|
PR NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 95866
|
| Min. Negotiated Rate |
$94.80 |
| Max. Negotiated Rate |
$170.86 |
| Rate for Payer: Aetna Commercial |
$158.99
|
| Rate for Payer: Aetna Medicare |
$123.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.99
|
| Rate for Payer: BCBS Complete |
$94.80
|
| Rate for Payer: BCBS MAPPO |
$118.65
|
| Rate for Payer: BCN Medicare Advantage |
$118.65
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cofinity Commercial |
$170.86
|
| Rate for Payer: Cofinity Commercial |
$158.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.58
|
| Rate for Payer: Nomi Health Commercial |
$142.38
|
| Rate for Payer: PACE SWMI |
$118.65
|
| Rate for Payer: PHP Commercial |
$166.11
|
| Rate for Payer: PHP Medicare Advantage |
$118.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.05
|
| Rate for Payer: Priority Health Medicare |
$118.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.65
|
| Rate for Payer: UHC Medicare Advantage |
$118.65
|
| Rate for Payer: UMR Bronson Commercial |
$109.02
|
|
|
PR NEEDLE ELECTROMYOGRAPHY LARYNX
|
Professional
|
Both
|
$372.00
|
|
|
Service Code
|
HCPCS 95865
|
| Min. Negotiated Rate |
$133.51 |
| Max. Negotiated Rate |
$241.80 |
| Rate for Payer: Aetna Commercial |
$178.90
|
| Rate for Payer: Aetna Medicare |
$138.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.90
|
| Rate for Payer: BCBS Complete |
$148.80
|
| Rate for Payer: BCBS MAPPO |
$133.51
|
| Rate for Payer: BCN Medicare Advantage |
$133.51
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cofinity Commercial |
$192.25
|
| Rate for Payer: Cofinity Commercial |
$178.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.19
|
| Rate for Payer: Nomi Health Commercial |
$160.21
|
| Rate for Payer: PACE SWMI |
$133.51
|
| Rate for Payer: PHP Commercial |
$186.91
|
| Rate for Payer: PHP Medicare Advantage |
$133.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.80
|
| Rate for Payer: Priority Health Medicare |
$133.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.51
|
| Rate for Payer: UHC Medicare Advantage |
$133.51
|
| Rate for Payer: UMR Bronson Commercial |
$171.12
|
|
|
PR NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 95885
|
| Min. Negotiated Rate |
$25.60 |
| Max. Negotiated Rate |
$77.53 |
| Rate for Payer: Aetna Commercial |
$72.15
|
| Rate for Payer: Aetna Commercial |
$72.15
|
| Rate for Payer: Aetna Medicare |
$55.99
|
| Rate for Payer: Aetna Medicare |
$55.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.53
|
| Rate for Payer: BCBS Complete |
$25.60
|
| Rate for Payer: BCBS Complete |
$61.60
|
| Rate for Payer: BCBS MAPPO |
$53.84
|
| Rate for Payer: BCBS MAPPO |
$53.84
|
| Rate for Payer: BCN Medicare Advantage |
$53.84
|
| Rate for Payer: BCN Medicare Advantage |
$53.84
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$77.53
|
| Rate for Payer: Cofinity Commercial |
$77.53
|
| Rate for Payer: Cofinity Commercial |
$72.15
|
| Rate for Payer: Cofinity Commercial |
$72.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.53
|
| Rate for Payer: Nomi Health Commercial |
$64.61
|
| Rate for Payer: Nomi Health Commercial |
$64.61
|
| Rate for Payer: PACE SWMI |
$53.84
|
| Rate for Payer: PACE SWMI |
$53.84
|
| Rate for Payer: PHP Commercial |
$75.38
|
| Rate for Payer: PHP Commercial |
$75.38
|
| Rate for Payer: PHP Medicare Advantage |
$53.84
|
| Rate for Payer: PHP Medicare Advantage |
$53.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.60
|
| Rate for Payer: Priority Health Medicare |
$53.84
|
| Rate for Payer: Priority Health Medicare |
$53.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.84
|
| Rate for Payer: UHC Medicare Advantage |
$53.84
|
| Rate for Payer: UHC Medicare Advantage |
$53.84
|
| Rate for Payer: UMR Bronson Commercial |
$29.44
|
| Rate for Payer: UMR Bronson Commercial |
$70.84
|
|
|
PR NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 95886
|
| Min. Negotiated Rate |
$85.24 |
| Max. Negotiated Rate |
$157.30 |
| Rate for Payer: Aetna Commercial |
$114.22
|
| Rate for Payer: Aetna Commercial |
$114.22
|
| Rate for Payer: Aetna Medicare |
$88.65
|
| Rate for Payer: Aetna Medicare |
$88.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.75
|
| Rate for Payer: BCBS Complete |
$96.80
|
| Rate for Payer: BCBS Complete |
$68.00
|
| Rate for Payer: BCBS MAPPO |
$85.24
|
| Rate for Payer: BCBS MAPPO |
$85.24
|
| Rate for Payer: BCN Medicare Advantage |
$85.24
|
| Rate for Payer: BCN Medicare Advantage |
$85.24
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cofinity Commercial |
$122.75
|
| Rate for Payer: Cofinity Commercial |
$122.75
|
| Rate for Payer: Cofinity Commercial |
$114.22
|
| Rate for Payer: Cofinity Commercial |
$114.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.50
|
| Rate for Payer: Nomi Health Commercial |
$102.29
|
| Rate for Payer: Nomi Health Commercial |
$102.29
|
| Rate for Payer: PACE SWMI |
$85.24
|
| Rate for Payer: PACE SWMI |
$85.24
|
| Rate for Payer: PHP Commercial |
$119.34
|
| Rate for Payer: PHP Commercial |
$119.34
|
| Rate for Payer: PHP Medicare Advantage |
$85.24
|
| Rate for Payer: PHP Medicare Advantage |
$85.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.30
|
| Rate for Payer: Priority Health Medicare |
$85.24
|
| Rate for Payer: Priority Health Medicare |
$85.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.24
|
| Rate for Payer: UHC Medicare Advantage |
$85.24
|
| Rate for Payer: UHC Medicare Advantage |
$85.24
|
| Rate for Payer: UMR Bronson Commercial |
$111.32
|
| Rate for Payer: UMR Bronson Commercial |
$78.20
|
|
|
PR NEEDLE EMG GUID W/CHEMODENERVATION
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 95874
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$95.01 |
| Rate for Payer: Aetna Commercial |
$88.41
|
| Rate for Payer: Aetna Medicare |
$68.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.41
|
| Rate for Payer: BCBS Complete |
$50.40
|
| Rate for Payer: BCBS MAPPO |
$65.98
|
| Rate for Payer: BCN Medicare Advantage |
$65.98
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cofinity Commercial |
$95.01
|
| Rate for Payer: Cofinity Commercial |
$88.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.28
|
| Rate for Payer: Nomi Health Commercial |
$79.18
|
| Rate for Payer: PACE SWMI |
$65.98
|
| Rate for Payer: PHP Commercial |
$92.37
|
| Rate for Payer: PHP Medicare Advantage |
$65.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.90
|
| Rate for Payer: Priority Health Medicare |
$65.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.98
|
| Rate for Payer: UHC Medicare Advantage |
$65.98
|
| Rate for Payer: UMR Bronson Commercial |
$57.96
|
|
|
PR NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 95870
|
| Min. Negotiated Rate |
$61.20 |
| Max. Negotiated Rate |
$103.74 |
| Rate for Payer: Aetna Commercial |
$96.53
|
| Rate for Payer: Aetna Medicare |
$74.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.74
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: BCBS MAPPO |
$72.04
|
| Rate for Payer: BCN Medicare Advantage |
$72.04
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$96.53
|
| Rate for Payer: Cofinity Commercial |
$103.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.64
|
| Rate for Payer: Nomi Health Commercial |
$86.45
|
| Rate for Payer: PACE SWMI |
$72.04
|
| Rate for Payer: PHP Commercial |
$100.86
|
| Rate for Payer: PHP Medicare Advantage |
$72.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health Medicare |
$72.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.04
|
| Rate for Payer: UHC Medicare Advantage |
$72.04
|
| Rate for Payer: UMR Bronson Commercial |
$70.38
|
|
|
PR NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION
|
Professional
|
Both
|
$272.00
|
|
|
Service Code
|
HCPCS 95887
|
| Min. Negotiated Rate |
$74.20 |
| Max. Negotiated Rate |
$176.80 |
| Rate for Payer: Aetna Commercial |
$99.43
|
| Rate for Payer: Aetna Commercial |
$99.43
|
| Rate for Payer: Aetna Medicare |
$77.17
|
| Rate for Payer: Aetna Medicare |
$77.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.43
|
| Rate for Payer: BCBS Complete |
$108.80
|
| Rate for Payer: BCBS Complete |
$53.60
|
| Rate for Payer: BCBS MAPPO |
$74.20
|
| Rate for Payer: BCBS MAPPO |
$74.20
|
| Rate for Payer: BCN Medicare Advantage |
$74.20
|
| Rate for Payer: BCN Medicare Advantage |
$74.20
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cofinity Commercial |
$99.43
|
| Rate for Payer: Cofinity Commercial |
$99.43
|
| Rate for Payer: Cofinity Commercial |
$106.85
|
| Rate for Payer: Cofinity Commercial |
$106.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.91
|
| Rate for Payer: Nomi Health Commercial |
$89.04
|
| Rate for Payer: Nomi Health Commercial |
$89.04
|
| Rate for Payer: PACE SWMI |
$74.20
|
| Rate for Payer: PACE SWMI |
$74.20
|
| Rate for Payer: PHP Commercial |
$103.88
|
| Rate for Payer: PHP Commercial |
$103.88
|
| Rate for Payer: PHP Medicare Advantage |
$74.20
|
| Rate for Payer: PHP Medicare Advantage |
$74.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.80
|
| Rate for Payer: Priority Health Medicare |
$74.20
|
| Rate for Payer: Priority Health Medicare |
$74.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.20
|
| Rate for Payer: UHC Medicare Advantage |
$74.20
|
| Rate for Payer: UHC Medicare Advantage |
$74.20
|
| Rate for Payer: UMR Bronson Commercial |
$125.12
|
| Rate for Payer: UMR Bronson Commercial |
$61.64
|
|
|
PR NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12
|
Professional
|
Both
|
$146.00
|
|
|
Service Code
|
HCPCS 95869
|
| Min. Negotiated Rate |
$58.40 |
| Max. Negotiated Rate |
$117.32 |
| Rate for Payer: Aetna Commercial |
$109.17
|
| Rate for Payer: Aetna Medicare |
$84.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.17
|
| Rate for Payer: BCBS Complete |
$58.40
|
| Rate for Payer: BCBS MAPPO |
$81.47
|
| Rate for Payer: BCN Medicare Advantage |
$81.47
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cofinity Commercial |
$117.32
|
| Rate for Payer: Cofinity Commercial |
$109.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.54
|
| Rate for Payer: Nomi Health Commercial |
$97.76
|
| Rate for Payer: PACE SWMI |
$81.47
|
| Rate for Payer: PHP Commercial |
$114.06
|
| Rate for Payer: PHP Medicare Advantage |
$81.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.90
|
| Rate for Payer: Priority Health Medicare |
$81.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.47
|
| Rate for Payer: UHC Medicare Advantage |
$81.47
|
| Rate for Payer: UMR Bronson Commercial |
$67.16
|
|
|
PR NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER
|
Professional
|
Both
|
$324.00
|
|
|
Service Code
|
HCPCS 95872
|
| Min. Negotiated Rate |
$129.60 |
| Max. Negotiated Rate |
$246.54 |
| Rate for Payer: Aetna Commercial |
$229.42
|
| Rate for Payer: Aetna Medicare |
$178.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.42
|
| Rate for Payer: BCBS Complete |
$129.60
|
| Rate for Payer: BCBS MAPPO |
$171.21
|
| Rate for Payer: BCN Medicare Advantage |
$171.21
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cofinity Commercial |
$246.54
|
| Rate for Payer: Cofinity Commercial |
$229.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.77
|
| Rate for Payer: Nomi Health Commercial |
$205.45
|
| Rate for Payer: PACE SWMI |
$171.21
|
| Rate for Payer: PHP Commercial |
$239.69
|
| Rate for Payer: PHP Medicare Advantage |
$171.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.60
|
| Rate for Payer: Priority Health Medicare |
$171.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.21
|
| Rate for Payer: UHC Medicare Advantage |
$171.21
|
| Rate for Payer: UMR Bronson Commercial |
$149.04
|
|
|
PR NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES
|
Professional
|
Both
|
$52.00
|
|
|
Service Code
|
HCPCS 20560
|
| Min. Negotiated Rate |
$14.35 |
| Max. Negotiated Rate |
$33.80 |
| Rate for Payer: Aetna Commercial |
$19.23
|
| Rate for Payer: Aetna Medicare |
$14.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.23
|
| Rate for Payer: BCBS Complete |
$20.80
|
| Rate for Payer: BCBS MAPPO |
$14.35
|
| Rate for Payer: BCN Medicare Advantage |
$14.35
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$20.66
|
| Rate for Payer: Cofinity Commercial |
$19.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.07
|
| Rate for Payer: Nomi Health Commercial |
$17.22
|
| Rate for Payer: PACE SWMI |
$14.35
|
| Rate for Payer: PHP Commercial |
$20.09
|
| Rate for Payer: PHP Medicare Advantage |
$14.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.80
|
| Rate for Payer: Priority Health Medicare |
$14.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.35
|
| Rate for Payer: UHC Medicare Advantage |
$14.35
|
| Rate for Payer: UMR Bronson Commercial |
$23.92
|
|
|
PR NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 20561
|
| Min. Negotiated Rate |
$21.67 |
| Max. Negotiated Rate |
$48.75 |
| Rate for Payer: Aetna Commercial |
$29.04
|
| Rate for Payer: Aetna Medicare |
$22.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.04
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: BCBS MAPPO |
$21.67
|
| Rate for Payer: BCN Medicare Advantage |
$21.67
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$29.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.75
|
| Rate for Payer: Nomi Health Commercial |
$26.00
|
| Rate for Payer: PACE SWMI |
$21.67
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: PHP Medicare Advantage |
$21.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
| Rate for Payer: Priority Health Medicare |
$21.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.67
|
| Rate for Payer: UHC Medicare Advantage |
$21.67
|
| Rate for Payer: UMR Bronson Commercial |
$34.50
|
|
|
PR NEGATIVE PRESSURE WOUND THERAPY DME <= 50 SQ CM
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
HCPCS 97605
|
| Min. Negotiated Rate |
$23.18 |
| Max. Negotiated Rate |
$63.70 |
| Rate for Payer: Aetna Commercial |
$31.06
|
| Rate for Payer: Aetna Medicare |
$24.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.06
|
| Rate for Payer: BCBS Complete |
$39.20
|
| Rate for Payer: BCBS MAPPO |
$23.18
|
| Rate for Payer: BCN Medicare Advantage |
$23.18
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cofinity Commercial |
$33.38
|
| Rate for Payer: Cofinity Commercial |
$31.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.34
|
| Rate for Payer: Nomi Health Commercial |
$27.82
|
| Rate for Payer: PACE SWMI |
$23.18
|
| Rate for Payer: PHP Commercial |
$32.45
|
| Rate for Payer: PHP Medicare Advantage |
$23.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.70
|
| Rate for Payer: Priority Health Medicare |
$23.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.18
|
| Rate for Payer: UHC Medicare Advantage |
$23.18
|
| Rate for Payer: UMR Bronson Commercial |
$45.08
|
|
|
PR NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 97606
|
| Min. Negotiated Rate |
$25.09 |
| Max. Negotiated Rate |
$92.95 |
| Rate for Payer: Aetna Commercial |
$33.62
|
| Rate for Payer: Aetna Medicare |
$26.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.62
|
| Rate for Payer: BCBS Complete |
$57.20
|
| Rate for Payer: BCBS MAPPO |
$25.09
|
| Rate for Payer: BCN Medicare Advantage |
$25.09
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cofinity Commercial |
$36.13
|
| Rate for Payer: Cofinity Commercial |
$33.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.34
|
| Rate for Payer: Nomi Health Commercial |
$30.11
|
| Rate for Payer: PACE SWMI |
$25.09
|
| Rate for Payer: PHP Commercial |
$35.13
|
| Rate for Payer: PHP Medicare Advantage |
$25.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
| Rate for Payer: Priority Health Medicare |
$25.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.09
|
| Rate for Payer: UHC Medicare Advantage |
$25.09
|
| Rate for Payer: UMR Bronson Commercial |
$65.78
|
|
|
PR NEG PRESSURE WOUND THERAPY NON DME <= 50 SQ CM
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 97607
|
| Min. Negotiated Rate |
$20.17 |
| Max. Negotiated Rate |
$99.45 |
| Rate for Payer: Aetna Commercial |
$27.03
|
| Rate for Payer: Aetna Medicare |
$20.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.03
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: BCBS MAPPO |
$20.17
|
| Rate for Payer: BCN Medicare Advantage |
$20.17
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$29.04
|
| Rate for Payer: Cofinity Commercial |
$27.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.18
|
| Rate for Payer: Nomi Health Commercial |
$24.20
|
| Rate for Payer: PACE SWMI |
$20.17
|
| Rate for Payer: PHP Commercial |
$28.24
|
| Rate for Payer: PHP Medicare Advantage |
$20.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health Medicare |
$20.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.17
|
| Rate for Payer: UHC Medicare Advantage |
$20.17
|
| Rate for Payer: UMR Bronson Commercial |
$70.38
|
|
|
PR NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 97608
|
| Min. Negotiated Rate |
$23.51 |
| Max. Negotiated Rate |
$99.45 |
| Rate for Payer: Aetna Commercial |
$31.50
|
| Rate for Payer: Aetna Medicare |
$24.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.50
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: BCBS MAPPO |
$23.51
|
| Rate for Payer: BCN Medicare Advantage |
$23.51
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$33.85
|
| Rate for Payer: Cofinity Commercial |
$31.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.69
|
| Rate for Payer: Nomi Health Commercial |
$28.21
|
| Rate for Payer: PACE SWMI |
$23.51
|
| Rate for Payer: PHP Commercial |
$32.91
|
| Rate for Payer: PHP Medicare Advantage |
$23.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health Medicare |
$23.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.51
|
| Rate for Payer: UHC Medicare Advantage |
$23.51
|
| Rate for Payer: UMR Bronson Commercial |
$70.38
|
|
|
PR NEPHRECTOMY PARTIAL
|
Professional
|
Both
|
$2,530.00
|
|
|
Service Code
|
HCPCS 50240
|
| Min. Negotiated Rate |
$1,012.00 |
| Max. Negotiated Rate |
$1,824.74 |
| Rate for Payer: Aetna Commercial |
$1,698.02
|
| Rate for Payer: Aetna Medicare |
$1,317.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,824.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,698.02
|
| Rate for Payer: BCBS Complete |
$1,012.00
|
| Rate for Payer: BCBS MAPPO |
$1,267.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,267.18
|
| Rate for Payer: Cash Price |
$2,024.00
|
| Rate for Payer: Cash Price |
$2,024.00
|
| Rate for Payer: Cofinity Commercial |
$1,824.74
|
| Rate for Payer: Cofinity Commercial |
$1,698.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,267.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,330.54
|
| Rate for Payer: Nomi Health Commercial |
$1,520.62
|
| Rate for Payer: PACE SWMI |
$1,267.18
|
| Rate for Payer: PHP Commercial |
$1,774.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,267.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,644.50
|
| Rate for Payer: Priority Health Medicare |
$1,267.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,267.18
|
| Rate for Payer: UHC Medicare Advantage |
$1,267.18
|
| Rate for Payer: UMR Bronson Commercial |
$1,163.80
|
|
|
PR NEPHRECTOMY TOT URETEREC&BLDR CUFF SEPAR INCISN
|
Professional
|
Both
|
$2,808.00
|
|
|
Service Code
|
HCPCS 50236
|
| Min. Negotiated Rate |
$1,123.20 |
| Max. Negotiated Rate |
$2,005.99 |
| Rate for Payer: Aetna Commercial |
$1,866.69
|
| Rate for Payer: Aetna Medicare |
$1,448.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,005.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,866.69
|
| Rate for Payer: BCBS Complete |
$1,123.20
|
| Rate for Payer: BCBS MAPPO |
$1,393.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,393.05
|
| Rate for Payer: Cash Price |
$2,246.40
|
| Rate for Payer: Cash Price |
$2,246.40
|
| Rate for Payer: Cofinity Commercial |
$2,005.99
|
| Rate for Payer: Cofinity Commercial |
$1,866.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,393.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,462.70
|
| Rate for Payer: Nomi Health Commercial |
$1,671.66
|
| Rate for Payer: PACE SWMI |
$1,393.05
|
| Rate for Payer: PHP Commercial |
$1,950.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,393.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,825.20
|
| Rate for Payer: Priority Health Medicare |
$1,393.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,393.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,393.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,291.68
|
|
|
PR NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ
|
Professional
|
Both
|
$3,705.00
|
|
|
Service Code
|
HCPCS 50220
|
| Min. Negotiated Rate |
$1,014.55 |
| Max. Negotiated Rate |
$2,408.25 |
| Rate for Payer: Aetna Commercial |
$1,359.50
|
| Rate for Payer: Aetna Medicare |
$1,055.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,460.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,359.50
|
| Rate for Payer: BCBS Complete |
$1,482.00
|
| Rate for Payer: BCBS MAPPO |
$1,014.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,014.55
|
| Rate for Payer: Cash Price |
$2,964.00
|
| Rate for Payer: Cash Price |
$2,964.00
|
| Rate for Payer: Cofinity Commercial |
$1,460.95
|
| Rate for Payer: Cofinity Commercial |
$1,359.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,014.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,065.28
|
| Rate for Payer: Nomi Health Commercial |
$1,217.46
|
| Rate for Payer: PACE SWMI |
$1,014.55
|
| Rate for Payer: PHP Commercial |
$1,420.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,014.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,408.25
|
| Rate for Payer: Priority Health Medicare |
$1,014.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,014.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,014.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,704.30
|
|
|
PR NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD
|
Professional
|
Both
|
$4,384.00
|
|
|
Service Code
|
HCPCS 50230
|
| Min. Negotiated Rate |
$1,222.17 |
| Max. Negotiated Rate |
$2,849.60 |
| Rate for Payer: Aetna Commercial |
$1,637.71
|
| Rate for Payer: Aetna Medicare |
$1,271.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,759.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,637.71
|
| Rate for Payer: BCBS Complete |
$1,753.60
|
| Rate for Payer: BCBS MAPPO |
$1,222.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,222.17
|
| Rate for Payer: Cash Price |
$3,507.20
|
| Rate for Payer: Cash Price |
$3,507.20
|
| Rate for Payer: Cofinity Commercial |
$1,759.92
|
| Rate for Payer: Cofinity Commercial |
$1,637.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,222.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,283.28
|
| Rate for Payer: Nomi Health Commercial |
$1,466.60
|
| Rate for Payer: PACE SWMI |
$1,222.17
|
| Rate for Payer: PHP Commercial |
$1,711.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,222.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,849.60
|
| Rate for Payer: Priority Health Medicare |
$1,222.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,222.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,222.17
|
| Rate for Payer: UMR Bronson Commercial |
$2,016.64
|
|
|
PR NEPHRECTOMY W/PRTL URETERECT OPN RIB RESCJ COMPL
|
Professional
|
Both
|
$3,454.00
|
|
|
Service Code
|
HCPCS 50225
|
| Min. Negotiated Rate |
$1,130.96 |
| Max. Negotiated Rate |
$2,245.10 |
| Rate for Payer: Aetna Commercial |
$1,515.49
|
| Rate for Payer: Aetna Medicare |
$1,176.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,628.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,515.49
|
| Rate for Payer: BCBS Complete |
$1,381.60
|
| Rate for Payer: BCBS MAPPO |
$1,130.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,130.96
|
| Rate for Payer: Cash Price |
$2,763.20
|
| Rate for Payer: Cash Price |
$2,763.20
|
| Rate for Payer: Cofinity Commercial |
$1,628.58
|
| Rate for Payer: Cofinity Commercial |
$1,515.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,130.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,187.51
|
| Rate for Payer: Nomi Health Commercial |
$1,357.15
|
| Rate for Payer: PACE SWMI |
$1,130.96
|
| Rate for Payer: PHP Commercial |
$1,583.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,130.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,245.10
|
| Rate for Payer: Priority Health Medicare |
$1,130.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,130.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,130.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,588.84
|
|
|
PR NEPHRECTOMY W/TOT URETERECT&BLDR CUFF SAME INC
|
Professional
|
Both
|
$2,488.00
|
|
|
Service Code
|
HCPCS 50234
|
| Min. Negotiated Rate |
$995.20 |
| Max. Negotiated Rate |
$1,788.38 |
| Rate for Payer: Aetna Commercial |
$1,664.19
|
| Rate for Payer: Aetna Medicare |
$1,291.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,788.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,664.19
|
| Rate for Payer: BCBS Complete |
$995.20
|
| Rate for Payer: BCBS MAPPO |
$1,241.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,241.93
|
| Rate for Payer: Cash Price |
$1,990.40
|
| Rate for Payer: Cash Price |
$1,990.40
|
| Rate for Payer: Cofinity Commercial |
$1,788.38
|
| Rate for Payer: Cofinity Commercial |
$1,664.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,241.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,304.03
|
| Rate for Payer: Nomi Health Commercial |
$1,490.32
|
| Rate for Payer: PACE SWMI |
$1,241.93
|
| Rate for Payer: PHP Commercial |
$1,738.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,241.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,617.20
|
| Rate for Payer: Priority Health Medicare |
$1,241.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,241.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,241.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,144.48
|
|
|
PR NEPHROLITHOTOMY REMOVAL CALCULUS
|
Professional
|
Both
|
$2,064.00
|
|
|
Service Code
|
HCPCS 50060
|
| Min. Negotiated Rate |
$825.60 |
| Max. Negotiated Rate |
$1,563.19 |
| Rate for Payer: Aetna Commercial |
$1,454.64
|
| Rate for Payer: Aetna Medicare |
$1,128.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,563.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,454.64
|
| Rate for Payer: BCBS Complete |
$825.60
|
| Rate for Payer: BCBS MAPPO |
$1,085.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,085.55
|
| Rate for Payer: Cash Price |
$1,651.20
|
| Rate for Payer: Cash Price |
$1,651.20
|
| Rate for Payer: Cofinity Commercial |
$1,563.19
|
| Rate for Payer: Cofinity Commercial |
$1,454.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,085.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,139.83
|
| Rate for Payer: Nomi Health Commercial |
$1,302.66
|
| Rate for Payer: PACE SWMI |
$1,085.55
|
| Rate for Payer: PHP Commercial |
$1,519.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,085.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,341.60
|
| Rate for Payer: Priority Health Medicare |
$1,085.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,085.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,085.55
|
| Rate for Payer: UMR Bronson Commercial |
$949.44
|
|
|
PR NEPHROLITHOTOMY RMVL LARGE STAGHORN CALCULUS
|
Professional
|
Both
|
$3,414.00
|
|
|
Service Code
|
HCPCS 50075
|
| Min. Negotiated Rate |
$1,365.60 |
| Max. Negotiated Rate |
$2,219.10 |
| Rate for Payer: Aetna Commercial |
$1,859.30
|
| Rate for Payer: Aetna Medicare |
$1,443.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,998.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,859.30
|
| Rate for Payer: BCBS Complete |
$1,365.60
|
| Rate for Payer: BCBS MAPPO |
$1,387.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,387.54
|
| Rate for Payer: Cash Price |
$2,731.20
|
| Rate for Payer: Cash Price |
$2,731.20
|
| Rate for Payer: Cofinity Commercial |
$1,998.06
|
| Rate for Payer: Cofinity Commercial |
$1,859.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,387.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,456.92
|
| Rate for Payer: Nomi Health Commercial |
$1,665.05
|
| Rate for Payer: PACE SWMI |
$1,387.54
|
| Rate for Payer: PHP Commercial |
$1,942.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,387.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,219.10
|
| Rate for Payer: Priority Health Medicare |
$1,387.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,387.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,387.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,570.44
|
|
|
PR NEPHRORRHAPHY SUTURE KIDNEY WOUND/INJURY
|
Professional
|
Both
|
$2,305.00
|
|
|
Service Code
|
HCPCS 50500
|
| Min. Negotiated Rate |
$922.00 |
| Max. Negotiated Rate |
$1,804.52 |
| Rate for Payer: Aetna Commercial |
$1,679.21
|
| Rate for Payer: Aetna Medicare |
$1,303.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,804.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,679.21
|
| Rate for Payer: BCBS Complete |
$922.00
|
| Rate for Payer: BCBS MAPPO |
$1,253.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,253.14
|
| Rate for Payer: Cash Price |
$1,844.00
|
| Rate for Payer: Cash Price |
$1,844.00
|
| Rate for Payer: Cofinity Commercial |
$1,804.52
|
| Rate for Payer: Cofinity Commercial |
$1,679.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,253.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,315.80
|
| Rate for Payer: Nomi Health Commercial |
$1,503.77
|
| Rate for Payer: PACE SWMI |
$1,253.14
|
| Rate for Payer: PHP Commercial |
$1,754.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,253.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,498.25
|
| Rate for Payer: Priority Health Medicare |
$1,253.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,253.14
|
| Rate for Payer: UHC Medicare Advantage |
$1,253.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,060.30
|
|
|
PR NEPHROSTOMY NEPHROTOMY W/DRAINAGE
|
Professional
|
Both
|
$1,765.00
|
|
|
Service Code
|
HCPCS 50040
|
| Min. Negotiated Rate |
$706.00 |
| Max. Negotiated Rate |
$1,272.60 |
| Rate for Payer: Aetna Commercial |
$1,184.22
|
| Rate for Payer: Aetna Medicare |
$919.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,272.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,184.22
|
| Rate for Payer: BCBS Complete |
$706.00
|
| Rate for Payer: BCBS MAPPO |
$883.75
|
| Rate for Payer: BCN Medicare Advantage |
$883.75
|
| Rate for Payer: Cash Price |
$1,412.00
|
| Rate for Payer: Cash Price |
$1,412.00
|
| Rate for Payer: Cofinity Commercial |
$1,272.60
|
| Rate for Payer: Cofinity Commercial |
$1,184.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$883.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$927.94
|
| Rate for Payer: Nomi Health Commercial |
$1,060.50
|
| Rate for Payer: PACE SWMI |
$883.75
|
| Rate for Payer: PHP Commercial |
$1,237.25
|
| Rate for Payer: PHP Medicare Advantage |
$883.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,147.25
|
| Rate for Payer: Priority Health Medicare |
$883.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$883.75
|
| Rate for Payer: UHC Medicare Advantage |
$883.75
|
| Rate for Payer: UMR Bronson Commercial |
$811.90
|
|
