|
PR MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN
|
Professional
|
Both
|
$2,044.00
|
|
|
Service Code
|
HCPCS 19307
|
| Min. Negotiated Rate |
$760.62 |
| Max. Negotiated Rate |
$18,089.98 |
| Rate for Payer: Aetna Commercial |
$1,530.57
|
| Rate for Payer: Aetna Medicare |
$1,187.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,530.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,644.80
|
| Rate for Payer: BCBS Complete |
$798.65
|
| Rate for Payer: BCBS MAPPO |
$1,142.22
|
| Rate for Payer: BCBS Trust/PPO |
$18,089.98
|
| Rate for Payer: BCN Commercial |
$1,727.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,142.22
|
| Rate for Payer: Cash Price |
$1,635.20
|
| Rate for Payer: Cash Price |
$1,635.20
|
| Rate for Payer: Cofinity Commercial |
$1,530.57
|
| Rate for Payer: Cofinity Commercial |
$1,644.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,142.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,199.33
|
| Rate for Payer: Meridian Medicaid |
$798.65
|
| Rate for Payer: Nomi Health Commercial |
$1,370.66
|
| Rate for Payer: PACE SWMI |
$1,142.22
|
| Rate for Payer: PHP Commercial |
$1,599.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,142.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$760.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,328.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,605.14
|
| Rate for Payer: Priority Health Medicare |
$1,142.22
|
| Rate for Payer: Priority Health Narrow Network |
$1,605.14
|
| Rate for Payer: Priority Health SBD |
$1,605.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,142.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,142.22
|
| Rate for Payer: UHCCP Medicaid |
$760.62
|
| Rate for Payer: UMR Bronson Commercial |
$940.24
|
|
|
PR MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN
|
Facility
|
OP
|
$2,044.00
|
|
|
Service Code
|
CPT 19307
|
| Hospital Charge Code |
19307
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$756.28 |
| Max. Negotiated Rate |
$20,082.39 |
| Rate for Payer: Aetna American Axle |
$1,328.60
|
| Rate for Payer: Aetna Commercial |
$1,737.40
|
| Rate for Payer: Aetna Medicare |
$6,645.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,328.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,987.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,987.00
|
| Rate for Payer: BCBS Complete |
$3,596.07
|
| Rate for Payer: BCBS MAPPO |
$6,389.60
|
| Rate for Payer: BCBS Trust/PPO |
$7,057.20
|
| Rate for Payer: BCN Commercial |
$7,057.20
|
| Rate for Payer: BCN Medicare Advantage |
$6,389.60
|
| Rate for Payer: Cash Price |
$1,635.20
|
| Rate for Payer: Cash Price |
$1,635.20
|
| Rate for Payer: Cash Price |
$1,635.20
|
| Rate for Payer: Cofinity Commercial |
$1,430.80
|
| Rate for Payer: Cofinity Commercial |
$1,757.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,430.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,635.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,389.60
|
| Rate for Payer: Healthscope Commercial |
$1,839.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,430.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,533.00
|
| Rate for Payer: Mclaren Medicaid |
$3,424.83
|
| Rate for Payer: Mclaren Medicare |
$6,389.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,709.08
|
| Rate for Payer: Meridian Medicaid |
$3,596.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,348.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,737.40
|
| Rate for Payer: Nomi Health Commercial |
$13,418.16
|
| Rate for Payer: PACE Medicare |
$6,070.12
|
| Rate for Payer: PACE SWMI |
$6,389.60
|
| Rate for Payer: PHP Commercial |
$1,737.40
|
| Rate for Payer: PHP Medicare Advantage |
$6,389.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,424.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,328.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,082.39
|
| Rate for Payer: Priority Health Medicare |
$6,389.60
|
| Rate for Payer: Priority Health Narrow Network |
$16,065.91
|
| Rate for Payer: Priority Health SBD |
$1,287.72
|
| Rate for Payer: Railroad Medicare Medicare |
$6,389.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,267.11
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,389.60
|
| Rate for Payer: UHC Exchange |
$1,151.92
|
| Rate for Payer: UHC Medicare Advantage |
$6,389.60
|
| Rate for Payer: UHCCP Medicaid |
$3,424.83
|
| Rate for Payer: UMR Bronson Commercial |
$756.28
|
| Rate for Payer: VA VA |
$6,389.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,533.00
|
|
|
PR MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN
|
Facility
|
IP
|
$2,044.00
|
|
|
Service Code
|
CPT 19307
|
| Hospital Charge Code |
19307
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$899.36 |
| Max. Negotiated Rate |
$1,839.60 |
| Rate for Payer: Aetna American Axle |
$1,328.60
|
| Rate for Payer: Aetna Commercial |
$1,737.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,328.60
|
| Rate for Payer: Cash Price |
$1,635.20
|
| Rate for Payer: Cofinity Commercial |
$1,430.80
|
| Rate for Payer: Cofinity Commercial |
$1,757.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,430.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,635.20
|
| Rate for Payer: Healthscope Commercial |
$1,839.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,430.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,533.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,737.40
|
| Rate for Payer: PHP Commercial |
$1,737.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,328.60
|
| Rate for Payer: Priority Health SBD |
$1,287.72
|
| Rate for Payer: UMR Bronson Commercial |
$899.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,533.00
|
|
|
PR MASTOIDECTOMY COMPLETE
|
Professional
|
Both
|
$2,704.00
|
|
|
Service Code
|
HCPCS 69502
|
| Min. Negotiated Rate |
$603.00 |
| Max. Negotiated Rate |
$4,242.78 |
| Rate for Payer: Aetna Commercial |
$1,186.88
|
| Rate for Payer: Aetna Medicare |
$921.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,186.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,275.45
|
| Rate for Payer: BCBS Complete |
$633.15
|
| Rate for Payer: BCBS MAPPO |
$885.73
|
| Rate for Payer: BCBS Trust/PPO |
$4,242.78
|
| Rate for Payer: BCN Commercial |
$1,393.22
|
| Rate for Payer: BCN Medicare Advantage |
$885.73
|
| Rate for Payer: Cash Price |
$2,163.20
|
| Rate for Payer: Cash Price |
$2,163.20
|
| Rate for Payer: Cofinity Commercial |
$1,186.88
|
| Rate for Payer: Cofinity Commercial |
$1,275.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$885.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$930.02
|
| Rate for Payer: Meridian Medicaid |
$633.15
|
| Rate for Payer: Nomi Health Commercial |
$1,062.88
|
| Rate for Payer: PACE SWMI |
$885.73
|
| Rate for Payer: PHP Commercial |
$1,240.02
|
| Rate for Payer: PHP Medicare Advantage |
$885.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$603.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,757.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,385.68
|
| Rate for Payer: Priority Health Medicare |
$885.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,385.68
|
| Rate for Payer: Priority Health SBD |
$1,385.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$885.73
|
| Rate for Payer: UHC Medicare Advantage |
$885.73
|
| Rate for Payer: UHCCP Medicaid |
$603.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,243.84
|
|
|
PR MASTOID OBLITERATION SEPARATE PROCEDURE
|
Professional
|
Both
|
$3,479.00
|
|
|
Service Code
|
HCPCS 69670
|
| Min. Negotiated Rate |
$602.79 |
| Max. Negotiated Rate |
$3,570.25 |
| Rate for Payer: Aetna Commercial |
$1,182.03
|
| Rate for Payer: Aetna Medicare |
$917.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,182.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,270.24
|
| Rate for Payer: BCBS Complete |
$632.93
|
| Rate for Payer: BCBS MAPPO |
$882.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,570.25
|
| Rate for Payer: BCN Commercial |
$1,394.20
|
| Rate for Payer: BCN Medicare Advantage |
$882.11
|
| Rate for Payer: Cash Price |
$2,783.20
|
| Rate for Payer: Cash Price |
$2,783.20
|
| Rate for Payer: Cofinity Commercial |
$1,182.03
|
| Rate for Payer: Cofinity Commercial |
$1,270.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$882.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$926.22
|
| Rate for Payer: Meridian Medicaid |
$632.93
|
| Rate for Payer: Nomi Health Commercial |
$1,058.53
|
| Rate for Payer: PACE SWMI |
$882.11
|
| Rate for Payer: PHP Commercial |
$1,234.95
|
| Rate for Payer: PHP Medicare Advantage |
$882.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$602.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,261.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,385.20
|
| Rate for Payer: Priority Health Medicare |
$882.11
|
| Rate for Payer: Priority Health Narrow Network |
$1,385.20
|
| Rate for Payer: Priority Health SBD |
$1,385.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$882.11
|
| Rate for Payer: UHC Medicare Advantage |
$882.11
|
| Rate for Payer: UHCCP Medicaid |
$602.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,600.34
|
|
|
PR MASTOPEXY
|
Professional
|
Both
|
$1,938.00
|
|
|
Service Code
|
HCPCS 19316
|
| Min. Negotiated Rate |
$293.06 |
| Max. Negotiated Rate |
$1,259.70 |
| Rate for Payer: Aetna Commercial |
$1,017.25
|
| Rate for Payer: Aetna Medicare |
$789.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,017.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,093.16
|
| Rate for Payer: BCBS Complete |
$538.10
|
| Rate for Payer: BCBS MAPPO |
$759.14
|
| Rate for Payer: BCBS Trust/PPO |
$293.06
|
| Rate for Payer: BCN Commercial |
$1,159.64
|
| Rate for Payer: BCN Medicare Advantage |
$759.14
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cash Price |
$1,550.40
|
| Rate for Payer: Cofinity Commercial |
$1,017.25
|
| Rate for Payer: Cofinity Commercial |
$1,093.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$759.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$797.10
|
| Rate for Payer: Meridian Medicaid |
$538.10
|
| Rate for Payer: Nomi Health Commercial |
$910.97
|
| Rate for Payer: PACE SWMI |
$759.14
|
| Rate for Payer: PHP Commercial |
$1,062.80
|
| Rate for Payer: PHP Medicare Advantage |
$759.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$512.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,259.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,077.32
|
| Rate for Payer: Priority Health Medicare |
$759.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,077.32
|
| Rate for Payer: Priority Health SBD |
$1,077.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$759.14
|
| Rate for Payer: UHC Medicare Advantage |
$759.14
|
| Rate for Payer: UHCCP Medicaid |
$512.48
|
| Rate for Payer: UMR Bronson Commercial |
$891.48
|
|
|
PR MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP
|
Facility
|
OP
|
$814.00
|
|
|
Service Code
|
CPT 19020
|
| Hospital Charge Code |
19020
|
| Min. Negotiated Rate |
$301.18 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$529.10
|
| Rate for Payer: Aetna Commercial |
$691.90
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$529.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,334.61
|
| Rate for Payer: BCN Commercial |
$2,334.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cofinity Commercial |
$700.04
|
| Rate for Payer: Cofinity Commercial |
$569.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$569.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$651.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$732.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$569.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$610.50
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$691.90
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$691.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$512.82
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.43
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$303.12
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$301.18
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$610.50
|
|
|
PR MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP
|
Professional
|
Both
|
$814.00
|
|
|
Service Code
|
HCPCS 19020
|
| Hospital Charge Code |
19020
|
| Min. Negotiated Rate |
$203.42 |
| Max. Negotiated Rate |
$6,614.63 |
| Rate for Payer: Aetna Commercial |
$401.97
|
| Rate for Payer: Aetna Medicare |
$311.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$401.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$431.97
|
| Rate for Payer: BCBS Complete |
$213.59
|
| Rate for Payer: BCBS MAPPO |
$299.98
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$692.46
|
| Rate for Payer: BCN Medicare Advantage |
$299.98
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cofinity Commercial |
$431.97
|
| Rate for Payer: Cofinity Commercial |
$401.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.98
|
| Rate for Payer: Meridian Medicaid |
$213.59
|
| Rate for Payer: Nomi Health Commercial |
$359.98
|
| Rate for Payer: PACE SWMI |
$299.98
|
| Rate for Payer: PHP Commercial |
$419.97
|
| Rate for Payer: PHP Medicare Advantage |
$299.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$429.85
|
| Rate for Payer: Priority Health Medicare |
$299.98
|
| Rate for Payer: Priority Health Narrow Network |
$429.85
|
| Rate for Payer: Priority Health SBD |
$429.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$299.98
|
| Rate for Payer: UHC Medicare Advantage |
$299.98
|
| Rate for Payer: UHCCP Medicaid |
$203.42
|
| Rate for Payer: UMR Bronson Commercial |
$374.44
|
|
|
PR MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP
|
Facility
|
IP
|
$814.00
|
|
|
Service Code
|
CPT 19020
|
| Hospital Charge Code |
19020
|
| Min. Negotiated Rate |
$358.16 |
| Max. Negotiated Rate |
$732.60 |
| Rate for Payer: Aetna American Axle |
$529.10
|
| Rate for Payer: Aetna Commercial |
$691.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$529.10
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cofinity Commercial |
$569.80
|
| Rate for Payer: Cofinity Commercial |
$700.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$569.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$651.20
|
| Rate for Payer: Healthscope Commercial |
$732.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$569.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$610.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$691.90
|
| Rate for Payer: PHP Commercial |
$691.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.10
|
| Rate for Payer: Priority Health SBD |
$512.82
|
| Rate for Payer: UMR Bronson Commercial |
$358.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$610.50
|
|
|
PR MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP
|
Professional
|
Both
|
$814.00
|
|
|
Service Code
|
HCPCS 19020
|
| Min. Negotiated Rate |
$203.42 |
| Max. Negotiated Rate |
$6,614.63 |
| Rate for Payer: Aetna Commercial |
$401.97
|
| Rate for Payer: Aetna Medicare |
$311.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$401.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$431.97
|
| Rate for Payer: BCBS Complete |
$213.59
|
| Rate for Payer: BCBS MAPPO |
$299.98
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$692.46
|
| Rate for Payer: BCN Medicare Advantage |
$299.98
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cash Price |
$651.20
|
| Rate for Payer: Cofinity Commercial |
$401.97
|
| Rate for Payer: Cofinity Commercial |
$431.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.98
|
| Rate for Payer: Meridian Medicaid |
$213.59
|
| Rate for Payer: Nomi Health Commercial |
$359.98
|
| Rate for Payer: PACE SWMI |
$299.98
|
| Rate for Payer: PHP Commercial |
$419.97
|
| Rate for Payer: PHP Medicare Advantage |
$299.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$429.85
|
| Rate for Payer: Priority Health Medicare |
$299.98
|
| Rate for Payer: Priority Health Narrow Network |
$429.85
|
| Rate for Payer: Priority Health SBD |
$429.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$299.98
|
| Rate for Payer: UHC Medicare Advantage |
$299.98
|
| Rate for Payer: UHCCP Medicaid |
$203.42
|
| Rate for Payer: UMR Bronson Commercial |
$374.44
|
|
|
PR MAST RAD W/PECTORAL MUSCLES AXILLARY LYMPH NODES
|
Professional
|
Both
|
$2,416.00
|
|
|
Service Code
|
HCPCS 19305
|
| Min. Negotiated Rate |
$738.90 |
| Max. Negotiated Rate |
$2,189.70 |
| Rate for Payer: Aetna Commercial |
$1,486.89
|
| Rate for Payer: Aetna Medicare |
$1,154.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,486.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,597.85
|
| Rate for Payer: BCBS Complete |
$775.84
|
| Rate for Payer: BCBS MAPPO |
$1,109.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,189.70
|
| Rate for Payer: BCN Commercial |
$1,685.94
|
| 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 |
$1,486.89
|
| Rate for Payer: Cofinity Commercial |
$1,597.85
|
| 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: Meridian Medicaid |
$775.84
|
| 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 Choice Medicaid |
$738.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,570.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,563.61
|
| Rate for Payer: Priority Health Medicare |
$1,109.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,563.61
|
| Rate for Payer: Priority Health SBD |
$1,563.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,109.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,109.62
|
| Rate for Payer: UHCCP Medicaid |
$738.90
|
| 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 |
$1.70 |
| Max. Negotiated Rate |
$2,544.29 |
| Rate for Payer: Aetna Commercial |
$18.18
|
| Rate for Payer: Aetna Medicare |
$14.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.54
|
| Rate for Payer: BCBS Complete |
$1.78
|
| Rate for Payer: BCBS MAPPO |
$13.57
|
| Rate for Payer: BCBS Trust/PPO |
$2,544.29
|
| Rate for Payer: BCN Commercial |
$21.51
|
| 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 |
$18.18
|
| Rate for Payer: Cofinity Commercial |
$19.54
|
| 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: Meridian Medicaid |
$1.78
|
| 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 Choice Medicaid |
$1.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.35
|
| Rate for Payer: Priority Health Medicare |
$13.57
|
| Rate for Payer: Priority Health Narrow Network |
$20.35
|
| Rate for Payer: Priority Health SBD |
$3.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.57
|
| Rate for Payer: UHC Medicare Advantage |
$13.57
|
| Rate for Payer: UHCCP Medicaid |
$1.70
|
| 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 |
$904.98 |
| Max. Negotiated Rate |
$2,643.74 |
| Rate for Payer: Aetna Commercial |
$2,281.20
|
| Rate for Payer: Aetna Medicare |
$1,770.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,281.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,451.44
|
| Rate for Payer: BCBS Complete |
$1,209.27
|
| Rate for Payer: BCBS MAPPO |
$1,702.39
|
| Rate for Payer: BCBS Trust/PPO |
$904.98
|
| Rate for Payer: BCN Commercial |
$2,643.74
|
| 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 |
$2,281.20
|
| Rate for Payer: Cofinity Commercial |
$2,451.44
|
| 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: Meridian Medicaid |
$1,209.27
|
| 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 Choice Medicaid |
$1,151.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,147.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,505.97
|
| Rate for Payer: Priority Health Medicare |
$1,702.39
|
| Rate for Payer: Priority Health Narrow Network |
$2,505.97
|
| Rate for Payer: Priority Health SBD |
$2,505.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,702.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,702.39
|
| Rate for Payer: UHCCP Medicaid |
$1,151.69
|
| Rate for Payer: UMR Bronson Commercial |
$1,519.84
|
|
|
PR MCCD, INITIAL RATE
|
Professional
|
Both
|
$163.00
|
|
|
Service Code
|
HCPCS G9001
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1,218.26 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$81.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$65.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,218.26
|
| Rate for Payer: BCN Commercial |
$136.23
|
| Rate for Payer: Cash Price |
$130.40
|
| 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 |
$0.01 |
| Max. Negotiated Rate |
$884.37 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$41.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: BCBS Trust/PPO |
$884.37
|
| Rate for Payer: BCN Commercial |
$68.13
|
| Rate for Payer: Cash Price |
$65.60
|
| 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 |
$0.01 |
| Max. Negotiated Rate |
$1,823.69 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$43.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$34.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,823.69
|
| Rate for Payer: BCN Commercial |
$50.00
|
| Rate for Payer: Cash Price |
$69.60
|
| 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 |
$0.01 |
| Max. Negotiated Rate |
$1,852.75 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$20.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,852.75
|
| Rate for Payer: BCN Commercial |
$28.81
|
| Rate for Payer: Cash Price |
$32.80
|
| 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 |
$28.97 |
| Max. Negotiated Rate |
$745.43 |
| Rate for Payer: Aetna Commercial |
$57.96
|
| Rate for Payer: Aetna Medicare |
$44.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.28
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS MAPPO |
$43.25
|
| Rate for Payer: BCBS Trust/PPO |
$745.43
|
| Rate for Payer: BCN Commercial |
$167.13
|
| 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 |
$57.96
|
| Rate for Payer: Cofinity Commercial |
$62.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.41
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Nomi Health Commercial |
$51.90
|
| Rate for Payer: PACE SWMI |
$43.25
|
| Rate for Payer: PHP Commercial |
$60.55
|
| Rate for Payer: PHP Medicare Advantage |
$43.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.73
|
| Rate for Payer: Priority Health Medicare |
$43.25
|
| Rate for Payer: Priority Health Narrow Network |
$70.73
|
| Rate for Payer: Priority Health SBD |
$70.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.25
|
| Rate for Payer: UHC Medicare Advantage |
$43.25
|
| Rate for Payer: UHCCP Medicaid |
$28.97
|
| Rate for Payer: UMR Bronson Commercial |
$108.56
|
|
|
PR MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS
|
Professional
|
Both
|
$1,142.00
|
|
|
Service Code
|
HCPCS 36595
|
| Min. Negotiated Rate |
$113.32 |
| Max. Negotiated Rate |
$871.31 |
| Rate for Payer: Aetna Commercial |
$228.68
|
| Rate for Payer: Aetna Medicare |
$177.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.75
|
| Rate for Payer: BCBS Complete |
$118.99
|
| Rate for Payer: BCBS MAPPO |
$170.66
|
| Rate for Payer: BCBS Trust/PPO |
$586.94
|
| Rate for Payer: BCN Commercial |
$871.31
|
| 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 |
$228.68
|
| Rate for Payer: Cofinity Commercial |
$245.75
|
| 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: Meridian Medicaid |
$118.99
|
| 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 Choice Medicaid |
$113.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$742.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$281.33
|
| Rate for Payer: Priority Health Medicare |
$170.66
|
| Rate for Payer: Priority Health Narrow Network |
$281.33
|
| Rate for Payer: Priority Health SBD |
$281.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.66
|
| Rate for Payer: UHC Medicare Advantage |
$170.66
|
| Rate for Payer: UHCCP Medicaid |
$113.32
|
| 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 |
$76.60 |
| Rate for Payer: Aetna Commercial |
$66.61
|
| Rate for Payer: Aetna Medicare |
$51.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.58
|
| Rate for Payer: BCBS Complete |
$41.60
|
| Rate for Payer: BCBS MAPPO |
$49.71
|
| Rate for Payer: BCBS Trust/PPO |
$76.60
|
| Rate for Payer: BCN Commercial |
$75.75
|
| 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 |
$66.61
|
| Rate for Payer: Cofinity Commercial |
$71.58
|
| 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 HMO/PPO/Tiered Network |
$72.82
|
| Rate for Payer: Priority Health Medicare |
$49.71
|
| Rate for Payer: Priority Health Narrow Network |
$72.82
|
| Rate for Payer: Priority Health SBD |
$72.82
|
| 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 |
$459.09 |
| Rate for Payer: Aetna Commercial |
$11.07
|
| Rate for Payer: Aetna Medicare |
$8.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.89
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$8.26
|
| Rate for Payer: BCBS Trust/PPO |
$459.09
|
| Rate for Payer: BCN Commercial |
$12.71
|
| 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 HMO/PPO/Tiered Network |
$11.66
|
| Rate for Payer: Priority Health Medicare |
$8.26
|
| Rate for Payer: Priority Health Narrow Network |
$11.66
|
| Rate for Payer: Priority Health SBD |
$11.66
|
| 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 |
$83.63 |
| Rate for Payer: Aetna Commercial |
$52.22
|
| Rate for Payer: Aetna Medicare |
$40.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.12
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: BCBS MAPPO |
$38.97
|
| Rate for Payer: BCBS Trust/PPO |
$83.63
|
| Rate for Payer: BCN Commercial |
$60.11
|
| 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 |
$52.22
|
| Rate for Payer: Cofinity Commercial |
$56.12
|
| 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 HMO/PPO/Tiered Network |
$56.99
|
| Rate for Payer: Priority Health Medicare |
$38.97
|
| Rate for Payer: Priority Health Narrow Network |
$56.99
|
| Rate for Payer: Priority Health SBD |
$56.99
|
| 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 |
$1,453.88 |
| Rate for Payer: Aetna Commercial |
$11.04
|
| Rate for Payer: Aetna Medicare |
$8.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.87
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: BCBS MAPPO |
$8.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,453.88
|
| Rate for Payer: BCN Commercial |
$12.71
|
| 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 HMO/PPO/Tiered Network |
$11.75
|
| Rate for Payer: Priority Health Medicare |
$8.24
|
| Rate for Payer: Priority Health Narrow Network |
$11.75
|
| Rate for Payer: Priority Health SBD |
$11.75
|
| 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 |
$275.04 |
| Rate for Payer: Aetna Commercial |
$275.04
|
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.04
|
| Rate for Payer: BCBS Complete |
$122.40
|
| Rate for Payer: BCBS Trust/PPO |
$260.00
|
| Rate for Payer: BCN Commercial |
$258.46
|
| Rate for Payer: Cash Price |
$244.80
|
| 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 |
$94.50 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: Aetna Medicare |
$53.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.50
|
| Rate for Payer: BCBS Complete |
$42.80
|
| Rate for Payer: BCBS Trust/PPO |
$88.32
|
| Rate for Payer: BCN Commercial |
$88.32
|
| Rate for Payer: Cash Price |
$85.60
|
| 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
|
|
