|
PR PHYS/QHP ATTN&SUPVJ HYPRBARIC OXYGEN TX/SESSION
|
Professional
|
Both
|
$384.00
|
|
|
Service Code
|
HCPCS 99183
|
| Min. Negotiated Rate |
$69.86 |
| Max. Negotiated Rate |
$288.00 |
| Rate for Payer: Aetna Commercial |
$144.57
|
| Rate for Payer: Aetna Medicare |
$112.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.36
|
| Rate for Payer: BCBS Complete |
$73.35
|
| Rate for Payer: BCBS MAPPO |
$107.89
|
| Rate for Payer: BCN Commercial |
$157.36
|
| Rate for Payer: BCN Medicare Advantage |
$107.89
|
| Rate for Payer: Cash Price |
$307.20
|
| Rate for Payer: Cash Price |
$307.20
|
| Rate for Payer: Cofinity Commercial |
$155.36
|
| Rate for Payer: Cofinity Commercial |
$144.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.28
|
| Rate for Payer: Meridian Medicaid |
$73.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$118.68
|
| Rate for Payer: Nomi Health Commercial |
$129.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$288.00
|
| Rate for Payer: PACE SWMI |
$107.89
|
| Rate for Payer: PHP Commercial |
$151.05
|
| Rate for Payer: PHP Medicare Advantage |
$107.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$145.11
|
| Rate for Payer: Priority Health Medicare |
$107.89
|
| Rate for Payer: Priority Health SBD |
$145.11
|
| Rate for Payer: Priority Health Tiered Network |
$145.11
|
| Rate for Payer: Railroad Medicare Medicare |
$107.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.74
|
| Rate for Payer: UHC Core |
$179.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$107.89
|
| Rate for Payer: UHC Exchange |
$179.74
|
| Rate for Payer: UHC Medicaid |
$69.86
|
| Rate for Payer: UHCCP Medicaid |
$69.86
|
| Rate for Payer: UMR Bronson Commercial |
$176.64
|
|
|
PR PHYS/QHP DIRECTION EMERGENCY MEDICAL SYSTEMS
|
Professional
|
Both
|
$258.00
|
|
|
Service Code
|
HCPCS 99288
|
| Min. Negotiated Rate |
$48.26 |
| Max. Negotiated Rate |
$193.50 |
| Rate for Payer: Aetna Commercial |
$48.75
|
| Rate for Payer: Aetna Medicare |
$129.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.75
|
| Rate for Payer: BCBS Complete |
$103.20
|
| Rate for Payer: BCN Commercial |
$48.26
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$72.00
|
| Rate for Payer: Priority Health SBD |
$72.00
|
| Rate for Payer: Priority Health Tiered Network |
$72.00
|
| Rate for Payer: UMR Bronson Commercial |
$118.68
|
|
|
PR PHYS/QHP EDUCATION SVCS RENDERED PTS GRP SETTING
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 99078
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Aetna Commercial |
$25.00
|
| Rate for Payer: Aetna Medicare |
$23.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.00
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: BCN Commercial |
$20.00
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$31.89
|
| Rate for Payer: Priority Health SBD |
$31.89
|
| Rate for Payer: Priority Health Tiered Network |
$31.89
|
| Rate for Payer: UMR Bronson Commercial |
$21.16
|
|
|
PR PHYS/QHP ONLINE EVALUATION & MANAGEMENT SERVICE
|
Professional
|
Both
|
$52.00
|
|
|
Service Code
|
HCPCS 99444
|
| Min. Negotiated Rate |
$20.80 |
| Max. Negotiated Rate |
$39.00 |
| Rate for Payer: Aetna Medicare |
$26.00
|
| Rate for Payer: BCBS Complete |
$20.80
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: UMR Bronson Commercial |
$23.92
|
|
|
PR PHYS/QHP O/P CARDIAC RHAB W/O CONT ECG MONITOR
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 93797
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Aetna Commercial |
$10.20
|
| Rate for Payer: Aetna Medicare |
$7.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.96
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS MAPPO |
$7.61
|
| Rate for Payer: BCN Commercial |
$12.45
|
| Rate for Payer: BCN Medicare Advantage |
$7.61
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$10.96
|
| Rate for Payer: Cofinity Commercial |
$10.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.99
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.37
|
| Rate for Payer: Nomi Health Commercial |
$9.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
| Rate for Payer: PACE SWMI |
$7.61
|
| Rate for Payer: PHP Commercial |
$10.65
|
| Rate for Payer: PHP Medicare Advantage |
$7.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.84
|
| Rate for Payer: Priority Health Medicare |
$7.61
|
| Rate for Payer: Priority Health SBD |
$11.84
|
| Rate for Payer: Priority Health Tiered Network |
$11.84
|
| Rate for Payer: Railroad Medicare Medicare |
$7.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.23
|
| Rate for Payer: UHC Core |
$14.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.61
|
| Rate for Payer: UHC Exchange |
$14.23
|
| Rate for Payer: UHC Medicaid |
$4.90
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
| Rate for Payer: UMR Bronson Commercial |
$15.64
|
|
|
PR PHYS/QHP TELEPHONE EVALUATION 11-20 MIN
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 99442
|
| Min. Negotiated Rate |
$37.41 |
| Max. Negotiated Rate |
$114.75 |
| Rate for Payer: Aetna Commercial |
$67.27
|
| Rate for Payer: Aetna Medicare |
$76.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.27
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: BCN Commercial |
$37.41
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.75
|
| Rate for Payer: UMR Bronson Commercial |
$70.38
|
|
|
PR PHYS/QHP TELEPHONE EVALUATION 21-30 MIN
|
Professional
|
Both
|
$222.00
|
|
|
Service Code
|
HCPCS 99443
|
| Min. Negotiated Rate |
$55.60 |
| Max. Negotiated Rate |
$166.50 |
| Rate for Payer: Aetna Commercial |
$99.17
|
| Rate for Payer: Aetna Medicare |
$111.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.17
|
| Rate for Payer: BCBS Complete |
$88.80
|
| Rate for Payer: BCN Commercial |
$55.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.50
|
| Rate for Payer: UMR Bronson Commercial |
$102.12
|
|
|
PR PHYS/QHP TELEPHONE EVALUATION 5-10 MIN
|
Professional
|
Both
|
$93.00
|
|
|
Service Code
|
HCPCS 99441
|
| Min. Negotiated Rate |
$18.69 |
| Max. Negotiated Rate |
$69.75 |
| Rate for Payer: Aetna Commercial |
$35.71
|
| Rate for Payer: Aetna Medicare |
$46.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.71
|
| Rate for Payer: BCBS Complete |
$37.20
|
| Rate for Payer: BCN Commercial |
$18.69
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.75
|
| Rate for Payer: UMR Bronson Commercial |
$42.78
|
|
|
PR PHYS STANDBY SVC PROLNG PHYS ATTN EA 30 MINUTES
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 99360
|
| Min. Negotiated Rate |
$60.51 |
| Max. Negotiated Rate |
$201.75 |
| Rate for Payer: Aetna Commercial |
$60.51
|
| Rate for Payer: Aetna Medicare |
$134.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.51
|
| Rate for Payer: BCBS Complete |
$107.60
|
| Rate for Payer: BCN Commercial |
$86.15
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$77.49
|
| Rate for Payer: Priority Health SBD |
$77.49
|
| Rate for Payer: Priority Health Tiered Network |
$77.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.67
|
| Rate for Payer: UHC Core |
$87.67
|
| Rate for Payer: UHC Exchange |
$87.67
|
| Rate for Payer: UMR Bronson Commercial |
$123.74
|
|
|
PR PINCH GRAFT 1/MLT SM ULCER TIP/OTH AR UP TO 2 CM
|
Professional
|
Both
|
$945.00
|
|
|
Service Code
|
HCPCS 15050
|
| Min. Negotiated Rate |
$273.28 |
| Max. Negotiated Rate |
$786.86 |
| Rate for Payer: Aetna Commercial |
$554.32
|
| Rate for Payer: Aetna Medicare |
$430.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$595.68
|
| Rate for Payer: BCBS Complete |
$286.94
|
| Rate for Payer: BCBS MAPPO |
$413.67
|
| Rate for Payer: BCN Commercial |
$694.69
|
| Rate for Payer: BCN Medicare Advantage |
$413.67
|
| Rate for Payer: Cash Price |
$756.00
|
| Rate for Payer: Cash Price |
$756.00
|
| Rate for Payer: Cofinity Commercial |
$554.32
|
| Rate for Payer: Cofinity Commercial |
$595.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$434.35
|
| Rate for Payer: Meridian Medicaid |
$286.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$455.04
|
| Rate for Payer: Nomi Health Commercial |
$496.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$708.75
|
| Rate for Payer: PACE SWMI |
$413.67
|
| Rate for Payer: PHP Commercial |
$579.14
|
| Rate for Payer: PHP Medicare Advantage |
$413.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$635.81
|
| Rate for Payer: Priority Health Medicare |
$413.67
|
| Rate for Payer: Priority Health SBD |
$635.81
|
| Rate for Payer: Priority Health Tiered Network |
$635.81
|
| Rate for Payer: Railroad Medicare Medicare |
$413.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$786.86
|
| Rate for Payer: UHC Core |
$786.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$413.67
|
| Rate for Payer: UHC Exchange |
$786.86
|
| Rate for Payer: UHC Medicaid |
$273.28
|
| Rate for Payer: UHCCP Medicaid |
$273.28
|
| Rate for Payer: UMR Bronson Commercial |
$434.70
|
|
|
PR PLACE CATH BRACHIAL ART
|
Professional
|
Both
|
$784.00
|
|
|
Service Code
|
HCPCS 36120
|
| Min. Negotiated Rate |
$313.60 |
| Max. Negotiated Rate |
$588.00 |
| Rate for Payer: Aetna Medicare |
$392.00
|
| Rate for Payer: BCBS Complete |
$313.60
|
| Rate for Payer: Cash Price |
$627.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$588.00
|
| Rate for Payer: UMR Bronson Commercial |
$360.64
|
|
|
PR PLACE DRAIN PERIPANCREATIC ACUTE PANCREATITIS
|
Professional
|
Both
|
$3,381.00
|
|
|
Service Code
|
HCPCS 48000
|
| Min. Negotiated Rate |
$1,113.99 |
| Max. Negotiated Rate |
$3,435.46 |
| Rate for Payer: Aetna Commercial |
$2,338.98
|
| Rate for Payer: Aetna Medicare |
$1,815.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,338.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,513.53
|
| Rate for Payer: BCBS Complete |
$1,169.69
|
| Rate for Payer: BCBS MAPPO |
$1,745.51
|
| Rate for Payer: BCN Commercial |
$2,819.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,745.51
|
| Rate for Payer: Cash Price |
$2,704.80
|
| Rate for Payer: Cash Price |
$2,704.80
|
| Rate for Payer: Cofinity Commercial |
$2,513.53
|
| Rate for Payer: Cofinity Commercial |
$2,338.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,745.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,832.79
|
| Rate for Payer: Meridian Medicaid |
$1,169.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,920.06
|
| Rate for Payer: Nomi Health Commercial |
$2,094.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,535.75
|
| Rate for Payer: PACE SWMI |
$1,745.51
|
| Rate for Payer: PHP Commercial |
$2,443.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,745.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,113.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,435.46
|
| Rate for Payer: Priority Health Medicare |
$1,745.51
|
| Rate for Payer: Priority Health SBD |
$3,435.46
|
| Rate for Payer: Priority Health Tiered Network |
$3,435.46
|
| Rate for Payer: Railroad Medicare Medicare |
$1,745.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,373.56
|
| Rate for Payer: UHC Core |
$3,373.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,745.51
|
| Rate for Payer: UHC Exchange |
$3,373.56
|
| Rate for Payer: UHC Medicaid |
$1,113.99
|
| Rate for Payer: UHCCP Medicaid |
$1,113.99
|
| Rate for Payer: UMR Bronson Commercial |
$1,555.26
|
|
|
PR PLACEMENT CHOLEDOCHAL STENT
|
Professional
|
Both
|
$2,623.00
|
|
|
Service Code
|
HCPCS 47801
|
| Min. Negotiated Rate |
$661.79 |
| Max. Negotiated Rate |
$2,027.78 |
| Rate for Payer: Aetna Commercial |
$1,376.94
|
| Rate for Payer: Aetna Medicare |
$1,068.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,376.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,479.70
|
| Rate for Payer: BCBS Complete |
$694.88
|
| Rate for Payer: BCBS MAPPO |
$1,027.57
|
| Rate for Payer: BCN Commercial |
$1,664.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,027.57
|
| Rate for Payer: Cash Price |
$2,098.40
|
| Rate for Payer: Cash Price |
$2,098.40
|
| Rate for Payer: Cofinity Commercial |
$1,376.94
|
| Rate for Payer: Cofinity Commercial |
$1,479.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,027.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,078.95
|
| Rate for Payer: Meridian Medicaid |
$694.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,130.33
|
| Rate for Payer: Nomi Health Commercial |
$1,233.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,967.25
|
| Rate for Payer: PACE SWMI |
$1,027.57
|
| Rate for Payer: PHP Commercial |
$1,438.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,027.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$661.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,027.78
|
| Rate for Payer: Priority Health Medicare |
$1,027.57
|
| Rate for Payer: Priority Health SBD |
$2,027.78
|
| Rate for Payer: Priority Health Tiered Network |
$2,027.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,027.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,985.06
|
| Rate for Payer: UHC Core |
$1,985.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,027.57
|
| Rate for Payer: UHC Exchange |
$1,985.06
|
| Rate for Payer: UHC Medicaid |
$661.79
|
| Rate for Payer: UHCCP Medicaid |
$661.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,206.58
|
|
|
PR PLACEMENT ENTEROSTOMY/CECOSTOMY TUBE OPEN
|
Professional
|
Both
|
$2,030.00
|
|
|
Service Code
|
HCPCS 44300
|
| Min. Negotiated Rate |
$507.79 |
| Max. Negotiated Rate |
$1,542.38 |
| Rate for Payer: Aetna Commercial |
$1,059.18
|
| Rate for Payer: Aetna Medicare |
$822.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,059.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,138.22
|
| Rate for Payer: BCBS Complete |
$533.18
|
| Rate for Payer: BCBS MAPPO |
$790.43
|
| Rate for Payer: BCN Commercial |
$1,265.87
|
| Rate for Payer: BCN Medicare Advantage |
$790.43
|
| Rate for Payer: Cash Price |
$1,624.00
|
| Rate for Payer: Cash Price |
$1,624.00
|
| Rate for Payer: Cofinity Commercial |
$1,059.18
|
| Rate for Payer: Cofinity Commercial |
$1,138.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$790.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$829.95
|
| Rate for Payer: Meridian Medicaid |
$533.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$869.47
|
| Rate for Payer: Nomi Health Commercial |
$948.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,522.50
|
| Rate for Payer: PACE SWMI |
$790.43
|
| Rate for Payer: PHP Commercial |
$1,106.60
|
| Rate for Payer: PHP Medicare Advantage |
$790.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$507.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,542.38
|
| Rate for Payer: Priority Health Medicare |
$790.43
|
| Rate for Payer: Priority Health SBD |
$1,542.38
|
| Rate for Payer: Priority Health Tiered Network |
$1,542.38
|
| Rate for Payer: Railroad Medicare Medicare |
$790.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,500.51
|
| Rate for Payer: UHC Core |
$1,500.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$790.43
|
| Rate for Payer: UHC Exchange |
$1,500.51
|
| Rate for Payer: UHC Medicaid |
$507.79
|
| Rate for Payer: UHCCP Medicaid |
$507.79
|
| Rate for Payer: UMR Bronson Commercial |
$933.80
|
|
|
PR PLACEMENT NEEDLE INTRAOSSEOUS INFUSION
|
Professional
|
Both
|
$582.00
|
|
|
Service Code
|
HCPCS 36680
|
| Min. Negotiated Rate |
$36.85 |
| Max. Negotiated Rate |
$436.50 |
| Rate for Payer: Aetna Commercial |
$77.48
|
| Rate for Payer: Aetna Medicare |
$60.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.26
|
| Rate for Payer: BCBS Complete |
$38.69
|
| Rate for Payer: BCBS MAPPO |
$57.82
|
| Rate for Payer: BCN Commercial |
$88.64
|
| Rate for Payer: BCN Medicare Advantage |
$57.82
|
| Rate for Payer: Cash Price |
$465.60
|
| Rate for Payer: Cash Price |
$465.60
|
| Rate for Payer: Cofinity Commercial |
$77.48
|
| Rate for Payer: Cofinity Commercial |
$83.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.71
|
| Rate for Payer: Meridian Medicaid |
$38.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.60
|
| Rate for Payer: Nomi Health Commercial |
$69.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$436.50
|
| Rate for Payer: PACE SWMI |
$57.82
|
| Rate for Payer: PHP Commercial |
$80.95
|
| Rate for Payer: PHP Medicare Advantage |
$57.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$95.33
|
| Rate for Payer: Priority Health Medicare |
$57.82
|
| Rate for Payer: Priority Health SBD |
$95.33
|
| Rate for Payer: Priority Health Tiered Network |
$95.33
|
| Rate for Payer: Railroad Medicare Medicare |
$57.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.60
|
| Rate for Payer: UHC Core |
$107.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$57.82
|
| Rate for Payer: UHC Exchange |
$107.60
|
| Rate for Payer: UHC Medicaid |
$36.85
|
| Rate for Payer: UHCCP Medicaid |
$36.85
|
| Rate for Payer: UMR Bronson Commercial |
$267.72
|
|
|
PR PLACEMENT SETON
|
Professional
|
Both
|
$402.00
|
|
|
Service Code
|
HCPCS 46020
|
| Min. Negotiated Rate |
$70.72 |
| Max. Negotiated Rate |
$410.67 |
| Rate for Payer: Aetna Commercial |
$146.19
|
| Rate for Payer: Aetna Medicare |
$113.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.10
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: BCBS MAPPO |
$109.10
|
| Rate for Payer: BCN Commercial |
$175.79
|
| Rate for Payer: BCN Medicare Advantage |
$109.10
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cofinity Commercial |
$146.19
|
| Rate for Payer: Cofinity Commercial |
$157.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.56
|
| Rate for Payer: Meridian Medicaid |
$74.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.01
|
| Rate for Payer: Nomi Health Commercial |
$130.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$301.50
|
| Rate for Payer: PACE SWMI |
$109.10
|
| Rate for Payer: PHP Commercial |
$152.74
|
| Rate for Payer: PHP Medicare Advantage |
$109.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$214.18
|
| Rate for Payer: Priority Health Medicare |
$109.10
|
| Rate for Payer: Priority Health SBD |
$214.18
|
| Rate for Payer: Priority Health Tiered Network |
$214.18
|
| Rate for Payer: Railroad Medicare Medicare |
$109.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$410.67
|
| Rate for Payer: UHC Core |
$410.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$109.10
|
| Rate for Payer: UHC Exchange |
$410.67
|
| Rate for Payer: UHC Medicaid |
$70.72
|
| Rate for Payer: UHCCP Medicaid |
$70.72
|
| Rate for Payer: UMR Bronson Commercial |
$184.92
|
|
|
PR PLACEMENT XTN PROSTH FOR ENDOVASCULAR RPR
|
Professional
|
Both
|
$701.00
|
|
|
Service Code
|
HCPCS 34709
|
| Min. Negotiated Rate |
$184.03 |
| Max. Negotiated Rate |
$583.86 |
| Rate for Payer: Aetna Commercial |
$393.12
|
| Rate for Payer: Aetna Medicare |
$305.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$393.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.45
|
| Rate for Payer: BCBS Complete |
$193.23
|
| Rate for Payer: BCBS MAPPO |
$293.37
|
| Rate for Payer: BCN Commercial |
$468.10
|
| Rate for Payer: BCN Medicare Advantage |
$293.37
|
| Rate for Payer: Cash Price |
$560.80
|
| Rate for Payer: Cash Price |
$560.80
|
| Rate for Payer: Cofinity Commercial |
$393.12
|
| Rate for Payer: Cofinity Commercial |
$422.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$293.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$308.04
|
| Rate for Payer: Meridian Medicaid |
$193.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$322.71
|
| Rate for Payer: Nomi Health Commercial |
$352.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$525.75
|
| Rate for Payer: PACE SWMI |
$293.37
|
| Rate for Payer: PHP Commercial |
$410.72
|
| Rate for Payer: PHP Medicare Advantage |
$293.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$184.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$503.39
|
| Rate for Payer: Priority Health Medicare |
$293.37
|
| Rate for Payer: Priority Health SBD |
$503.39
|
| Rate for Payer: Priority Health Tiered Network |
$503.39
|
| Rate for Payer: Railroad Medicare Medicare |
$293.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$583.86
|
| Rate for Payer: UHC Core |
$583.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$293.37
|
| Rate for Payer: UHC Exchange |
$583.86
|
| Rate for Payer: UHC Medicaid |
$184.03
|
| Rate for Payer: UHCCP Medicaid |
$184.03
|
| Rate for Payer: UMR Bronson Commercial |
$322.46
|
|
|
PR PLACE NEEDLE/CATH A-V DIALYSIS SHUNT,1ST ACCESS W/ RAD EVAL
|
Professional
|
Both
|
$1,555.00
|
|
|
Service Code
|
HCPCS 36147
|
| Min. Negotiated Rate |
$622.00 |
| Max. Negotiated Rate |
$1,166.25 |
| Rate for Payer: Aetna Medicare |
$777.50
|
| Rate for Payer: BCBS Complete |
$622.00
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,166.25
|
| Rate for Payer: UMR Bronson Commercial |
$715.30
|
|
|
PR PLACE NEEDLE/CATH A-V DIALYSIS SHUNT,ADDL ACCESS FOR THERAPY
|
Professional
|
Both
|
$693.00
|
|
|
Service Code
|
HCPCS 36148
|
| Min. Negotiated Rate |
$277.20 |
| Max. Negotiated Rate |
$519.75 |
| Rate for Payer: Aetna Medicare |
$346.50
|
| Rate for Payer: BCBS Complete |
$277.20
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$519.75
|
| Rate for Payer: UMR Bronson Commercial |
$318.78
|
|
|
PR PLASTIC OPERATION PENIS INJURY
|
Professional
|
Both
|
$2,042.00
|
|
|
Service Code
|
HCPCS 54440
|
| Min. Negotiated Rate |
$711.74 |
| Max. Negotiated Rate |
$3,224.79 |
| Rate for Payer: Aetna Commercial |
$711.74
|
| Rate for Payer: Aetna Medicare |
$1,021.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$711.74
|
| Rate for Payer: BCBS Complete |
$777.06
|
| Rate for Payer: BCN Commercial |
$3,224.79
|
| Rate for Payer: Cash Price |
$1,633.60
|
| Rate for Payer: Cash Price |
$1,633.60
|
| Rate for Payer: Meridian Medicaid |
$777.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,531.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$740.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$915.14
|
| Rate for Payer: Priority Health SBD |
$915.14
|
| Rate for Payer: Priority Health Tiered Network |
$915.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,093.72
|
| Rate for Payer: UHC Core |
$2,093.72
|
| Rate for Payer: UHC Exchange |
$2,093.72
|
| Rate for Payer: UHC Medicaid |
$740.06
|
| Rate for Payer: UHCCP Medicaid |
$740.06
|
| Rate for Payer: UMR Bronson Commercial |
$939.32
|
|
|
PR PLASTIC REPAIR INTROITUS
|
Professional
|
Both
|
$926.00
|
|
|
Service Code
|
HCPCS 56800
|
| Min. Negotiated Rate |
$144.84 |
| Max. Negotiated Rate |
$694.50 |
| Rate for Payer: Aetna Commercial |
$299.17
|
| Rate for Payer: Aetna Medicare |
$232.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.49
|
| Rate for Payer: BCBS Complete |
$152.08
|
| Rate for Payer: BCBS MAPPO |
$223.26
|
| Rate for Payer: BCN Commercial |
$381.45
|
| Rate for Payer: BCN Medicare Advantage |
$223.26
|
| Rate for Payer: Cash Price |
$740.80
|
| Rate for Payer: Cash Price |
$740.80
|
| Rate for Payer: Cofinity Commercial |
$321.49
|
| Rate for Payer: Cofinity Commercial |
$299.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$223.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$234.42
|
| Rate for Payer: Meridian Medicaid |
$152.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$245.59
|
| Rate for Payer: Nomi Health Commercial |
$267.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.50
|
| Rate for Payer: PACE SWMI |
$223.26
|
| Rate for Payer: PHP Commercial |
$312.56
|
| Rate for Payer: PHP Medicare Advantage |
$223.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$386.32
|
| Rate for Payer: Priority Health Medicare |
$223.26
|
| Rate for Payer: Priority Health SBD |
$386.32
|
| Rate for Payer: Priority Health Tiered Network |
$386.32
|
| Rate for Payer: Railroad Medicare Medicare |
$223.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$436.11
|
| Rate for Payer: UHC Core |
$436.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$223.26
|
| Rate for Payer: UHC Exchange |
$436.11
|
| Rate for Payer: UHC Medicaid |
$144.84
|
| Rate for Payer: UHCCP Medicaid |
$144.84
|
| Rate for Payer: UMR Bronson Commercial |
$425.96
|
|
|
PR PLASTIC REPAIR URETHROCELE
|
Professional
|
Both
|
$833.00
|
|
|
Service Code
|
HCPCS 57230
|
| Min. Negotiated Rate |
$237.71 |
| Max. Negotiated Rate |
$719.73 |
| Rate for Payer: Aetna Commercial |
$490.39
|
| Rate for Payer: Aetna Medicare |
$380.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$490.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$526.98
|
| Rate for Payer: BCBS Complete |
$249.60
|
| Rate for Payer: BCBS MAPPO |
$365.96
|
| Rate for Payer: BCN Commercial |
$627.96
|
| Rate for Payer: BCN Medicare Advantage |
$365.96
|
| Rate for Payer: Cash Price |
$666.40
|
| Rate for Payer: Cash Price |
$666.40
|
| Rate for Payer: Cofinity Commercial |
$490.39
|
| Rate for Payer: Cofinity Commercial |
$526.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$365.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$384.26
|
| Rate for Payer: Meridian Medicaid |
$249.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$402.56
|
| Rate for Payer: Nomi Health Commercial |
$439.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.75
|
| Rate for Payer: PACE SWMI |
$365.96
|
| Rate for Payer: PHP Commercial |
$512.34
|
| Rate for Payer: PHP Medicare Advantage |
$365.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$635.98
|
| Rate for Payer: Priority Health Medicare |
$365.96
|
| Rate for Payer: Priority Health SBD |
$635.98
|
| Rate for Payer: Priority Health Tiered Network |
$635.98
|
| Rate for Payer: Railroad Medicare Medicare |
$365.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$719.73
|
| Rate for Payer: UHC Core |
$719.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$365.96
|
| Rate for Payer: UHC Exchange |
$719.73
|
| Rate for Payer: UHC Medicaid |
$237.71
|
| Rate for Payer: UHCCP Medicaid |
$237.71
|
| Rate for Payer: UMR Bronson Commercial |
$383.18
|
|
|
PR PLASTIC RPR PENIS CORRECT ANGULATION
|
Professional
|
Both
|
$3,915.00
|
|
|
Service Code
|
HCPCS 54360
|
| Min. Negotiated Rate |
$416.42 |
| Max. Negotiated Rate |
$2,936.25 |
| Rate for Payer: Aetna Commercial |
$862.96
|
| Rate for Payer: Aetna Medicare |
$669.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$862.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$927.36
|
| Rate for Payer: BCBS Complete |
$437.24
|
| Rate for Payer: BCBS MAPPO |
$644.00
|
| Rate for Payer: BCN Commercial |
$1,080.62
|
| Rate for Payer: BCN Medicare Advantage |
$644.00
|
| Rate for Payer: Cash Price |
$3,132.00
|
| Rate for Payer: Cash Price |
$3,132.00
|
| Rate for Payer: Cofinity Commercial |
$862.96
|
| Rate for Payer: Cofinity Commercial |
$927.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$676.20
|
| Rate for Payer: Meridian Medicaid |
$437.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$708.40
|
| Rate for Payer: Nomi Health Commercial |
$772.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,936.25
|
| Rate for Payer: PACE SWMI |
$644.00
|
| Rate for Payer: PHP Commercial |
$901.60
|
| Rate for Payer: PHP Medicare Advantage |
$644.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,177.15
|
| Rate for Payer: Priority Health Medicare |
$644.00
|
| Rate for Payer: Priority Health SBD |
$1,177.15
|
| Rate for Payer: Priority Health Tiered Network |
$1,177.15
|
| Rate for Payer: Railroad Medicare Medicare |
$644.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,272.20
|
| Rate for Payer: UHC Core |
$1,272.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$644.00
|
| Rate for Payer: UHC Exchange |
$1,272.20
|
| Rate for Payer: UHC Medicaid |
$416.42
|
| Rate for Payer: UHCCP Medicaid |
$416.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,800.90
|
|
|
PR PLASTICS COSMETIC CONSULT OFFICE VISIT
|
Professional
|
Both
|
$77.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Aetna Medicare |
$38.50
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.75
|
| Rate for Payer: UMR Bronson Commercial |
$35.42
|
|
|
PR PLASTICS COSMETIC FAT GRAFTING
|
Professional
|
Both
|
$2,575.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,030.00 |
| Max. Negotiated Rate |
$1,931.25 |
| Rate for Payer: Aetna Medicare |
$1,287.50
|
| Rate for Payer: BCBS Complete |
$1,030.00
|
| Rate for Payer: Cash Price |
$2,060.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,931.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,184.50
|
|
