|
PR NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX
|
Professional
|
Both
|
$873.00
|
|
|
Service Code
|
HCPCS 44385
|
| Min. Negotiated Rate |
$46.22 |
| Max. Negotiated Rate |
$1,990.63 |
| Rate for Payer: Aetna Commercial |
$92.14
|
| Rate for Payer: Aetna Medicare |
$71.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.01
|
| Rate for Payer: BCBS Complete |
$48.53
|
| Rate for Payer: BCBS MAPPO |
$68.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,990.63
|
| Rate for Payer: BCN Commercial |
$317.65
|
| Rate for Payer: BCN Medicare Advantage |
$68.76
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cofinity Commercial |
$92.14
|
| Rate for Payer: Cofinity Commercial |
$99.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.20
|
| Rate for Payer: Meridian Medicaid |
$48.53
|
| Rate for Payer: Nomi Health Commercial |
$82.51
|
| Rate for Payer: PACE SWMI |
$68.76
|
| Rate for Payer: PHP Commercial |
$96.26
|
| Rate for Payer: PHP Medicare Advantage |
$68.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$567.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.45
|
| Rate for Payer: Priority Health Medicare |
$68.76
|
| Rate for Payer: Priority Health Narrow Network |
$129.45
|
| Rate for Payer: Priority Health SBD |
$129.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.76
|
| Rate for Payer: UHC Medicare Advantage |
$68.76
|
| Rate for Payer: UHCCP Medicaid |
$46.22
|
| Rate for Payer: UMR Bronson Commercial |
$401.58
|
|
|
PR NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,038.00
|
|
|
Service Code
|
HCPCS 44386
|
| Min. Negotiated Rate |
$56.45 |
| Max. Negotiated Rate |
$3,257.50 |
| Rate for Payer: Aetna Commercial |
$112.47
|
| Rate for Payer: Aetna Medicare |
$87.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.86
|
| Rate for Payer: BCBS Complete |
$59.27
|
| Rate for Payer: BCBS MAPPO |
$83.93
|
| Rate for Payer: BCBS Trust/PPO |
$3,257.50
|
| Rate for Payer: BCN Commercial |
$458.38
|
| Rate for Payer: BCN Medicare Advantage |
$83.93
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cash Price |
$830.40
|
| Rate for Payer: Cofinity Commercial |
$112.47
|
| Rate for Payer: Cofinity Commercial |
$120.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.13
|
| Rate for Payer: Meridian Medicaid |
$59.27
|
| Rate for Payer: Nomi Health Commercial |
$100.72
|
| Rate for Payer: PACE SWMI |
$83.93
|
| Rate for Payer: PHP Commercial |
$117.50
|
| Rate for Payer: PHP Medicare Advantage |
$83.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.09
|
| Rate for Payer: Priority Health Medicare |
$83.93
|
| Rate for Payer: Priority Health Narrow Network |
$158.09
|
| Rate for Payer: Priority Health SBD |
$158.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.93
|
| Rate for Payer: UHC Medicare Advantage |
$83.93
|
| Rate for Payer: UHCCP Medicaid |
$56.45
|
| Rate for Payer: UMR Bronson Commercial |
$477.48
|
|
|
PR NDSC NJX IMPLT MATRL URT&/BLDR NCK
|
Professional
|
Both
|
$1,749.00
|
|
|
Service Code
|
HCPCS 51715
|
| Min. Negotiated Rate |
$126.74 |
| Max. Negotiated Rate |
$2,071.46 |
| Rate for Payer: Aetna Commercial |
$255.12
|
| Rate for Payer: Aetna Medicare |
$198.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.16
|
| Rate for Payer: BCBS Complete |
$133.08
|
| Rate for Payer: BCBS MAPPO |
$190.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,071.46
|
| Rate for Payer: BCN Commercial |
$544.39
|
| Rate for Payer: BCN Medicare Advantage |
$190.39
|
| Rate for Payer: Cash Price |
$1,399.20
|
| Rate for Payer: Cash Price |
$1,399.20
|
| Rate for Payer: Cofinity Commercial |
$255.12
|
| Rate for Payer: Cofinity Commercial |
$274.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.91
|
| Rate for Payer: Meridian Medicaid |
$133.08
|
| Rate for Payer: Nomi Health Commercial |
$228.47
|
| Rate for Payer: PACE SWMI |
$190.39
|
| Rate for Payer: PHP Commercial |
$266.55
|
| Rate for Payer: PHP Medicare Advantage |
$190.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,136.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$315.30
|
| Rate for Payer: Priority Health Medicare |
$190.39
|
| Rate for Payer: Priority Health Narrow Network |
$315.30
|
| Rate for Payer: Priority Health SBD |
$315.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$190.39
|
| Rate for Payer: UHC Medicare Advantage |
$190.39
|
| Rate for Payer: UHCCP Medicaid |
$126.74
|
| Rate for Payer: UMR Bronson Commercial |
$804.54
|
|
|
PR NDSC SURG W/VIDEO-ASSISTED HARVEST VEIN CABG
|
Professional
|
Both
|
$342.00
|
|
|
Service Code
|
HCPCS 33508
|
| Min. Negotiated Rate |
$10.01 |
| Max. Negotiated Rate |
$878.56 |
| Rate for Payer: Aetna Commercial |
$20.56
|
| Rate for Payer: Aetna Medicare |
$15.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.09
|
| Rate for Payer: BCBS Complete |
$10.51
|
| Rate for Payer: BCBS MAPPO |
$15.34
|
| Rate for Payer: BCBS Trust/PPO |
$878.56
|
| Rate for Payer: BCN Commercial |
$22.97
|
| Rate for Payer: BCN Medicare Advantage |
$15.34
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cofinity Commercial |
$20.56
|
| Rate for Payer: Cofinity Commercial |
$22.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.11
|
| Rate for Payer: Meridian Medicaid |
$10.51
|
| Rate for Payer: Nomi Health Commercial |
$18.41
|
| Rate for Payer: PACE SWMI |
$15.34
|
| Rate for Payer: PHP Commercial |
$21.48
|
| Rate for Payer: PHP Medicare Advantage |
$15.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.00
|
| Rate for Payer: Priority Health Medicare |
$15.34
|
| Rate for Payer: Priority Health Narrow Network |
$25.00
|
| Rate for Payer: Priority Health SBD |
$25.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.34
|
| Rate for Payer: UHC Medicare Advantage |
$15.34
|
| Rate for Payer: UHCCP Medicaid |
$10.01
|
| Rate for Payer: UMR Bronson Commercial |
$157.32
|
|
|
PR NDSC URETEROTOMY RMVL FB/CALCULUS
|
Professional
|
Both
|
$691.00
|
|
|
Service Code
|
HCPCS 50980
|
| Min. Negotiated Rate |
$224.50 |
| Max. Negotiated Rate |
$2,962.71 |
| Rate for Payer: Aetna Commercial |
$451.89
|
| Rate for Payer: Aetna Medicare |
$350.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$451.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$485.61
|
| Rate for Payer: BCBS Complete |
$235.72
|
| Rate for Payer: BCBS MAPPO |
$337.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,962.71
|
| Rate for Payer: BCN Commercial |
$507.73
|
| Rate for Payer: BCN Medicare Advantage |
$337.23
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cofinity Commercial |
$451.89
|
| Rate for Payer: Cofinity Commercial |
$485.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$337.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$354.09
|
| Rate for Payer: Meridian Medicaid |
$235.72
|
| Rate for Payer: Nomi Health Commercial |
$404.68
|
| Rate for Payer: PACE SWMI |
$337.23
|
| Rate for Payer: PHP Commercial |
$472.12
|
| Rate for Payer: PHP Medicare Advantage |
$337.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$558.16
|
| Rate for Payer: Priority Health Medicare |
$337.23
|
| Rate for Payer: Priority Health Narrow Network |
$558.16
|
| Rate for Payer: Priority Health SBD |
$558.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$337.23
|
| Rate for Payer: UHC Medicare Advantage |
$337.23
|
| Rate for Payer: UHCCP Medicaid |
$224.50
|
| Rate for Payer: UMR Bronson Commercial |
$317.86
|
|
|
PR NDSC URETEROTOMY URTRL CATHJ W/WO DILAT URETER
|
Professional
|
Both
|
$693.00
|
|
|
Service Code
|
HCPCS 50972
|
| Min. Negotiated Rate |
$225.99 |
| Max. Negotiated Rate |
$2,720.22 |
| Rate for Payer: Aetna Commercial |
$454.92
|
| Rate for Payer: Aetna Medicare |
$353.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$454.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$488.87
|
| Rate for Payer: BCBS Complete |
$237.29
|
| Rate for Payer: BCBS MAPPO |
$339.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,720.22
|
| Rate for Payer: BCN Commercial |
$510.66
|
| Rate for Payer: BCN Medicare Advantage |
$339.49
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Cofinity Commercial |
$454.92
|
| Rate for Payer: Cofinity Commercial |
$488.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.46
|
| Rate for Payer: Meridian Medicaid |
$237.29
|
| Rate for Payer: Nomi Health Commercial |
$407.39
|
| Rate for Payer: PACE SWMI |
$339.49
|
| Rate for Payer: PHP Commercial |
$475.29
|
| Rate for Payer: PHP Medicare Advantage |
$339.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.83
|
| Rate for Payer: Priority Health Medicare |
$339.49
|
| Rate for Payer: Priority Health Narrow Network |
$560.83
|
| Rate for Payer: Priority Health SBD |
$560.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.49
|
| Rate for Payer: UHC Medicare Advantage |
$339.49
|
| Rate for Payer: UHCCP Medicaid |
$225.99
|
| Rate for Payer: UMR Bronson Commercial |
$318.78
|
|
|
PR NDSC WRST SURG W/RLS TRANSVRS CARPL LIGM
|
Professional
|
Both
|
$1,877.00
|
|
|
Service Code
|
HCPCS 29848
|
| Min. Negotiated Rate |
$337.61 |
| Max. Negotiated Rate |
$1,220.05 |
| Rate for Payer: Aetna Commercial |
$664.25
|
| Rate for Payer: Aetna Medicare |
$515.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$664.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$713.82
|
| Rate for Payer: BCBS Complete |
$354.49
|
| Rate for Payer: BCBS MAPPO |
$495.71
|
| Rate for Payer: BCBS Trust/PPO |
$571.09
|
| Rate for Payer: BCN Commercial |
$756.47
|
| Rate for Payer: BCN Medicare Advantage |
$495.71
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cash Price |
$1,501.60
|
| Rate for Payer: Cofinity Commercial |
$664.25
|
| Rate for Payer: Cofinity Commercial |
$713.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$495.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$520.50
|
| Rate for Payer: Meridian Medicaid |
$354.49
|
| Rate for Payer: Nomi Health Commercial |
$594.85
|
| Rate for Payer: PACE SWMI |
$495.71
|
| Rate for Payer: PHP Commercial |
$693.99
|
| Rate for Payer: PHP Medicare Advantage |
$495.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$337.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,220.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$797.90
|
| Rate for Payer: Priority Health Medicare |
$495.71
|
| Rate for Payer: Priority Health Narrow Network |
$797.90
|
| Rate for Payer: Priority Health SBD |
$797.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$495.71
|
| Rate for Payer: UHC Medicare Advantage |
$495.71
|
| Rate for Payer: UHCCP Medicaid |
$337.61
|
| Rate for Payer: UMR Bronson Commercial |
$863.42
|
|
|
PR NECK LIFT
|
Professional
|
Both
|
$2,040.00
|
|
|
Service Code
|
HCPCS 00541
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$816.00 |
| Max. Negotiated Rate |
$1,326.00 |
| Rate for Payer: Aetna Medicare |
$1,020.00
|
| Rate for Payer: BCBS Complete |
$816.00
|
| Rate for Payer: Cash Price |
$1,632.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,326.00
|
| Rate for Payer: UMR Bronson Commercial |
$938.40
|
|
|
PR NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 95868
|
| Min. Negotiated Rate |
$38.55 |
| Max. Negotiated Rate |
$284.75 |
| Rate for Payer: Aetna Commercial |
$153.19
|
| Rate for Payer: Aetna Medicare |
$118.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.62
|
| Rate for Payer: BCBS Complete |
$40.48
|
| Rate for Payer: BCBS MAPPO |
$114.32
|
| Rate for Payer: BCBS Trust/PPO |
$284.75
|
| Rate for Payer: BCN Commercial |
$203.29
|
| Rate for Payer: BCN Medicare Advantage |
$114.32
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$153.19
|
| Rate for Payer: Cofinity Commercial |
$164.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.04
|
| Rate for Payer: Meridian Medicaid |
$40.48
|
| Rate for Payer: Nomi Health Commercial |
$137.18
|
| Rate for Payer: PACE SWMI |
$114.32
|
| Rate for Payer: PHP Commercial |
$160.05
|
| Rate for Payer: PHP Medicare Advantage |
$114.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.71
|
| Rate for Payer: Priority Health Medicare |
$114.32
|
| Rate for Payer: Priority Health Narrow Network |
$187.71
|
| Rate for Payer: Priority Health SBD |
$82.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.32
|
| Rate for Payer: UHC Medicare Advantage |
$114.32
|
| Rate for Payer: UHCCP Medicaid |
$38.55
|
| Rate for Payer: UMR Bronson Commercial |
$123.74
|
|
|
PR NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI
|
Professional
|
Both
|
$195.00
|
|
|
Service Code
|
HCPCS 95867
|
| Min. Negotiated Rate |
$26.20 |
| Max. Negotiated Rate |
$620.75 |
| Rate for Payer: Aetna Commercial |
$126.42
|
| Rate for Payer: Aetna Medicare |
$98.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.85
|
| Rate for Payer: BCBS Complete |
$27.51
|
| Rate for Payer: BCBS MAPPO |
$94.34
|
| Rate for Payer: BCBS Trust/PPO |
$620.75
|
| Rate for Payer: BCN Commercial |
$156.38
|
| Rate for Payer: BCN Medicare Advantage |
$94.34
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cofinity Commercial |
$126.42
|
| Rate for Payer: Cofinity Commercial |
$135.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.06
|
| Rate for Payer: Meridian Medicaid |
$27.51
|
| Rate for Payer: Nomi Health Commercial |
$113.21
|
| Rate for Payer: PACE SWMI |
$94.34
|
| Rate for Payer: PHP Commercial |
$132.08
|
| Rate for Payer: PHP Medicare Advantage |
$94.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.29
|
| Rate for Payer: Priority Health Medicare |
$94.34
|
| Rate for Payer: Priority Health Narrow Network |
$144.29
|
| Rate for Payer: Priority Health SBD |
$55.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$94.34
|
| Rate for Payer: UHC Medicare Advantage |
$94.34
|
| Rate for Payer: UHCCP Medicaid |
$26.20
|
| Rate for Payer: UMR Bronson Commercial |
$89.70
|
|
|
PR NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 95866
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$665.13 |
| Rate for Payer: Aetna Commercial |
$158.99
|
| Rate for Payer: Aetna Medicare |
$123.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.86
|
| Rate for Payer: BCBS Complete |
$43.17
|
| Rate for Payer: BCBS MAPPO |
$118.65
|
| Rate for Payer: BCBS Trust/PPO |
$665.13
|
| Rate for Payer: BCN Commercial |
$184.72
|
| 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 |
$158.99
|
| Rate for Payer: Cofinity Commercial |
$170.86
|
| 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: Meridian Medicaid |
$43.17
|
| 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 Choice Medicaid |
$41.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$166.01
|
| Rate for Payer: Priority Health Medicare |
$118.65
|
| Rate for Payer: Priority Health Narrow Network |
$166.01
|
| Rate for Payer: Priority Health SBD |
$84.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.65
|
| Rate for Payer: UHC Medicare Advantage |
$118.65
|
| Rate for Payer: UHCCP Medicaid |
$41.11
|
| Rate for Payer: UMR Bronson Commercial |
$109.02
|
|
|
PR NEEDLE ELECTROMYOGRAPHY LARYNX
|
Professional
|
Both
|
$372.00
|
|
|
Service Code
|
HCPCS 95865
|
| Min. Negotiated Rate |
$51.33 |
| Max. Negotiated Rate |
$990.03 |
| Rate for Payer: Aetna Commercial |
$178.90
|
| Rate for Payer: Aetna Medicare |
$138.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.25
|
| Rate for Payer: BCBS Complete |
$53.90
|
| Rate for Payer: BCBS MAPPO |
$133.51
|
| Rate for Payer: BCBS Trust/PPO |
$990.03
|
| Rate for Payer: BCN Commercial |
$217.95
|
| 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 |
$178.90
|
| Rate for Payer: Cofinity Commercial |
$192.25
|
| 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: Meridian Medicaid |
$53.90
|
| 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 Choice Medicaid |
$51.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$201.73
|
| Rate for Payer: Priority Health Medicare |
$133.51
|
| Rate for Payer: Priority Health Narrow Network |
$201.73
|
| Rate for Payer: Priority Health SBD |
$109.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.51
|
| Rate for Payer: UHC Medicare Advantage |
$133.51
|
| Rate for Payer: UHCCP Medicaid |
$51.33
|
| 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 |
$11.50 |
| Max. Negotiated Rate |
$1,360.37 |
| 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) |
$77.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.15
|
| Rate for Payer: BCBS Complete |
$12.08
|
| Rate for Payer: BCBS Complete |
$12.08
|
| Rate for Payer: BCBS MAPPO |
$53.84
|
| Rate for Payer: BCBS MAPPO |
$53.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,360.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,360.37
|
| Rate for Payer: BCN Commercial |
$90.41
|
| Rate for Payer: BCN Commercial |
$90.41
|
| 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 |
$123.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$72.15
|
| Rate for Payer: Cofinity Commercial |
$77.53
|
| Rate for Payer: Cofinity Commercial |
$77.53
|
| 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: Meridian Medicaid |
$12.08
|
| Rate for Payer: Meridian Medicaid |
$12.08
|
| 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 Choice Medicaid |
$11.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.50
|
| 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 HMO/PPO/Tiered Network |
$83.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.68
|
| Rate for Payer: Priority Health Medicare |
$53.84
|
| Rate for Payer: Priority Health Medicare |
$53.84
|
| Rate for Payer: Priority Health Narrow Network |
$83.68
|
| Rate for Payer: Priority Health Narrow Network |
$83.68
|
| Rate for Payer: Priority Health SBD |
$24.43
|
| Rate for Payer: Priority Health SBD |
$24.43
|
| 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: UHCCP Medicaid |
$11.50
|
| Rate for Payer: UHCCP Medicaid |
$11.50
|
| Rate for Payer: UMR Bronson Commercial |
$70.84
|
| Rate for Payer: UMR Bronson Commercial |
$29.44
|
|
|
PR NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 95886
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$1,755.54 |
| 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) |
$122.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.22
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCBS MAPPO |
$85.24
|
| Rate for Payer: BCBS MAPPO |
$85.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,755.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,755.54
|
| Rate for Payer: BCN Commercial |
$142.21
|
| Rate for Payer: BCN Commercial |
$142.21
|
| 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 |
$136.00
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cofinity Commercial |
$114.22
|
| Rate for Payer: Cofinity Commercial |
$122.75
|
| Rate for Payer: Cofinity Commercial |
$122.75
|
| 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: Meridian Medicaid |
$29.75
|
| Rate for Payer: Meridian Medicaid |
$29.75
|
| 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 Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| 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 HMO/PPO/Tiered Network |
$141.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.11
|
| Rate for Payer: Priority Health Medicare |
$85.24
|
| Rate for Payer: Priority Health Medicare |
$85.24
|
| Rate for Payer: Priority Health Narrow Network |
$141.11
|
| Rate for Payer: Priority Health Narrow Network |
$141.11
|
| Rate for Payer: Priority Health SBD |
$67.22
|
| Rate for Payer: Priority Health SBD |
$67.22
|
| 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: UHCCP Medicaid |
$28.33
|
| Rate for Payer: UHCCP Medicaid |
$28.33
|
| Rate for Payer: UMR Bronson Commercial |
$78.20
|
| Rate for Payer: UMR Bronson Commercial |
$111.32
|
|
|
PR NEEDLE EMG GUID W/CHEMODENERVATION
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 95874
|
| Min. Negotiated Rate |
$12.14 |
| Max. Negotiated Rate |
$1,247.84 |
| Rate for Payer: Aetna Commercial |
$88.41
|
| Rate for Payer: Aetna Medicare |
$68.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.01
|
| Rate for Payer: BCBS Complete |
$12.75
|
| Rate for Payer: BCBS MAPPO |
$65.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,247.84
|
| Rate for Payer: BCN Commercial |
$112.89
|
| 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 |
$88.41
|
| Rate for Payer: Cofinity Commercial |
$95.01
|
| 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: Meridian Medicaid |
$12.75
|
| 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 Choice Medicaid |
$12.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.13
|
| Rate for Payer: Priority Health Medicare |
$65.98
|
| Rate for Payer: Priority Health Narrow Network |
$103.13
|
| Rate for Payer: Priority Health SBD |
$25.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.98
|
| Rate for Payer: UHC Medicare Advantage |
$65.98
|
| Rate for Payer: UHCCP Medicaid |
$12.14
|
| 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 |
$12.35 |
| Max. Negotiated Rate |
$288.98 |
| Rate for Payer: Aetna Commercial |
$96.53
|
| Rate for Payer: Aetna Medicare |
$74.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.53
|
| Rate for Payer: BCBS Complete |
$12.97
|
| Rate for Payer: BCBS MAPPO |
$72.04
|
| Rate for Payer: BCBS Trust/PPO |
$288.98
|
| Rate for Payer: BCN Commercial |
$121.68
|
| 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 |
$103.74
|
| Rate for Payer: Cofinity Commercial |
$96.53
|
| 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: Meridian Medicaid |
$12.97
|
| 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 Choice Medicaid |
$12.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.63
|
| Rate for Payer: Priority Health Medicare |
$72.04
|
| Rate for Payer: Priority Health Narrow Network |
$112.63
|
| Rate for Payer: Priority Health SBD |
$26.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.04
|
| Rate for Payer: UHC Medicare Advantage |
$72.04
|
| Rate for Payer: UHCCP Medicaid |
$12.35
|
| 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 |
$23.22 |
| Max. Negotiated Rate |
$1,456.52 |
| 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) |
$99.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.85
|
| Rate for Payer: BCBS Complete |
$24.38
|
| Rate for Payer: BCBS Complete |
$24.38
|
| Rate for Payer: BCBS MAPPO |
$74.20
|
| Rate for Payer: BCBS MAPPO |
$74.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,456.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,456.52
|
| Rate for Payer: BCN Commercial |
$122.17
|
| Rate for Payer: BCN Commercial |
$122.17
|
| 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 |
$107.20
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cofinity Commercial |
$106.85
|
| Rate for Payer: Cofinity Commercial |
$99.43
|
| Rate for Payer: Cofinity Commercial |
$99.43
|
| 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: Meridian Medicaid |
$24.38
|
| Rate for Payer: Meridian Medicaid |
$24.38
|
| 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 Choice Medicaid |
$23.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.22
|
| 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 HMO/PPO/Tiered Network |
$112.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.17
|
| Rate for Payer: Priority Health Medicare |
$74.20
|
| Rate for Payer: Priority Health Medicare |
$74.20
|
| Rate for Payer: Priority Health Narrow Network |
$112.17
|
| Rate for Payer: Priority Health Narrow Network |
$112.17
|
| Rate for Payer: Priority Health SBD |
$48.85
|
| Rate for Payer: Priority Health SBD |
$48.85
|
| 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: UHCCP Medicaid |
$23.22
|
| Rate for Payer: UHCCP Medicaid |
$23.22
|
| Rate for Payer: UMR Bronson Commercial |
$61.64
|
| Rate for Payer: UMR Bronson Commercial |
$125.12
|
|
|
PR NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12
|
Professional
|
Both
|
$146.00
|
|
|
Service Code
|
HCPCS 95869
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$296.90 |
| Rate for Payer: Aetna Commercial |
$109.17
|
| Rate for Payer: Aetna Medicare |
$84.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.32
|
| Rate for Payer: BCBS Complete |
$12.97
|
| Rate for Payer: BCBS MAPPO |
$81.47
|
| Rate for Payer: BCBS Trust/PPO |
$296.90
|
| Rate for Payer: BCN Commercial |
$140.25
|
| 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 |
$109.17
|
| Rate for Payer: Cofinity Commercial |
$117.32
|
| 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: Meridian Medicaid |
$12.97
|
| 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 Choice Medicaid |
$12.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.91
|
| Rate for Payer: Priority Health Medicare |
$81.47
|
| Rate for Payer: Priority Health Narrow Network |
$128.91
|
| Rate for Payer: Priority Health SBD |
$26.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.47
|
| Rate for Payer: UHC Medicare Advantage |
$81.47
|
| Rate for Payer: UHCCP Medicaid |
$12.35
|
| 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 |
$92.66 |
| Max. Negotiated Rate |
$411.55 |
| Rate for Payer: Aetna Commercial |
$229.42
|
| Rate for Payer: Aetna Medicare |
$178.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.54
|
| Rate for Payer: BCBS Complete |
$97.29
|
| Rate for Payer: BCBS MAPPO |
$171.21
|
| Rate for Payer: BCBS Trust/PPO |
$411.55
|
| Rate for Payer: BCN Commercial |
$287.34
|
| 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 |
$229.42
|
| Rate for Payer: Cofinity Commercial |
$246.54
|
| 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: Meridian Medicaid |
$97.29
|
| 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 Choice Medicaid |
$92.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.65
|
| Rate for Payer: Priority Health Medicare |
$171.21
|
| Rate for Payer: Priority Health Narrow Network |
$254.65
|
| Rate for Payer: Priority Health SBD |
$197.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.21
|
| Rate for Payer: UHC Medicare Advantage |
$171.21
|
| Rate for Payer: UHCCP Medicaid |
$92.66
|
| 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 |
$37.63 |
| Rate for Payer: Aetna Commercial |
$19.23
|
| Rate for Payer: Aetna Medicare |
$14.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.66
|
| Rate for Payer: BCBS Complete |
$20.80
|
| Rate for Payer: BCBS MAPPO |
$14.35
|
| Rate for Payer: BCBS Trust/PPO |
$37.50
|
| Rate for Payer: BCN Commercial |
$37.63
|
| 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 |
$19.23
|
| Rate for Payer: Cofinity Commercial |
$20.66
|
| 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 HMO/PPO/Tiered Network |
$22.40
|
| Rate for Payer: Priority Health Medicare |
$14.35
|
| Rate for Payer: Priority Health Narrow Network |
$22.40
|
| Rate for Payer: Priority Health SBD |
$22.40
|
| 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 |
$54.73 |
| Rate for Payer: Aetna Commercial |
$29.04
|
| Rate for Payer: Aetna Medicare |
$22.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.20
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: BCBS MAPPO |
$21.67
|
| Rate for Payer: BCBS Trust/PPO |
$37.50
|
| Rate for Payer: BCN Commercial |
$54.73
|
| 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 HMO/PPO/Tiered Network |
$33.59
|
| Rate for Payer: Priority Health Medicare |
$21.67
|
| Rate for Payer: Priority Health Narrow Network |
$33.59
|
| Rate for Payer: Priority Health SBD |
$33.59
|
| 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 |
$15.55 |
| Max. Negotiated Rate |
$796.68 |
| Rate for Payer: Aetna Commercial |
$31.06
|
| Rate for Payer: Aetna Medicare |
$24.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.38
|
| Rate for Payer: BCBS Complete |
$16.33
|
| Rate for Payer: BCBS MAPPO |
$23.18
|
| Rate for Payer: BCBS Trust/PPO |
$796.68
|
| Rate for Payer: BCN Commercial |
$62.06
|
| 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 |
$31.06
|
| Rate for Payer: Cofinity Commercial |
$33.38
|
| 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: Meridian Medicaid |
$16.33
|
| 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 Choice Medicaid |
$15.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.51
|
| Rate for Payer: Priority Health Medicare |
$23.18
|
| Rate for Payer: Priority Health Narrow Network |
$34.51
|
| Rate for Payer: Priority Health SBD |
$34.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.18
|
| Rate for Payer: UHC Medicare Advantage |
$23.18
|
| Rate for Payer: UHCCP Medicaid |
$15.55
|
| 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 |
$16.83 |
| Max. Negotiated Rate |
$1,160.68 |
| Rate for Payer: Aetna Commercial |
$33.62
|
| Rate for Payer: Aetna Medicare |
$26.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.13
|
| Rate for Payer: BCBS Complete |
$17.67
|
| Rate for Payer: BCBS MAPPO |
$25.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,160.68
|
| Rate for Payer: BCN Commercial |
$74.28
|
| 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 |
$33.62
|
| Rate for Payer: Cofinity Commercial |
$36.13
|
| 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: Meridian Medicaid |
$17.67
|
| 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 Choice Medicaid |
$16.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.30
|
| Rate for Payer: Priority Health Medicare |
$25.09
|
| Rate for Payer: Priority Health Narrow Network |
$37.30
|
| Rate for Payer: Priority Health SBD |
$37.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.09
|
| Rate for Payer: UHC Medicare Advantage |
$25.09
|
| Rate for Payer: UHCCP Medicaid |
$16.83
|
| 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 |
$13.42 |
| Max. Negotiated Rate |
$768.68 |
| Rate for Payer: Aetna Commercial |
$27.03
|
| Rate for Payer: Aetna Medicare |
$20.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.04
|
| Rate for Payer: BCBS Complete |
$14.09
|
| Rate for Payer: BCBS MAPPO |
$20.17
|
| Rate for Payer: BCBS Trust/PPO |
$768.68
|
| Rate for Payer: BCN Commercial |
$535.59
|
| 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 |
$27.03
|
| Rate for Payer: Cofinity Commercial |
$29.04
|
| 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: Meridian Medicaid |
$14.09
|
| 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 Choice Medicaid |
$13.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.82
|
| Rate for Payer: Priority Health Medicare |
$20.17
|
| Rate for Payer: Priority Health Narrow Network |
$35.82
|
| Rate for Payer: Priority Health SBD |
$35.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.17
|
| Rate for Payer: UHC Medicare Advantage |
$20.17
|
| Rate for Payer: UHCCP Medicaid |
$13.42
|
| 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 |
$15.55 |
| Max. Negotiated Rate |
$1,073.51 |
| Rate for Payer: Aetna Commercial |
$31.50
|
| Rate for Payer: Aetna Medicare |
$24.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.85
|
| Rate for Payer: BCBS Complete |
$16.33
|
| Rate for Payer: BCBS MAPPO |
$23.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,073.51
|
| Rate for Payer: BCN Commercial |
$537.55
|
| 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 |
$31.50
|
| Rate for Payer: Cofinity Commercial |
$33.85
|
| 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: Meridian Medicaid |
$16.33
|
| 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 Choice Medicaid |
$15.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.48
|
| Rate for Payer: Priority Health Medicare |
$23.51
|
| Rate for Payer: Priority Health Narrow Network |
$39.48
|
| Rate for Payer: Priority Health SBD |
$39.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.51
|
| Rate for Payer: UHC Medicare Advantage |
$23.51
|
| Rate for Payer: UHCCP Medicaid |
$15.55
|
| Rate for Payer: UMR Bronson Commercial |
$70.38
|
|
