|
PR MAST RAD W/PECTORAL MUSCLES AXILLARY LYMPH NODES
|
Professional
|
Both
|
$2,416.00
|
|
|
Service Code
|
HCPCS 19305
|
| Min. Negotiated Rate |
$966.40 |
| Max. Negotiated Rate |
$1,597.85 |
| Rate for Payer: Aetna Commercial |
$1,486.89
|
| Rate for Payer: Aetna Medicare |
$1,154.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,597.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,486.89
|
| Rate for Payer: BCBS Complete |
$966.40
|
| Rate for Payer: BCBS MAPPO |
$1,109.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,109.62
|
| Rate for Payer: Cash Price |
$1,932.80
|
| Rate for Payer: Cash Price |
$1,932.80
|
| Rate for Payer: Cofinity Commercial |
$1,597.85
|
| Rate for Payer: Cofinity Commercial |
$1,486.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,109.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,165.10
|
| Rate for Payer: Nomi Health Commercial |
$1,331.54
|
| Rate for Payer: PACE SWMI |
$1,109.62
|
| Rate for Payer: PHP Commercial |
$1,553.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,109.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,570.40
|
| Rate for Payer: Priority Health Medicare |
$1,109.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,109.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,109.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,111.36
|
|
|
PR MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 94200
|
| Min. Negotiated Rate |
$13.57 |
| Max. Negotiated Rate |
$28.60 |
| Rate for Payer: Aetna Commercial |
$18.18
|
| Rate for Payer: Aetna Medicare |
$14.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.18
|
| Rate for Payer: BCBS Complete |
$17.60
|
| Rate for Payer: BCBS MAPPO |
$13.57
|
| Rate for Payer: BCN Medicare Advantage |
$13.57
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$19.54
|
| Rate for Payer: Cofinity Commercial |
$18.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.25
|
| Rate for Payer: Nomi Health Commercial |
$16.28
|
| Rate for Payer: PACE SWMI |
$13.57
|
| Rate for Payer: PHP Commercial |
$19.00
|
| Rate for Payer: PHP Medicare Advantage |
$13.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.60
|
| Rate for Payer: Priority Health Medicare |
$13.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.57
|
| Rate for Payer: UHC Medicare Advantage |
$13.57
|
| Rate for Payer: UMR Bronson Commercial |
$20.24
|
|
|
PR MAXILLECTOMY W/O ORBITAL EXENTERATION
|
Professional
|
Both
|
$3,304.00
|
|
|
Service Code
|
HCPCS 31225
|
| Min. Negotiated Rate |
$1,321.60 |
| Max. Negotiated Rate |
$2,451.44 |
| Rate for Payer: Aetna Commercial |
$2,281.20
|
| Rate for Payer: Aetna Medicare |
$1,770.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,451.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,281.20
|
| Rate for Payer: BCBS Complete |
$1,321.60
|
| Rate for Payer: BCBS MAPPO |
$1,702.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,702.39
|
| Rate for Payer: Cash Price |
$2,643.20
|
| Rate for Payer: Cash Price |
$2,643.20
|
| Rate for Payer: Cofinity Commercial |
$2,451.44
|
| Rate for Payer: Cofinity Commercial |
$2,281.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,702.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,787.51
|
| Rate for Payer: Nomi Health Commercial |
$2,042.87
|
| Rate for Payer: PACE SWMI |
$1,702.39
|
| Rate for Payer: PHP Commercial |
$2,383.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,702.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,147.60
|
| Rate for Payer: Priority Health Medicare |
$1,702.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,702.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,702.39
|
| Rate for Payer: UMR Bronson Commercial |
$1,519.84
|
|
|
PR MCCD, INITIAL RATE
|
Professional
|
Both
|
$163.00
|
|
|
Service Code
|
HCPCS G9001
|
| Min. Negotiated Rate |
$65.20 |
| Max. Negotiated Rate |
$105.95 |
| Rate for Payer: Aetna Medicare |
$81.50
|
| Rate for Payer: BCBS Complete |
$65.20
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.95
|
| Rate for Payer: UMR Bronson Commercial |
$74.98
|
|
|
PR MCCD,MAINTENANCE RATE
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS G9002
|
| Min. Negotiated Rate |
$32.80 |
| Max. Negotiated Rate |
$53.30 |
| Rate for Payer: Aetna Medicare |
$41.00
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
| Rate for Payer: UMR Bronson Commercial |
$37.72
|
|
|
PR MCCD,PHYS COOR-CARE OVRSGHT
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
HCPCS G9008
|
| Min. Negotiated Rate |
$34.80 |
| Max. Negotiated Rate |
$56.55 |
| Rate for Payer: Aetna Medicare |
$43.50
|
| Rate for Payer: BCBS Complete |
$34.80
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.55
|
| Rate for Payer: UMR Bronson Commercial |
$40.02
|
|
|
PR MCCD, SCH TEAM CONF
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS G9007
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$26.65 |
| Rate for Payer: Aetna Medicare |
$20.50
|
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.65
|
| Rate for Payer: UMR Bronson Commercial |
$18.86
|
|
|
PR MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN
|
Professional
|
Both
|
$236.00
|
|
|
Service Code
|
HCPCS 36596
|
| Min. Negotiated Rate |
$43.25 |
| Max. Negotiated Rate |
$153.40 |
| Rate for Payer: Aetna Commercial |
$57.95
|
| Rate for Payer: Aetna Medicare |
$44.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.95
|
| Rate for Payer: BCBS Complete |
$94.40
|
| Rate for Payer: BCBS MAPPO |
$43.25
|
| Rate for Payer: BCN Medicare Advantage |
$43.25
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cofinity Commercial |
$57.95
|
| Rate for Payer: Cofinity Commercial |
$62.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.41
|
| Rate for Payer: Nomi Health Commercial |
$51.90
|
| Rate for Payer: PACE SWMI |
$43.25
|
| Rate for Payer: PHP Commercial |
$60.55
|
| Rate for Payer: PHP Medicare Advantage |
$43.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.40
|
| Rate for Payer: Priority Health Medicare |
$43.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.25
|
| Rate for Payer: UHC Medicare Advantage |
$43.25
|
| Rate for Payer: UMR Bronson Commercial |
$108.56
|
|
|
PR MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS
|
Professional
|
Both
|
$1,142.00
|
|
|
Service Code
|
HCPCS 36595
|
| Min. Negotiated Rate |
$170.66 |
| Max. Negotiated Rate |
$742.30 |
| Rate for Payer: Aetna Commercial |
$228.68
|
| Rate for Payer: Aetna Medicare |
$177.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.68
|
| Rate for Payer: BCBS Complete |
$456.80
|
| Rate for Payer: BCBS MAPPO |
$170.66
|
| Rate for Payer: BCN Medicare Advantage |
$170.66
|
| Rate for Payer: Cash Price |
$913.60
|
| Rate for Payer: Cash Price |
$913.60
|
| Rate for Payer: Cofinity Commercial |
$245.75
|
| Rate for Payer: Cofinity Commercial |
$228.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.19
|
| Rate for Payer: Nomi Health Commercial |
$204.79
|
| Rate for Payer: PACE SWMI |
$170.66
|
| Rate for Payer: PHP Commercial |
$238.92
|
| Rate for Payer: PHP Medicare Advantage |
$170.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$742.30
|
| Rate for Payer: Priority Health Medicare |
$170.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.66
|
| Rate for Payer: UHC Medicare Advantage |
$170.66
|
| Rate for Payer: UMR Bronson Commercial |
$525.32
|
|
|
PR MD CERTIFICATION HHA PATIENT
|
Professional
|
Both
|
$104.00
|
|
|
Service Code
|
HCPCS G0180
|
| Min. Negotiated Rate |
$41.60 |
| Max. Negotiated Rate |
$71.58 |
| Rate for Payer: Aetna Commercial |
$66.61
|
| Rate for Payer: Aetna Medicare |
$51.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.61
|
| Rate for Payer: BCBS Complete |
$41.60
|
| Rate for Payer: BCBS MAPPO |
$49.71
|
| Rate for Payer: BCN Medicare Advantage |
$49.71
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cofinity Commercial |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$66.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.20
|
| Rate for Payer: Nomi Health Commercial |
$59.65
|
| Rate for Payer: PACE SWMI |
$49.71
|
| Rate for Payer: PHP Commercial |
$69.59
|
| Rate for Payer: PHP Medicare Advantage |
$49.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.60
|
| Rate for Payer: Priority Health Medicare |
$49.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.71
|
| Rate for Payer: UHC Medicare Advantage |
$49.71
|
| Rate for Payer: UMR Bronson Commercial |
$47.84
|
|
|
PR MD INR TEST REVIE INTER MGMT
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS G0250
|
| Min. Negotiated Rate |
$8.26 |
| Max. Negotiated Rate |
$20.15 |
| Rate for Payer: Aetna Commercial |
$11.07
|
| Rate for Payer: Aetna Medicare |
$8.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.07
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$8.26
|
| Rate for Payer: BCN Medicare Advantage |
$8.26
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$11.89
|
| Rate for Payer: Cofinity Commercial |
$11.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.67
|
| Rate for Payer: Nomi Health Commercial |
$9.91
|
| Rate for Payer: PACE SWMI |
$8.26
|
| Rate for Payer: PHP Commercial |
$11.56
|
| Rate for Payer: PHP Medicare Advantage |
$8.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health Medicare |
$8.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.26
|
| Rate for Payer: UHC Medicare Advantage |
$8.26
|
| Rate for Payer: UMR Bronson Commercial |
$14.26
|
|
|
PR MD RECERTIFICATION HHA PT
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS G0179
|
| Min. Negotiated Rate |
$31.60 |
| Max. Negotiated Rate |
$56.12 |
| Rate for Payer: Aetna Commercial |
$52.22
|
| Rate for Payer: Aetna Medicare |
$40.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.22
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: BCBS MAPPO |
$38.97
|
| Rate for Payer: BCN Medicare Advantage |
$38.97
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$56.12
|
| Rate for Payer: Cofinity Commercial |
$52.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.92
|
| Rate for Payer: Nomi Health Commercial |
$46.76
|
| Rate for Payer: PACE SWMI |
$38.97
|
| Rate for Payer: PHP Commercial |
$54.56
|
| Rate for Payer: PHP Medicare Advantage |
$38.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
| Rate for Payer: Priority Health Medicare |
$38.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.97
|
| Rate for Payer: UHC Medicare Advantage |
$38.97
|
| Rate for Payer: UMR Bronson Commercial |
$36.34
|
|
|
PR MD SERVICE REQUIRED FOR PMD
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS G0372
|
| Min. Negotiated Rate |
$8.24 |
| Max. Negotiated Rate |
$18.85 |
| Rate for Payer: Aetna Commercial |
$11.04
|
| Rate for Payer: Aetna Medicare |
$8.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.04
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: BCBS MAPPO |
$8.24
|
| Rate for Payer: BCN Medicare Advantage |
$8.24
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cofinity Commercial |
$11.87
|
| Rate for Payer: Cofinity Commercial |
$11.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.65
|
| Rate for Payer: Nomi Health Commercial |
$9.89
|
| Rate for Payer: PACE SWMI |
$8.24
|
| Rate for Payer: PHP Commercial |
$11.54
|
| Rate for Payer: PHP Medicare Advantage |
$8.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
| Rate for Payer: Priority Health Medicare |
$8.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.24
|
| Rate for Payer: UHC Medicare Advantage |
$8.24
|
| Rate for Payer: UMR Bronson Commercial |
$13.34
|
|
|
PR MEASLES MUMPS RUBELLA VARICELLA VACC LIVE SUBQ
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 90710
|
| Min. Negotiated Rate |
$122.40 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: BCBS Complete |
$122.40
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: UMR Bronson Commercial |
$140.76
|
|
|
PR MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ
|
Professional
|
Both
|
$107.00
|
|
|
Service Code
|
HCPCS 90707
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$69.55 |
| Rate for Payer: Aetna Medicare |
$53.50
|
| Rate for Payer: BCBS Complete |
$42.80
|
| Rate for Payer: Cash Price |
$85.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.55
|
| Rate for Payer: UMR Bronson Commercial |
$49.22
|
|
|
PR MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 51798
|
| Min. Negotiated Rate |
$10.48 |
| Max. Negotiated Rate |
$22.10 |
| Rate for Payer: Aetna Commercial |
$14.04
|
| Rate for Payer: Aetna Medicare |
$10.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.04
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: BCBS MAPPO |
$10.48
|
| Rate for Payer: BCN Medicare Advantage |
$10.48
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$15.09
|
| Rate for Payer: Cofinity Commercial |
$14.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.00
|
| Rate for Payer: Nomi Health Commercial |
$12.58
|
| Rate for Payer: PACE SWMI |
$10.48
|
| Rate for Payer: PHP Commercial |
$14.67
|
| Rate for Payer: PHP Medicare Advantage |
$10.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.10
|
| Rate for Payer: Priority Health Medicare |
$10.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.48
|
| Rate for Payer: UMR Bronson Commercial |
$15.64
|
|
|
PR MEATOTOMY CUTTING MEATUS SPX EXCEPT INFANT
|
Professional
|
Both
|
$342.00
|
|
|
Service Code
|
HCPCS 53020
|
| Min. Negotiated Rate |
$92.04 |
| Max. Negotiated Rate |
$222.30 |
| Rate for Payer: Aetna Commercial |
$123.33
|
| Rate for Payer: Aetna Medicare |
$95.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.33
|
| Rate for Payer: BCBS Complete |
$136.80
|
| Rate for Payer: BCBS MAPPO |
$92.04
|
| Rate for Payer: BCN Medicare Advantage |
$92.04
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cofinity Commercial |
$132.54
|
| Rate for Payer: Cofinity Commercial |
$123.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.64
|
| Rate for Payer: Nomi Health Commercial |
$110.45
|
| Rate for Payer: PACE SWMI |
$92.04
|
| Rate for Payer: PHP Commercial |
$128.86
|
| Rate for Payer: PHP Medicare Advantage |
$92.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.30
|
| Rate for Payer: Priority Health Medicare |
$92.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.04
|
| Rate for Payer: UHC Medicare Advantage |
$92.04
|
| Rate for Payer: UMR Bronson Commercial |
$157.32
|
|
|
PR MEATOTOMY CUTTING MEATUS SPX INFANT
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 53025
|
| Min. Negotiated Rate |
$65.82 |
| Max. Negotiated Rate |
$232.05 |
| Rate for Payer: Aetna Commercial |
$88.20
|
| Rate for Payer: Aetna Medicare |
$68.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.20
|
| Rate for Payer: BCBS Complete |
$142.80
|
| Rate for Payer: BCBS MAPPO |
$65.82
|
| Rate for Payer: BCN Medicare Advantage |
$65.82
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$94.78
|
| Rate for Payer: Cofinity Commercial |
$88.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.11
|
| Rate for Payer: Nomi Health Commercial |
$78.98
|
| Rate for Payer: PACE SWMI |
$65.82
|
| Rate for Payer: PHP Commercial |
$92.15
|
| Rate for Payer: PHP Medicare Advantage |
$65.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health Medicare |
$65.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.82
|
| Rate for Payer: UHC Medicare Advantage |
$65.82
|
| Rate for Payer: UMR Bronson Commercial |
$164.22
|
|
|
PR MEDIASTINOSCOPY INCL BIOPSIES WHEN PERFORMED
|
Professional
|
Both
|
$2,243.00
|
|
|
Service Code
|
HCPCS 39400
|
| Min. Negotiated Rate |
$897.20 |
| Max. Negotiated Rate |
$1,457.95 |
| Rate for Payer: Aetna Medicare |
$1,121.50
|
| Rate for Payer: BCBS Complete |
$897.20
|
| Rate for Payer: Cash Price |
$1,794.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,457.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,031.78
|
|
|
PR MEDIASTINOSCOPY INCLUDES MEDIASTINAL MASS BIOPSY
|
Professional
|
Both
|
$970.00
|
|
|
Service Code
|
HCPCS 39401
|
| Min. Negotiated Rate |
$297.19 |
| Max. Negotiated Rate |
$630.50 |
| Rate for Payer: Aetna Commercial |
$398.23
|
| Rate for Payer: Aetna Medicare |
$309.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$398.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$427.95
|
| Rate for Payer: BCBS Complete |
$388.00
|
| Rate for Payer: BCBS MAPPO |
$297.19
|
| Rate for Payer: BCN Medicare Advantage |
$297.19
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Cofinity Commercial |
$398.23
|
| Rate for Payer: Cofinity Commercial |
$427.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.05
|
| Rate for Payer: Nomi Health Commercial |
$356.63
|
| Rate for Payer: PACE SWMI |
$297.19
|
| Rate for Payer: PHP Commercial |
$416.07
|
| Rate for Payer: PHP Medicare Advantage |
$297.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.50
|
| Rate for Payer: Priority Health Medicare |
$297.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$297.19
|
| Rate for Payer: UHC Medicare Advantage |
$297.19
|
| Rate for Payer: UMR Bronson Commercial |
$446.20
|
|
|
PR MEDIASTINOSCOPY WITH LYMPH NODE BIOPSY/IES
|
Professional
|
Both
|
$845.00
|
|
|
Service Code
|
HCPCS 39402
|
| Min. Negotiated Rate |
$338.00 |
| Max. Negotiated Rate |
$559.58 |
| Rate for Payer: Aetna Commercial |
$520.72
|
| Rate for Payer: Aetna Medicare |
$404.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$559.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$520.72
|
| Rate for Payer: BCBS Complete |
$338.00
|
| Rate for Payer: BCBS MAPPO |
$388.60
|
| Rate for Payer: BCN Medicare Advantage |
$388.60
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Cash Price |
$676.00
|
| Rate for Payer: Cofinity Commercial |
$559.58
|
| Rate for Payer: Cofinity Commercial |
$520.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$388.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$408.03
|
| Rate for Payer: Nomi Health Commercial |
$466.32
|
| Rate for Payer: PACE SWMI |
$388.60
|
| Rate for Payer: PHP Commercial |
$544.04
|
| Rate for Payer: PHP Medicare Advantage |
$388.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$549.25
|
| Rate for Payer: Priority Health Medicare |
$388.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$388.60
|
| Rate for Payer: UHC Medicare Advantage |
$388.60
|
| Rate for Payer: UMR Bronson Commercial |
$388.70
|
|
|
PR MEDIAST W/EXPL DRG RMVL FB/BX CRV APPR
|
Professional
|
Both
|
$2,549.00
|
|
|
Service Code
|
HCPCS 39000
|
| Min. Negotiated Rate |
$484.23 |
| Max. Negotiated Rate |
$1,656.85 |
| Rate for Payer: Aetna Commercial |
$648.87
|
| Rate for Payer: Aetna Medicare |
$503.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$697.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$648.87
|
| Rate for Payer: BCBS Complete |
$1,019.60
|
| Rate for Payer: BCBS MAPPO |
$484.23
|
| Rate for Payer: BCN Medicare Advantage |
$484.23
|
| Rate for Payer: Cash Price |
$2,039.20
|
| Rate for Payer: Cash Price |
$2,039.20
|
| Rate for Payer: Cofinity Commercial |
$697.29
|
| Rate for Payer: Cofinity Commercial |
$648.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$484.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$508.44
|
| Rate for Payer: Nomi Health Commercial |
$581.08
|
| Rate for Payer: PACE SWMI |
$484.23
|
| Rate for Payer: PHP Commercial |
$677.92
|
| Rate for Payer: PHP Medicare Advantage |
$484.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,656.85
|
| Rate for Payer: Priority Health Medicare |
$484.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$484.23
|
| Rate for Payer: UHC Medicare Advantage |
$484.23
|
| Rate for Payer: UMR Bronson Commercial |
$1,172.54
|
|
|
PR MEDIAST W/EXPL DRG RMVL FB/BX TTHRC APPR
|
Professional
|
Both
|
$5,247.00
|
|
|
Service Code
|
HCPCS 39010
|
| Min. Negotiated Rate |
$760.02 |
| Max. Negotiated Rate |
$3,410.55 |
| Rate for Payer: Aetna Commercial |
$1,018.43
|
| Rate for Payer: Aetna Medicare |
$790.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,094.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,018.43
|
| Rate for Payer: BCBS Complete |
$2,098.80
|
| Rate for Payer: BCBS MAPPO |
$760.02
|
| Rate for Payer: BCN Medicare Advantage |
$760.02
|
| Rate for Payer: Cash Price |
$4,197.60
|
| Rate for Payer: Cash Price |
$4,197.60
|
| Rate for Payer: Cofinity Commercial |
$1,094.43
|
| Rate for Payer: Cofinity Commercial |
$1,018.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$760.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$798.02
|
| Rate for Payer: Nomi Health Commercial |
$912.02
|
| Rate for Payer: PACE SWMI |
$760.02
|
| Rate for Payer: PHP Commercial |
$1,064.03
|
| Rate for Payer: PHP Medicare Advantage |
$760.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,410.55
|
| Rate for Payer: Priority Health Medicare |
$760.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$760.02
|
| Rate for Payer: UHC Medicare Advantage |
$760.02
|
| Rate for Payer: UMR Bronson Commercial |
$2,413.62
|
|
|
PR MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 97802
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$43.47 |
| Rate for Payer: Aetna Commercial |
$40.45
|
| Rate for Payer: Aetna Medicare |
$31.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.45
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: BCBS MAPPO |
$30.19
|
| Rate for Payer: BCN Medicare Advantage |
$30.19
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$43.47
|
| Rate for Payer: Cofinity Commercial |
$40.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.70
|
| Rate for Payer: Nomi Health Commercial |
$36.23
|
| Rate for Payer: PACE SWMI |
$30.19
|
| Rate for Payer: PHP Commercial |
$42.27
|
| Rate for Payer: PHP Medicare Advantage |
$30.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
| Rate for Payer: Priority Health Medicare |
$30.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.19
|
| Rate for Payer: UHC Medicare Advantage |
$30.19
|
| Rate for Payer: UMR Bronson Commercial |
$28.06
|
|
|
PR MEDICAL NUTRITION RE-ASSMT&IVNTJ INDIV EA 15 M
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 97803
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$36.78 |
| Rate for Payer: Aetna Commercial |
$34.22
|
| Rate for Payer: Aetna Medicare |
$26.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.22
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCBS MAPPO |
$25.54
|
| Rate for Payer: BCN Medicare Advantage |
$25.54
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$36.78
|
| Rate for Payer: Cofinity Commercial |
$34.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.82
|
| Rate for Payer: Nomi Health Commercial |
$30.65
|
| Rate for Payer: PACE SWMI |
$25.54
|
| Rate for Payer: PHP Commercial |
$35.76
|
| Rate for Payer: PHP Medicare Advantage |
$25.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
| Rate for Payer: Priority Health Medicare |
$25.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.54
|
| Rate for Payer: UHC Medicare Advantage |
$25.54
|
| Rate for Payer: UMR Bronson Commercial |
$23.00
|
|
