroad Medicare Medicare |
$222.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$465.55
|
| Rate for Payer: UHC Core |
$465.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$222.63
|
| Rate for Payer: UHC Exchange |
$465.55
|
| Rate for Payer: UHC Medicaid |
$142.92
|
| Rate for Payer: UHCCP Medicaid |
$142.92
|
| Rate for Payer: UMR Bronson Commercial |
$383.18
|
|
|
PR NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS
|
Professional
|
Both
|
$792.00
|
|
|
Service Code
|
HCPCS 31288
|
| Min. Negotiated Rate |
$126.31 |
| Max. Negotiated Rate |
$594.00 |
| Rate for Payer: Aetna Commercial |
$263.50
|
| Rate for Payer: Aetna Medicare |
$204.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.16
|
| Rate for Payer: BCBS Complete |
$132.63
|
| Rate for Payer: BCBS MAPPO |
$196.64
|
| Rate for Payer: BCN Commercial |
$349.08
|
| Rate for Payer: BCN Medicare Advantage |
$196.64
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cofinity Commercial |
$263.50
|
| Rate for Payer: Cofinity Commercial |
$283.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.47
|
| Rate for Payer: Meridian Medicaid |
$132.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$216.30
|
| Rate for Payer: Nomi Health Commercial |
$235.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.00
|
| Rate for Payer: PACE SWMI |
$196.64
|
| Rate for Payer: PHP Commercial |
$275.30
|
| Rate for Payer: PHP Medicare Advantage |
$196.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$328.74
|
| Rate for Payer: Priority Health Medicare |
$196.64
|
| Rate for Payer: Priority Health SBD |
$328.74
|
| Rate for Payer: Priority Health Tiered Network |
$328.74
|
| Rate for Payer: Railroad Medicare Medicare |
$196.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$410.38
|
| Rate for Payer: UHC Core |
$410.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$196.64
|
| Rate for Payer: UHC Exchange |
$410.38
|
| Rate for Payer: UHC Medicaid |
$126.31
|
| Rate for Payer: UHCCP Medicaid |
$126.31
|
| Rate for Payer: UMR Bronson Commercial |
$364.32
|
|
|
PR NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 11-20 MIN
|
Professional
|
Both
|
$76.00
|
|
|
Service Code
|
HCPCS 99447
|
| Min. Negotiated Rate |
$20.45 |
| Max. Negotiated Rate |
$57.00 |
| Rate for Payer: Aetna Commercial |
$42.63
|
| Rate for Payer: Aetna Medicare |
$33.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.81
|
| Rate for Payer: BCBS Complete |
$21.47
|
| Rate for Payer: BCBS MAPPO |
$31.81
|
| Rate for Payer: BCN Commercial |
$53.29
|
| Rate for Payer: BCN Medicare Advantage |
$31.81
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cofinity Commercial |
$42.63
|
| Rate for Payer: Cofinity Commercial |
$45.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.40
|
| Rate for Payer: Meridian Medicaid |
$21.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.99
|
| Rate for Payer: Nomi Health Commercial |
$38.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.00
|
| Rate for Payer: PACE SWMI |
$31.81
|
| Rate for Payer: PHP Commercial |
$44.53
|
| Rate for Payer: PHP Medicare Advantage |
$31.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$40.56
|
| Rate for Payer: Priority Health Medicare |
$31.81
|
| Rate for Payer: Priority Health SBD |
$40.56
|
| Rate for Payer: Priority Health Tiered Network |
$40.56
|
| Rate for Payer: Railroad Medicare Medicare |
$31.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.60
|
| Rate for Payer: UHC Core |
$51.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.81
|
| Rate for Payer: UHC Exchange |
$51.60
|
| Rate for Payer: UHC Medicaid |
$20.45
|
| Rate for Payer: UHCCP Medicaid |
$20.45
|
| Rate for Payer: UMR Bronson Commercial |
$34.96
|
|
