|
PR PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS
|
Professional
|
Both
|
$174.00
|
|
|
Service Code
|
HCPCS 99395
|
| Min. Negotiated Rate |
$77.66 |
| Max. Negotiated Rate |
$130.50 |
| Rate for Payer: Aetna Commercial |
$90.96
|
| Rate for Payer: Aetna Medicare |
$87.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.96
|
| Rate for Payer: BCBS Complete |
$81.54
|
| Rate for Payer: BCN Commercial |
$127.86
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$81.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$130.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$111.50
|
| Rate for Payer: Priority Health SBD |
$111.50
|
| Rate for Payer: Priority Health Tiered Network |
$111.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.76
|
| Rate for Payer: UHC Core |
$127.76
|
| Rate for Payer: UHC Exchange |
$127.76
|
| Rate for Payer: UHC Medicaid |
$77.66
|
| Rate for Payer: UHCCP Medicaid |
$77.66
|
| Rate for Payer: UMR Bronson Commercial |
$80.04
|
|
|
PR PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS
|
Professional
|
Both
|
$187.00
|
|
|
Service Code
|
HCPCS 99396
|
| Min. Negotiated Rate |
$85.27 |
| Max. Negotiated Rate |
$140.25 |
| Rate for Payer: Aetna Commercial |
$98.74
|
| Rate for Payer: Aetna Medicare |
$93.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.74
|
| Rate for Payer: BCBS Complete |
$89.53
|
| Rate for Payer: BCN Commercial |
$135.86
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Meridian Medicaid |
$89.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$121.08
|
| Rate for Payer: Priority Health SBD |
$121.08
|
| Rate for Payer: Priority Health Tiered Network |
$121.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.27
|
| Rate for Payer: UHC Core |
$139.27
|
| Rate for Payer: UHC Exchange |
$139.27
|
| Rate for Payer: UHC Medicaid |
$85.27
|
| Rate for Payer: UHCCP Medicaid |
$85.27
|
| Rate for Payer: UMR Bronson Commercial |
$86.02
|
|
|
PR PERIODIC PREVENTIVE MED EST PATIENT 5-11YRS
|
Professional
|
Both
|
$157.00
|
|
|
Service Code
|
HCPCS 99393
|
| Min. Negotiated Rate |
$66.69 |
| Max. Negotiated Rate |
$117.75 |
| Rate for Payer: Aetna Commercial |
$78.23
|
| Rate for Payer: Aetna Medicare |
$78.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.23
|
| Rate for Payer: BCBS Complete |
$70.02
|
| Rate for Payer: BCN Commercial |
$113.70
|
| Rate for Payer: Cash Price |
$125.60
|
| Rate for Payer: Cash Price |
$125.60
|
| Rate for Payer: Meridian Medicaid |
$70.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$94.51
|
| Rate for Payer: Priority Health SBD |
$94.51
|
| Rate for Payer: Priority Health Tiered Network |
$94.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.70
|
| Rate for Payer: UHC Core |
$109.70
|
| Rate for Payer: UHC Exchange |
$109.70
|
| Rate for Payer: UHC Medicaid |
$66.69
|
| Rate for Payer: UHCCP Medicaid |
$66.69
|
| Rate for Payer: UMR Bronson Commercial |
$72.22
|
|
|
PR PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
HCPCS 99397
|
| Min. Negotiated Rate |
$89.84 |
| Max. Negotiated Rate |
$151.50 |
| Rate for Payer: Aetna Commercial |
$103.72
|
| Rate for Payer: Aetna Medicare |
$101.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.72
|
| Rate for Payer: BCBS Complete |
$94.33
|
| Rate for Payer: BCN Commercial |
$146.39
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Meridian Medicaid |
$94.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$151.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$127.18
|
| Rate for Payer: Priority Health SBD |
$127.18
|
| Rate for Payer: Priority Health Tiered Network |
$127.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.79
|
| Rate for Payer: UHC Core |
$146.79
|
| Rate for Payer: UHC Exchange |
$146.79
|
| Rate for Payer: UHC Medicaid |
$89.84
|
| Rate for Payer: UHCCP Medicaid |
$89.84
|
| Rate for Payer: UMR Bronson Commercial |
$92.92
|
|
|
PR PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON
|
Professional
|
Both
|
$70.00
|
|
|
Service Code
|
HCPCS 93286
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$66.24 |
| Rate for Payer: Aetna Commercial |
$55.68
|
| Rate for Payer: Aetna Medicare |
$43.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.83
|
| Rate for Payer: BCBS MAPPO |
$41.55
|
| Rate for Payer: BCN Commercial |
$66.24
|
| Rate for Payer: BCN Medicare Advantage |
$41.55
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cofinity Commercial |
$59.83
|
| Rate for Payer: Cofinity Commercial |
$55.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.70
|
| Rate for Payer: Nomi Health Commercial |
$49.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.50
|
| Rate for Payer: PACE SWMI |
$41.55
|
| Rate for Payer: PHP Commercial |
$58.17
|
| Rate for Payer: PHP Medicare Advantage |
$41.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$62.95
|
| Rate for Payer: Priority Health Medicare |
$41.55
|
| Rate for Payer: Priority Health SBD |
$62.95
|
| Rate for Payer: Priority Health Tiered Network |
$62.95
|
| Rate for Payer: Railroad Medicare Medicare |
$41.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.19
|
| Rate for Payer: UHC Core |
$62.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.55
|
| Rate for Payer: UHC Exchange |
$62.19
|
| Rate for Payer: UMR Bronson Commercial |
$32.20
|
|
|
PR PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 93287
|
| Min. Negotiated Rate |
$22.08 |
| Max. Negotiated Rate |
$76.69 |
| Rate for Payer: Aetna Commercial |
$65.34
|
| Rate for Payer: Aetna Medicare |
$50.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.21
|
| Rate for Payer: BCBS MAPPO |
$48.76
|
| Rate for Payer: BCN Commercial |
$76.69
|
| Rate for Payer: BCN Medicare Advantage |
$48.76
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$65.34
|
| Rate for Payer: Cofinity Commercial |
$70.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.64
|
| Rate for Payer: Nomi Health Commercial |
$58.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.00
|
| Rate for Payer: PACE SWMI |
$48.76
|
| Rate for Payer: PHP Commercial |
$68.26
|
| Rate for Payer: PHP Medicare Advantage |
$48.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$72.88
|
| Rate for Payer: Priority Health Medicare |
$48.76
|
| Rate for Payer: Priority Health SBD |
$72.88
|
| Rate for Payer: Priority Health Tiered Network |
$72.88
|
| Rate for Payer: Railroad Medicare Medicare |
$48.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.67
|
| Rate for Payer: UHC Core |
$74.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$48.76
|
| Rate for Payer: UHC Exchange |
$74.67
|
| Rate for Payer: UMR Bronson Commercial |
$22.08
|
|
|
PR PERIRECTAL INJ SCLEROSING SOLUTION PROLAPSE
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 45520
|
| Min. Negotiated Rate |
$24.07 |
| Max. Negotiated Rate |
$224.25 |
| Rate for Payer: Aetna Commercial |
$48.95
|
| Rate for Payer: Aetna Medicare |
$37.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.60
|
| Rate for Payer: BCBS Complete |
$25.27
|
| Rate for Payer: BCBS MAPPO |
$36.53
|
| Rate for Payer: BCN Commercial |
$60.76
|
| Rate for Payer: BCN Medicare Advantage |
$36.53
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cofinity Commercial |
$52.60
|
| Rate for Payer: Cofinity Commercial |
$48.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.36
|
| Rate for Payer: Meridian Medicaid |
$25.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.18
|
| Rate for Payer: Nomi Health Commercial |
$43.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$224.25
|
| Rate for Payer: PACE SWMI |
$36.53
|
| Rate for Payer: PHP Commercial |
$51.14
|
| Rate for Payer: PHP Medicare Advantage |
$36.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$74.02
|
| Rate for Payer: Priority Health Medicare |
$36.53
|
| Rate for Payer: Priority Health SBD |
$74.02
|
| Rate for Payer: Priority Health Tiered Network |
$74.02
|
| Rate for Payer: Railroad Medicare Medicare |
$36.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.43
|
| Rate for Payer: UHC Core |
$69.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.53
|
| Rate for Payer: UHC Exchange |
$69.43
|
| Rate for Payer: UHC Medicaid |
$24.07
|
| Rate for Payer: UHCCP Medicaid |
$24.07
|
| Rate for Payer: UMR Bronson Commercial |
$137.54
|
|
|
PR PERITONEAL LAVAGE W/WO IMAGING GUIDANCE
|
Professional
|
Both
|
$141.00
|
|
|
Service Code
|
HCPCS 49084
|
| Min. Negotiated Rate |
$61.13 |
| Max. Negotiated Rate |
$195.38 |
| Rate for Payer: Aetna Commercial |
$129.32
|
| Rate for Payer: Aetna Medicare |
$100.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.97
|
| Rate for Payer: BCBS Complete |
$64.19
|
| Rate for Payer: BCBS MAPPO |
$96.51
|
| Rate for Payer: BCN Commercial |
$160.35
|
| Rate for Payer: BCN Medicare Advantage |
$96.51
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cofinity Commercial |
$129.32
|
| Rate for Payer: Cofinity Commercial |
$138.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.34
|
| Rate for Payer: Meridian Medicaid |
$64.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$106.16
|
| Rate for Payer: Nomi Health Commercial |
$115.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.75
|
| Rate for Payer: PACE SWMI |
$96.51
|
| Rate for Payer: PHP Commercial |
$135.11
|
| Rate for Payer: PHP Medicare Advantage |
$96.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$195.38
|
| Rate for Payer: Priority Health Medicare |
$96.51
|
| Rate for Payer: Priority Health SBD |
$195.38
|
| Rate for Payer: Priority Health Tiered Network |
$195.38
|
| Rate for Payer: Railroad Medicare Medicare |
$96.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$194.51
|
| Rate for Payer: UHC Core |
$194.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$96.51
|
| Rate for Payer: UHC Exchange |
$194.51
|
| Rate for Payer: UHC Medicaid |
$61.13
|
| Rate for Payer: UHCCP Medicaid |
$61.13
|
| Rate for Payer: UMR Bronson Commercial |
$64.86
|
|
|
PR PERQ ACCESS & CLOSURE FEM ART FOR DELIVERY NDGFT
|
Professional
|
Both
|
$275.00
|
|
|
Service Code
|
HCPCS 34713
|
| Min. Negotiated Rate |
$70.29 |
| Max. Negotiated Rate |
$224.88 |
| Rate for Payer: Aetna Commercial |
$150.15
|
| Rate for Payer: Aetna Medicare |
$116.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.35
|
| Rate for Payer: BCBS Complete |
$73.80
|
| Rate for Payer: BCBS MAPPO |
$112.05
|
| Rate for Payer: BCN Commercial |
$179.28
|
| Rate for Payer: BCN Medicare Advantage |
$112.05
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cofinity Commercial |
$150.15
|
| Rate for Payer: Cofinity Commercial |
$161.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.65
|
| Rate for Payer: Meridian Medicaid |
$73.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$123.25
|
| Rate for Payer: Nomi Health Commercial |
$134.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.25
|
| Rate for Payer: PACE SWMI |
$112.05
|
| Rate for Payer: PHP Commercial |
$156.87
|
| Rate for Payer: PHP Medicare Advantage |
$112.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$192.79
|
| Rate for Payer: Priority Health Medicare |
$112.05
|
| Rate for Payer: Priority Health SBD |
$192.79
|
| Rate for Payer: Priority Health Tiered Network |
$192.79
|
| Rate for Payer: Railroad Medicare Medicare |
$112.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.88
|
| Rate for Payer: UHC Core |
$224.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$112.05
|
| Rate for Payer: UHC Exchange |
$224.88
|
| Rate for Payer: UHC Medicaid |
$70.29
|
| Rate for Payer: UHCCP Medicaid |
$70.29
|
| Rate for Payer: UMR Bronson Commercial |
$126.50
|
|
|
PR PERQ ART TRLUML M-THROMBEC &/NFS INTRACRANIAL
|
Professional
|
Both
|
$1,663.00
|
|
|
Service Code
|
HCPCS 61645
|
| Min. Negotiated Rate |
$482.02 |
| Max. Negotiated Rate |
$1,487.75 |
| Rate for Payer: Aetna Commercial |
$1,023.37
|
| Rate for Payer: Aetna Medicare |
$794.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,023.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,099.74
|
| Rate for Payer: BCBS Complete |
$506.12
|
| Rate for Payer: BCBS MAPPO |
$763.71
|
| Rate for Payer: BCN Commercial |
$1,264.87
|
| Rate for Payer: BCN Medicare Advantage |
$763.71
|
| Rate for Payer: Cash Price |
$1,330.40
|
| Rate for Payer: Cash Price |
$1,330.40
|
| Rate for Payer: Cofinity Commercial |
$1,023.37
|
| Rate for Payer: Cofinity Commercial |
$1,099.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$763.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$801.90
|
| Rate for Payer: Meridian Medicaid |
$506.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$840.08
|
| Rate for Payer: Nomi Health Commercial |
$916.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,247.25
|
| Rate for Payer: PACE SWMI |
$763.71
|
| Rate for Payer: PHP Commercial |
$1,069.19
|
| Rate for Payer: PHP Medicare Advantage |
$763.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,469.12
|
| Rate for Payer: Priority Health Medicare |
$763.71
|
| Rate for Payer: Priority Health SBD |
$1,469.12
|
| Rate for Payer: Priority Health Tiered Network |
$1,469.12
|
| Rate for Payer: Railroad Medicare Medicare |
$763.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,487.75
|
| Rate for Payer: UHC Core |
$1,487.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$763.71
|
| Rate for Payer: UHC Exchange |
$1,487.75
|
| Rate for Payer: UHC Medicaid |
$482.02
|
| Rate for Payer: UHCCP Medicaid |
$482.02
|
| Rate for Payer: UMR Bronson Commercial |
$764.98
|
|
|
PR PERQ BALO DILA IC VSPSM EA VSL DIFF VASC TER
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 61642
|
| Min. Negotiated Rate |
$285.60 |
| Max. Negotiated Rate |
$617.84 |
| Rate for Payer: Aetna Commercial |
$445.23
|
| Rate for Payer: Aetna Medicare |
$357.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$445.23
|
| Rate for Payer: BCBS Complete |
$285.60
|
| Rate for Payer: BCN Commercial |
$490.01
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$535.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$569.14
|
| Rate for Payer: Priority Health SBD |
$569.14
|
| Rate for Payer: Priority Health Tiered Network |
$569.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$617.84
|
| Rate for Payer: UHC Core |
$617.84
|
| Rate for Payer: UHC Exchange |
$617.84
|
| Rate for Payer: UMR Bronson Commercial |
$328.44
|
|
|
PR PERQ BALO DILA IC VSPSM EA VSL SM VASC TER
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 61641
|
| Min. Negotiated Rate |
$142.80 |
| Max. Negotiated Rate |
$308.92 |
| Rate for Payer: Aetna Commercial |
$222.61
|
| Rate for Payer: Aetna Medicare |
$178.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.61
|
| Rate for Payer: BCBS Complete |
$142.80
|
| Rate for Payer: BCN Commercial |
$245.01
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$284.56
|
| Rate for Payer: Priority Health SBD |
$284.56
|
| Rate for Payer: Priority Health Tiered Network |
$284.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.92
|
| Rate for Payer: UHC Core |
$308.92
|
| Rate for Payer: UHC Exchange |
$308.92
|
| Rate for Payer: UMR Bronson Commercial |
$164.22
|
|
|
PR PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG
|
Professional
|
Both
|
$231.00
|
|
|
Service Code
|
HCPCS 19285
|
| Min. Negotiated Rate |
$45.80 |
| Max. Negotiated Rate |
$173.25 |
| Rate for Payer: Aetna Commercial |
$96.06
|
| Rate for Payer: Aetna Medicare |
$74.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.06
|
| Rate for Payer: BCBS Complete |
$48.09
|
| Rate for Payer: BCBS MAPPO |
$71.69
|
| Rate for Payer: BCN Commercial |
$123.49
|
| Rate for Payer: BCN Medicare Advantage |
$71.69
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$96.06
|
| Rate for Payer: Cofinity Commercial |
$103.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.27
|
| Rate for Payer: Meridian Medicaid |
$48.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.86
|
| Rate for Payer: Nomi Health Commercial |
$86.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$173.25
|
| Rate for Payer: PACE SWMI |
$71.69
|
| Rate for Payer: PHP Commercial |
$100.37
|
| Rate for Payer: PHP Medicare Advantage |
$71.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$113.03
|
| Rate for Payer: Priority Health Medicare |
$71.69
|
| Rate for Payer: Priority Health SBD |
$113.03
|
| Rate for Payer: Priority Health Tiered Network |
$113.03
|
| Rate for Payer: Railroad Medicare Medicare |
$71.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.98
|
| Rate for Payer: UHC Core |
$152.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.69
|
| Rate for Payer: UHC Exchange |
$152.98
|
| Rate for Payer: UHC Medicaid |
$45.80
|
| Rate for Payer: UHCCP Medicaid |
$45.80
|
| Rate for Payer: UMR Bronson Commercial |
$106.26
|
|
|
PR PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE
|
Professional
|
Both
|
$70.00
|
|
|
Service Code
|
HCPCS 19286
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$77.41 |
| Rate for Payer: Aetna Commercial |
$48.24
|
| Rate for Payer: Aetna Medicare |
$37.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.84
|
| Rate for Payer: BCBS Complete |
$24.15
|
| Rate for Payer: BCBS MAPPO |
$36.00
|
| Rate for Payer: BCN Commercial |
$61.75
|
| Rate for Payer: BCN Medicare Advantage |
$36.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cofinity Commercial |
$48.24
|
| Rate for Payer: Cofinity Commercial |
$51.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.80
|
| Rate for Payer: Meridian Medicaid |
$24.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.60
|
| Rate for Payer: Nomi Health Commercial |
$43.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.50
|
| Rate for Payer: PACE SWMI |
$36.00
|
| Rate for Payer: PHP Commercial |
$50.40
|
| Rate for Payer: PHP Medicare Advantage |
$36.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$56.52
|
| Rate for Payer: Priority Health Medicare |
$36.00
|
| Rate for Payer: Priority Health SBD |
$56.52
|
| Rate for Payer: Priority Health Tiered Network |
$56.52
|
| Rate for Payer: Railroad Medicare Medicare |
$36.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.41
|
| Rate for Payer: UHC Core |
$77.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.00
|
| Rate for Payer: UHC Exchange |
$77.41
|
| Rate for Payer: UHC Medicaid |
$23.00
|
| Rate for Payer: UHCCP Medicaid |
$23.00
|
| Rate for Payer: UMR Bronson Commercial |
$32.20
|
|
|
PR PERQ CLSR TCAT L ATR APNDGE W/ENDOCARDIAL IMPLNT
|
Professional
|
Both
|
$1,713.00
|
|
|
Service Code
|
HCPCS 33340
|
| Min. Negotiated Rate |
$394.48 |
| Max. Negotiated Rate |
$1,408.50 |
| Rate for Payer: Aetna Commercial |
$818.40
|
| Rate for Payer: Aetna Medicare |
$635.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$818.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$879.48
|
| Rate for Payer: BCBS Complete |
$414.20
|
| Rate for Payer: BCBS MAPPO |
$610.75
|
| Rate for Payer: BCN Commercial |
$1,138.89
|
| Rate for Payer: BCN Medicare Advantage |
$610.75
|
| Rate for Payer: Cash Price |
$1,370.40
|
| Rate for Payer: Cash Price |
$1,370.40
|
| Rate for Payer: Cofinity Commercial |
$818.40
|
| Rate for Payer: Cofinity Commercial |
$879.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$610.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$641.29
|
| Rate for Payer: Meridian Medicaid |
$414.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$671.83
|
| Rate for Payer: Nomi Health Commercial |
$732.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,284.75
|
| Rate for Payer: PACE SWMI |
$610.75
|
| Rate for Payer: PHP Commercial |
$855.05
|
| Rate for Payer: PHP Medicare Advantage |
$610.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$394.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,224.72
|
| Rate for Payer: Priority Health Medicare |
$610.75
|
| Rate for Payer: Priority Health SBD |
$1,224.72
|
| Rate for Payer: Priority Health Tiered Network |
$1,224.72
|
| Rate for Payer: Railroad Medicare Medicare |
$610.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,408.50
|
| Rate for Payer: UHC Core |
$1,408.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$610.75
|
| Rate for Payer: UHC Exchange |
$1,408.50
|
| Rate for Payer: UHC Medicaid |
$394.48
|
| Rate for Payer: UHCCP Medicaid |
$394.48
|
| Rate for Payer: UMR Bronson Commercial |
$787.98
|
|
|
PR PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS 19281
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$282.75 |
| Rate for Payer: Aetna Commercial |
$111.18
|
| Rate for Payer: Aetna Medicare |
$86.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.48
|
| Rate for Payer: BCBS Complete |
$55.69
|
| Rate for Payer: BCBS MAPPO |
$82.97
|
| Rate for Payer: BCN Commercial |
$144.41
|
| Rate for Payer: BCN Medicare Advantage |
$82.97
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cofinity Commercial |
$111.18
|
| Rate for Payer: Cofinity Commercial |
$119.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.12
|
| Rate for Payer: Meridian Medicaid |
$55.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$91.27
|
| Rate for Payer: Nomi Health Commercial |
$99.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.75
|
| Rate for Payer: PACE SWMI |
$82.97
|
| Rate for Payer: PHP Commercial |
$116.16
|
| Rate for Payer: PHP Medicare Advantage |
$82.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$132.17
|
| Rate for Payer: Priority Health Medicare |
$82.97
|
| Rate for Payer: Priority Health SBD |
$132.17
|
| Rate for Payer: Priority Health Tiered Network |
$132.17
|
| Rate for Payer: Railroad Medicare Medicare |
$82.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.14
|
| Rate for Payer: UHC Core |
$178.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$82.97
|
| Rate for Payer: UHC Exchange |
$178.14
|
| Rate for Payer: UHC Medicaid |
$53.04
|
| Rate for Payer: UHCCP Medicaid |
$53.04
|
| Rate for Payer: UMR Bronson Commercial |
$173.42
|
|
|
PR PERQ DEVICE PLACEMT BREAST LOC EA LESION W/GDNCE
|
Professional
|
Both
|
$263.00
|
|
|
Service Code
|
HCPCS 19282
|
| Min. Negotiated Rate |
$26.41 |
| Max. Negotiated Rate |
$197.25 |
| Rate for Payer: Aetna Commercial |
$55.26
|
| Rate for Payer: Aetna Medicare |
$42.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.39
|
| Rate for Payer: BCBS Complete |
$27.73
|
| Rate for Payer: BCBS MAPPO |
$41.24
|
| Rate for Payer: BCN Commercial |
$72.21
|
| Rate for Payer: BCN Medicare Advantage |
$41.24
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cofinity Commercial |
$55.26
|
| Rate for Payer: Cofinity Commercial |
$59.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.30
|
| Rate for Payer: Meridian Medicaid |
$27.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.36
|
| Rate for Payer: Nomi Health Commercial |
$49.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.25
|
| Rate for Payer: PACE SWMI |
$41.24
|
| Rate for Payer: PHP Commercial |
$57.74
|
| Rate for Payer: PHP Medicare Advantage |
$41.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$66.08
|
| Rate for Payer: Priority Health Medicare |
$41.24
|
| Rate for Payer: Priority Health SBD |
$66.08
|
| Rate for Payer: Priority Health Tiered Network |
$66.08
|
| Rate for Payer: Railroad Medicare Medicare |
$41.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.70
|
| Rate for Payer: UHC Core |
$89.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.24
|
| Rate for Payer: UHC Exchange |
$89.70
|
| Rate for Payer: UHC Medicaid |
$26.41
|
| Rate for Payer: UHCCP Medicaid |
$26.41
|
| Rate for Payer: UMR Bronson Commercial |
$120.98
|
|
|
PR PERQ DILATION XST TRC ENDOUROLOGIC PX W/IMG
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 50436
|
| Min. Negotiated Rate |
$86.90 |
| Max. Negotiated Rate |
$266.20 |
| Rate for Payer: Aetna Commercial |
$180.66
|
| Rate for Payer: Aetna Medicare |
$140.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.14
|
| Rate for Payer: BCBS Complete |
$91.25
|
| Rate for Payer: BCBS MAPPO |
$134.82
|
| Rate for Payer: BCN Commercial |
$223.60
|
| Rate for Payer: BCN Medicare Advantage |
$134.82
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cofinity Commercial |
$180.66
|
| Rate for Payer: Cofinity Commercial |
$194.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.56
|
| Rate for Payer: Meridian Medicaid |
$91.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$148.30
|
| Rate for Payer: Nomi Health Commercial |
$161.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$235.50
|
| Rate for Payer: PACE SWMI |
$134.82
|
| Rate for Payer: PHP Commercial |
$188.75
|
| Rate for Payer: PHP Medicare Advantage |
$134.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$243.57
|
| Rate for Payer: Priority Health Medicare |
$134.82
|
| Rate for Payer: Priority Health SBD |
$243.57
|
| Rate for Payer: Priority Health Tiered Network |
$243.57
|
| Rate for Payer: Railroad Medicare Medicare |
$134.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.20
|
| Rate for Payer: UHC Core |
$266.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$134.82
|
| Rate for Payer: UHC Exchange |
$266.20
|
| Rate for Payer: UHC Medicaid |
$86.90
|
| Rate for Payer: UHCCP Medicaid |
$86.90
|
| Rate for Payer: UMR Bronson Commercial |
$144.44
|
|
|
PR PERQ DILATION XST TRC NEW ACCESS RENAL COLTJ SYS
|
Professional
|
Both
|
$877.00
|
|
|
Service Code
|
HCPCS 50437
|
| Min. Negotiated Rate |
$142.92 |
| Max. Negotiated Rate |
$657.75 |
| Rate for Payer: Aetna Commercial |
$298.12
|
| Rate for Payer: Aetna Medicare |
$231.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.37
|
| Rate for Payer: BCBS Complete |
$150.07
|
| Rate for Payer: BCBS MAPPO |
$222.48
|
| Rate for Payer: BCN Commercial |
$371.49
|
| Rate for Payer: BCN Medicare Advantage |
$222.48
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cofinity Commercial |
$298.12
|
| Rate for Payer: Cofinity Commercial |
$320.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$233.60
|
| Rate for Payer: Meridian Medicaid |
$150.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$244.73
|
| Rate for Payer: Nomi Health Commercial |
$266.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$657.75
|
| Rate for Payer: PACE SWMI |
$222.48
|
| Rate for Payer: PHP Commercial |
$311.47
|
| Rate for Payer: PHP Medicare Advantage |
$222.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$142.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$404.67
|
| Rate for Payer: Priority Health Medicare |
$222.48
|
| Rate for Payer: Priority Health SBD |
$404.67
|
| Rate for Payer: Priority Health Tiered Network |
$404.67
|
| Rate for Payer: Railroad Medicare Medicare |
$222.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$447.23
|
| Rate for Payer: UHC Core |
$447.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$222.48
|
| Rate for Payer: UHC Exchange |
$447.23
|
| Rate for Payer: UHC Medicaid |
$142.92
|
| Rate for Payer: UHCCP Medicaid |
$142.92
|
| Rate for Payer: UMR Bronson Commercial |
$403.42
|
|
|
PR PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING
|
Professional
|
Both
|
$1,014.00
|
|
|
Service Code
|
HCPCS 32557
|
| Min. Negotiated Rate |
$82.43 |
| Max. Negotiated Rate |
$760.50 |
| Rate for Payer: Aetna Commercial |
$173.17
|
| Rate for Payer: Aetna Medicare |
$134.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.09
|
| Rate for Payer: BCBS Complete |
$86.55
|
| Rate for Payer: BCBS MAPPO |
$129.23
|
| Rate for Payer: BCN Commercial |
$218.12
|
| Rate for Payer: BCN Medicare Advantage |
$129.23
|
| Rate for Payer: Cash Price |
$811.20
|
| Rate for Payer: Cash Price |
$811.20
|
| Rate for Payer: Cofinity Commercial |
$173.17
|
| Rate for Payer: Cofinity Commercial |
$186.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.69
|
| Rate for Payer: Meridian Medicaid |
$86.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$142.15
|
| Rate for Payer: Nomi Health Commercial |
$155.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$760.50
|
| Rate for Payer: PACE SWMI |
$129.23
|
| Rate for Payer: PHP Commercial |
$180.92
|
| Rate for Payer: PHP Medicare Advantage |
$129.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$205.40
|
| Rate for Payer: Priority Health Medicare |
$129.23
|
| Rate for Payer: Priority Health SBD |
$205.40
|
| Rate for Payer: Priority Health Tiered Network |
$205.40
|
| Rate for Payer: Railroad Medicare Medicare |
$129.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.90
|
| Rate for Payer: UHC Core |
$270.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$129.23
|
| Rate for Payer: UHC Exchange |
$270.90
|
| Rate for Payer: UHC Medicaid |
$82.43
|
| Rate for Payer: UHCCP Medicaid |
$82.43
|
| Rate for Payer: UMR Bronson Commercial |
$466.44
|
|
|
PR PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING
|
Professional
|
Both
|
$911.00
|
|
|
Service Code
|
HCPCS 32556
|
| Min. Negotiated Rate |
$71.36 |
| Max. Negotiated Rate |
$683.25 |
| Rate for Payer: Aetna Commercial |
$149.97
|
| Rate for Payer: Aetna Medicare |
$116.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.16
|
| Rate for Payer: BCBS Complete |
$74.93
|
| Rate for Payer: BCBS MAPPO |
$111.92
|
| Rate for Payer: BCN Commercial |
$183.76
|
| Rate for Payer: BCN Medicare Advantage |
$111.92
|
| Rate for Payer: Cash Price |
$728.80
|
| Rate for Payer: Cash Price |
$728.80
|
| Rate for Payer: Cofinity Commercial |
$149.97
|
| Rate for Payer: Cofinity Commercial |
$161.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.52
|
| Rate for Payer: Meridian Medicaid |
$74.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$123.11
|
| Rate for Payer: Nomi Health Commercial |
$134.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$683.25
|
| Rate for Payer: PACE SWMI |
$111.92
|
| Rate for Payer: PHP Commercial |
$156.69
|
| Rate for Payer: PHP Medicare Advantage |
$111.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$173.04
|
| Rate for Payer: Priority Health Medicare |
$111.92
|
| Rate for Payer: Priority Health SBD |
$173.04
|
| Rate for Payer: Priority Health Tiered Network |
$173.04
|
| Rate for Payer: Railroad Medicare Medicare |
$111.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.38
|
| Rate for Payer: UHC Core |
$219.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$111.92
|
| Rate for Payer: UHC Exchange |
$219.38
|
| Rate for Payer: UHC Medicaid |
$71.36
|
| Rate for Payer: UHCCP Medicaid |
$71.36
|
| Rate for Payer: UMR Bronson Commercial |
$419.06
|
|
|
PR PERQ NL/PL LITHOTRP COMPLEX >2 CM MLT LOCATIONS
|
Professional
|
Both
|
$2,521.00
|
|
|
Service Code
|
HCPCS 50081
|
| Min. Negotiated Rate |
$638.79 |
| Max. Negotiated Rate |
$2,259.95 |
| Rate for Payer: Aetna Commercial |
$1,330.12
|
| Rate for Payer: Aetna Medicare |
$1,032.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,330.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,429.39
|
| Rate for Payer: BCBS Complete |
$670.73
|
| Rate for Payer: BCBS MAPPO |
$992.63
|
| Rate for Payer: BCN Commercial |
$1,674.21
|
| Rate for Payer: BCN Medicare Advantage |
$992.63
|
| Rate for Payer: Cash Price |
$2,016.80
|
| Rate for Payer: Cash Price |
$2,016.80
|
| Rate for Payer: Cofinity Commercial |
$1,330.12
|
| Rate for Payer: Cofinity Commercial |
$1,429.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$992.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,042.26
|
| Rate for Payer: Meridian Medicaid |
$670.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,091.89
|
| Rate for Payer: Nomi Health Commercial |
$1,191.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,890.75
|
| Rate for Payer: PACE SWMI |
$992.63
|
| Rate for Payer: PHP Commercial |
$1,389.68
|
| Rate for Payer: PHP Medicare Advantage |
$992.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$638.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,823.76
|
| Rate for Payer: Priority Health Medicare |
$992.63
|
| Rate for Payer: Priority Health SBD |
$1,823.76
|
| Rate for Payer: Priority Health Tiered Network |
$1,823.76
|
| Rate for Payer: Railroad Medicare Medicare |
$992.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,259.95
|
| Rate for Payer: UHC Core |
$2,259.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$992.63
|
| Rate for Payer: UHC Exchange |
$2,259.95
|
| Rate for Payer: UHC Medicaid |
$638.79
|
| Rate for Payer: UHCCP Medicaid |
$638.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,159.66
|
|
|
PR PERQ NL/PL LITHOTRP SIMPLE UP TO 2 CM 1 LOCATION
|
Professional
|
Both
|
$1,714.00
|
|
|
Service Code
|
HCPCS 50080
|
| Min. Negotiated Rate |
$400.87 |
| Max. Negotiated Rate |
$1,535.13 |
| Rate for Payer: Aetna Commercial |
$831.24
|
| Rate for Payer: Aetna Medicare |
$645.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$831.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$893.28
|
| Rate for Payer: BCBS Complete |
$420.91
|
| Rate for Payer: BCBS MAPPO |
$620.33
|
| Rate for Payer: BCN Commercial |
$1,042.27
|
| Rate for Payer: BCN Medicare Advantage |
$620.33
|
| Rate for Payer: Cash Price |
$1,371.20
|
| Rate for Payer: Cash Price |
$1,371.20
|
| Rate for Payer: Cofinity Commercial |
$831.24
|
| Rate for Payer: Cofinity Commercial |
$893.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$620.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$651.35
|
| Rate for Payer: Meridian Medicaid |
$420.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$682.36
|
| Rate for Payer: Nomi Health Commercial |
$744.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,285.50
|
| Rate for Payer: PACE SWMI |
$620.33
|
| Rate for Payer: PHP Commercial |
$868.46
|
| Rate for Payer: PHP Medicare Advantage |
$620.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,135.37
|
| Rate for Payer: Priority Health Medicare |
$620.33
|
| Rate for Payer: Priority Health SBD |
$1,135.37
|
| Rate for Payer: Priority Health Tiered Network |
$1,135.37
|
| Rate for Payer: Railroad Medicare Medicare |
$620.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,535.13
|
| Rate for Payer: UHC Core |
$1,535.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$620.33
|
| Rate for Payer: UHC Exchange |
$1,535.13
|
| Rate for Payer: UHC Medicaid |
$400.87
|
| Rate for Payer: UHCCP Medicaid |
$400.87
|
| Rate for Payer: UMR Bronson Commercial |
$788.44
|
|
|
PR PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY
|
Professional
|
Both
|
$523.00
|
|
|
Service Code
|
HCPCS 33017
|
| Min. Negotiated Rate |
$136.53 |
| Max. Negotiated Rate |
$437.37 |
| Rate for Payer: Aetna Commercial |
$289.51
|
| Rate for Payer: Aetna Medicare |
$224.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.11
|
| Rate for Payer: BCBS Complete |
$143.36
|
| Rate for Payer: BCBS MAPPO |
$216.05
|
| Rate for Payer: BCN Commercial |
$361.04
|
| Rate for Payer: BCN Medicare Advantage |
$216.05
|
| Rate for Payer: Cash Price |
$418.40
|
| Rate for Payer: Cash Price |
$418.40
|
| Rate for Payer: Cofinity Commercial |
$289.51
|
| Rate for Payer: Cofinity Commercial |
$311.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.85
|
| Rate for Payer: Meridian Medicaid |
$143.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$237.66
|
| Rate for Payer: Nomi Health Commercial |
$259.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$392.25
|
| Rate for Payer: PACE SWMI |
$216.05
|
| Rate for Payer: PHP Commercial |
$302.47
|
| Rate for Payer: PHP Medicare Advantage |
$216.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$388.25
|
| Rate for Payer: Priority Health Medicare |
$216.05
|
| Rate for Payer: Priority Health SBD |
$388.25
|
| Rate for Payer: Priority Health Tiered Network |
$388.25
|
| Rate for Payer: Railroad Medicare Medicare |
$216.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$437.37
|
| Rate for Payer: UHC Core |
$437.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$216.05
|
| Rate for Payer: UHC Exchange |
$437.37
|
| Rate for Payer: UHC Medicaid |
$136.53
|
| Rate for Payer: UHCCP Medicaid |
$136.53
|
| Rate for Payer: UMR Bronson Commercial |
$240.58
|
|
|
PR PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC
|
Professional
|
Both
|
$444.00
|
|
|
Service Code
|
HCPCS 43762
|
| Min. Negotiated Rate |
$21.94 |
| Max. Negotiated Rate |
$333.00 |
| Rate for Payer: Aetna Commercial |
$46.38
|
| Rate for Payer: Aetna Medicare |
$35.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.84
|
| Rate for Payer: BCBS Complete |
$23.04
|
| Rate for Payer: BCBS MAPPO |
$34.61
|
| Rate for Payer: BCN Commercial |
$55.77
|
| Rate for Payer: BCN Medicare Advantage |
$34.61
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cofinity Commercial |
$46.38
|
| Rate for Payer: Cofinity Commercial |
$49.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.34
|
| Rate for Payer: Meridian Medicaid |
$23.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.07
|
| Rate for Payer: Nomi Health Commercial |
$41.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$333.00
|
| Rate for Payer: PACE SWMI |
$34.61
|
| Rate for Payer: PHP Commercial |
$48.45
|
| Rate for Payer: PHP Medicare Advantage |
$34.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$67.96
|
| Rate for Payer: Priority Health Medicare |
$34.61
|
| Rate for Payer: Priority Health SBD |
$67.96
|
| Rate for Payer: Priority Health Tiered Network |
$67.96
|
| Rate for Payer: Railroad Medicare Medicare |
$34.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.84
|
| Rate for Payer: UHC Core |
$67.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$34.61
|
| Rate for Payer: UHC Exchange |
$67.84
|
| Rate for Payer: UHC Medicaid |
$21.94
|
| Rate for Payer: UHCCP Medicaid |
$21.94
|
| Rate for Payer: UMR Bronson Commercial |
$204.24
|
|
