|
PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN
|
Facility
|
IP
|
$308.00
|
|
|
Service Code
|
CPT 62323
|
| Hospital Charge Code |
62323
|
| Min. Negotiated Rate |
$135.52 |
| Max. Negotiated Rate |
$277.20 |
| Rate for Payer: Aetna American Axle |
$200.20
|
| Rate for Payer: Aetna Commercial |
$261.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.20
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cofinity Commercial |
$215.60
|
| Rate for Payer: Cofinity Commercial |
$264.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$215.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$246.40
|
| Rate for Payer: Healthscope Commercial |
$277.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$215.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261.80
|
| Rate for Payer: PHP Commercial |
$261.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.20
|
| Rate for Payer: Priority Health SBD |
$194.04
|
| Rate for Payer: UMR Bronson Commercial |
$135.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.00
|
|
|
PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN
|
Facility
|
OP
|
$308.00
|
|
|
Service Code
|
CPT 62323
|
| Hospital Charge Code |
62323
|
| Min. Negotiated Rate |
$95.09 |
| Max. Negotiated Rate |
$2,132.58 |
| Rate for Payer: Aetna American Axle |
$200.20
|
| Rate for Payer: Aetna Commercial |
$261.80
|
| Rate for Payer: Aetna Medicare |
$705.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$848.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$848.15
|
| Rate for Payer: BCBS Complete |
$381.87
|
| Rate for Payer: BCBS MAPPO |
$678.52
|
| Rate for Payer: BCBS Trust/PPO |
$676.84
|
| Rate for Payer: BCN Commercial |
$676.84
|
| Rate for Payer: BCN Medicare Advantage |
$678.52
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cofinity Commercial |
$264.88
|
| Rate for Payer: Cofinity Commercial |
$215.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$215.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$246.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$678.52
|
| Rate for Payer: Healthscope Commercial |
$277.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$215.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.00
|
| Rate for Payer: Mclaren Medicaid |
$363.69
|
| Rate for Payer: Mclaren Medicare |
$678.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$712.45
|
| Rate for Payer: Meridian Medicaid |
$381.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$780.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261.80
|
| Rate for Payer: Nomi Health Commercial |
$1,424.89
|
| Rate for Payer: PACE Medicare |
$644.59
|
| Rate for Payer: PACE SWMI |
$678.52
|
| Rate for Payer: PHP Commercial |
$261.80
|
| Rate for Payer: PHP Medicare Advantage |
$678.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,132.58
|
| Rate for Payer: Priority Health Medicare |
$678.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,706.06
|
| Rate for Payer: Priority Health SBD |
$194.04
|
| Rate for Payer: Railroad Medicare Medicare |
$678.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.60
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$678.52
|
| Rate for Payer: UHC Exchange |
$95.09
|
| Rate for Payer: UHC Medicare Advantage |
$678.52
|
| Rate for Payer: UHCCP Medicaid |
$363.69
|
| Rate for Payer: UMR Bronson Commercial |
$113.96
|
| Rate for Payer: VA VA |
$678.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.00
|
|
|
PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN
|
Professional
|
Both
|
$308.00
|
|
|
Service Code
|
HCPCS 62323
|
| Hospital Charge Code |
62323
|
| Min. Negotiated Rate |
$63.26 |
| Max. Negotiated Rate |
$1,879.69 |
| Rate for Payer: Aetna Commercial |
$126.15
|
| Rate for Payer: Aetna Medicare |
$97.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.56
|
| Rate for Payer: BCBS Complete |
$66.42
|
| Rate for Payer: BCBS MAPPO |
$94.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,879.69
|
| Rate for Payer: BCN Commercial |
$378.23
|
| Rate for Payer: BCN Medicare Advantage |
$94.14
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cash Price |
$246.40
|
| Rate for Payer: Cofinity Commercial |
$135.56
|
| Rate for Payer: Cofinity Commercial |
$126.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.85
|
| Rate for Payer: Meridian Medicaid |
$66.42
|
| Rate for Payer: Nomi Health Commercial |
$112.97
|
| Rate for Payer: PACE SWMI |
$94.14
|
| Rate for Payer: PHP Commercial |
$131.80
|
| Rate for Payer: PHP Medicare Advantage |
$94.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$168.34
|
| Rate for Payer: Priority Health Medicare |
$94.14
|
| Rate for Payer: Priority Health Narrow Network |
$168.34
|
| Rate for Payer: Priority Health SBD |
$168.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$94.14
|
| Rate for Payer: UHC Medicare Advantage |
$94.14
|
| Rate for Payer: UHCCP Medicaid |
$63.26
|
| Rate for Payer: UMR Bronson Commercial |
$141.68
|
|
|
PR NJX INFUS/BOLUS DX/SBST EDRL/SUBARACH LUM/SACRAL
|
Professional
|
Both
|
$872.00
|
|
|
Service Code
|
HCPCS 62319
|
| Min. Negotiated Rate |
$348.80 |
| Max. Negotiated Rate |
$566.80 |
| Rate for Payer: Aetna Medicare |
$436.00
|
| Rate for Payer: BCBS Complete |
$348.80
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.80
|
| Rate for Payer: UMR Bronson Commercial |
$401.12
|
|
|
PR NJX NONCMPND SCLEROSANT MULTIPLE INCMPTNT VEINS
|
Professional
|
Both
|
$2,850.00
|
|
|
Service Code
|
HCPCS 36466
|
| Min. Negotiated Rate |
$95.21 |
| Max. Negotiated Rate |
$2,083.23 |
| Rate for Payer: Aetna Commercial |
$194.89
|
| Rate for Payer: Aetna Medicare |
$151.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.43
|
| Rate for Payer: BCBS Complete |
$99.97
|
| Rate for Payer: BCBS MAPPO |
$145.44
|
| Rate for Payer: BCN Commercial |
$2,083.23
|
| Rate for Payer: BCN Medicare Advantage |
$145.44
|
| Rate for Payer: Cash Price |
$2,280.00
|
| Rate for Payer: Cash Price |
$2,280.00
|
| Rate for Payer: Cofinity Commercial |
$194.89
|
| Rate for Payer: Cofinity Commercial |
$209.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.71
|
| Rate for Payer: Meridian Medicaid |
$99.97
|
| Rate for Payer: Nomi Health Commercial |
$174.53
|
| Rate for Payer: PACE SWMI |
$145.44
|
| Rate for Payer: PHP Commercial |
$203.62
|
| Rate for Payer: PHP Medicare Advantage |
$145.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,852.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$236.66
|
| Rate for Payer: Priority Health Medicare |
$145.44
|
| Rate for Payer: Priority Health Narrow Network |
$236.66
|
| Rate for Payer: Priority Health SBD |
$236.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.44
|
| Rate for Payer: UHC Medicare Advantage |
$145.44
|
| Rate for Payer: UHCCP Medicaid |
$95.21
|
| Rate for Payer: UMR Bronson Commercial |
$1,311.00
|
|
|
PR NJX NONCMPND SCLEROSANT SINGLE INCMPTNT VEIN
|
Professional
|
Both
|
$2,699.00
|
|
|
Service Code
|
HCPCS 36465
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$1,929.79 |
| Rate for Payer: Aetna Commercial |
$154.41
|
| Rate for Payer: Aetna Medicare |
$119.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.93
|
| Rate for Payer: BCBS Complete |
$79.17
|
| Rate for Payer: BCBS MAPPO |
$115.23
|
| Rate for Payer: BCN Commercial |
$1,929.79
|
| Rate for Payer: BCN Medicare Advantage |
$115.23
|
| Rate for Payer: Cash Price |
$2,159.20
|
| Rate for Payer: Cash Price |
$2,159.20
|
| Rate for Payer: Cofinity Commercial |
$165.93
|
| Rate for Payer: Cofinity Commercial |
$154.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.99
|
| Rate for Payer: Meridian Medicaid |
$79.17
|
| Rate for Payer: Nomi Health Commercial |
$138.28
|
| Rate for Payer: PACE SWMI |
$115.23
|
| Rate for Payer: PHP Commercial |
$161.32
|
| Rate for Payer: PHP Medicare Advantage |
$115.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,754.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$185.60
|
| Rate for Payer: Priority Health Medicare |
$115.23
|
| Rate for Payer: Priority Health Narrow Network |
$185.60
|
| Rate for Payer: Priority Health SBD |
$185.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.23
|
| Rate for Payer: UHC Medicare Advantage |
$115.23
|
| Rate for Payer: UHCCP Medicaid |
$75.40
|
| Rate for Payer: UMR Bronson Commercial |
$1,241.54
|
|
|
PR NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION
|
Professional
|
Both
|
$612.00
|
|
|
Service Code
|
HCPCS 0232T
|
| Min. Negotiated Rate |
$91.43 |
| Max. Negotiated Rate |
$397.80 |
| Rate for Payer: Aetna Commercial |
$128.61
|
| Rate for Payer: Aetna Commercial |
$128.61
|
| Rate for Payer: Aetna Medicare |
$459.00
|
| Rate for Payer: Aetna Medicare |
$306.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.61
|
| Rate for Payer: BCBS Complete |
$244.80
|
| Rate for Payer: BCBS Complete |
$367.20
|
| Rate for Payer: BCBS Trust/PPO |
$91.43
|
| Rate for Payer: BCBS Trust/PPO |
$91.43
|
| Rate for Payer: BCN Commercial |
$349.25
|
| Rate for Payer: BCN Commercial |
$349.25
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.70
|
| Rate for Payer: UMR Bronson Commercial |
$281.52
|
| Rate for Payer: UMR Bronson Commercial |
$422.28
|
|
|
PR NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION
|
Facility
|
OP
|
$612.00
|
|
|
Service Code
|
CPT 0232T
|
| Hospital Charge Code |
0232T
|
| Min. Negotiated Rate |
$209.56 |
| Max. Negotiated Rate |
$1,228.82 |
| Rate for Payer: Aetna American Axle |
$397.80
|
| Rate for Payer: Aetna Commercial |
$520.20
|
| Rate for Payer: Aetna Medicare |
$406.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$488.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$488.71
|
| Rate for Payer: BCBS Complete |
$220.04
|
| Rate for Payer: BCBS MAPPO |
$390.97
|
| Rate for Payer: BCN Medicare Advantage |
$390.97
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$526.32
|
| Rate for Payer: Cofinity Commercial |
$428.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$428.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.97
|
| Rate for Payer: Healthscope Commercial |
$550.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$428.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.00
|
| Rate for Payer: Mclaren Medicaid |
$209.56
|
| Rate for Payer: Mclaren Medicare |
$390.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$410.52
|
| Rate for Payer: Meridian Medicaid |
$220.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$449.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.20
|
| Rate for Payer: Nomi Health Commercial |
$1,172.91
|
| Rate for Payer: PACE Medicare |
$371.42
|
| Rate for Payer: PACE SWMI |
$390.97
|
| Rate for Payer: PHP Commercial |
$520.20
|
| Rate for Payer: PHP Medicare Advantage |
$390.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,228.82
|
| Rate for Payer: Priority Health Medicare |
$390.97
|
| Rate for Payer: Priority Health Narrow Network |
$983.06
|
| Rate for Payer: Priority Health SBD |
$385.56
|
| Rate for Payer: Railroad Medicare Medicare |
$390.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,100.54
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$390.97
|
| Rate for Payer: UHC Exchange |
$747.18
|
| Rate for Payer: UHC Medicare Advantage |
$390.97
|
| Rate for Payer: UHCCP Medicaid |
$209.56
|
| Rate for Payer: UMR Bronson Commercial |
$226.44
|
| Rate for Payer: VA VA |
$390.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.00
|
|
|
PR NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION
|
Facility
|
IP
|
$612.00
|
|
|
Service Code
|
CPT 0232T
|
| Hospital Charge Code |
0232T
|
| Min. Negotiated Rate |
$269.28 |
| Max. Negotiated Rate |
$550.80 |
| Rate for Payer: Aetna American Axle |
$397.80
|
| Rate for Payer: Aetna Commercial |
$520.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.80
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$428.40
|
| Rate for Payer: Cofinity Commercial |
$526.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$428.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.60
|
| Rate for Payer: Healthscope Commercial |
$550.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$428.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.20
|
| Rate for Payer: PHP Commercial |
$520.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health SBD |
$385.56
|
| Rate for Payer: UMR Bronson Commercial |
$269.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.00
|
|
|
PR NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION
|
Professional
|
Both
|
$612.00
|
|
|
Service Code
|
HCPCS 0232T
|
| Hospital Charge Code |
0232T
|
| Min. Negotiated Rate |
$91.43 |
| Max. Negotiated Rate |
$397.80 |
| Rate for Payer: Aetna Commercial |
$128.61
|
| Rate for Payer: Aetna Commercial |
$128.61
|
| Rate for Payer: Aetna Medicare |
$306.00
|
| Rate for Payer: Aetna Medicare |
$459.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.61
|
| Rate for Payer: BCBS Complete |
$244.80
|
| Rate for Payer: BCBS Complete |
$367.20
|
| Rate for Payer: BCBS Trust/PPO |
$91.43
|
| Rate for Payer: BCBS Trust/PPO |
$91.43
|
| Rate for Payer: BCN Commercial |
$349.25
|
| Rate for Payer: BCN Commercial |
$349.25
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: UMR Bronson Commercial |
$422.28
|
| Rate for Payer: UMR Bronson Commercial |
$281.52
|
|
|
PR NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS
|
Professional
|
Both
|
$207.00
|
|
|
Service Code
|
HCPCS 50431
|
| Min. Negotiated Rate |
$42.17 |
| Max. Negotiated Rate |
$2,577.05 |
| Rate for Payer: Aetna Commercial |
$83.90
|
| Rate for Payer: Aetna Medicare |
$65.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.16
|
| Rate for Payer: BCBS Complete |
$44.28
|
| Rate for Payer: BCBS MAPPO |
$62.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,577.05
|
| Rate for Payer: BCN Commercial |
$476.46
|
| Rate for Payer: BCN Medicare Advantage |
$62.61
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cofinity Commercial |
$90.16
|
| Rate for Payer: Cofinity Commercial |
$83.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.74
|
| Rate for Payer: Meridian Medicaid |
$44.28
|
| Rate for Payer: Nomi Health Commercial |
$75.13
|
| Rate for Payer: PACE SWMI |
$62.61
|
| Rate for Payer: PHP Commercial |
$87.65
|
| Rate for Payer: PHP Medicare Advantage |
$62.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.86
|
| Rate for Payer: Priority Health Medicare |
$62.61
|
| Rate for Payer: Priority Health Narrow Network |
$103.86
|
| Rate for Payer: Priority Health SBD |
$103.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.61
|
| Rate for Payer: UHC Medicare Advantage |
$62.61
|
| Rate for Payer: UHCCP Medicaid |
$42.17
|
| Rate for Payer: UMR Bronson Commercial |
$95.22
|
|
|
PR NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS
|
Professional
|
Both
|
$240.00
|
|
|
Service Code
|
HCPCS 50430
|
| Min. Negotiated Rate |
$96.70 |
| Max. Negotiated Rate |
$2,447.09 |
| Rate for Payer: Aetna Commercial |
$193.86
|
| Rate for Payer: Aetna Medicare |
$150.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.32
|
| Rate for Payer: BCBS Complete |
$101.54
|
| Rate for Payer: BCBS MAPPO |
$144.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,447.09
|
| Rate for Payer: BCN Commercial |
$931.42
|
| Rate for Payer: BCN Medicare Advantage |
$144.67
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$193.86
|
| Rate for Payer: Cofinity Commercial |
$208.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.90
|
| Rate for Payer: Meridian Medicaid |
$101.54
|
| Rate for Payer: Nomi Health Commercial |
$173.60
|
| Rate for Payer: PACE SWMI |
$144.67
|
| Rate for Payer: PHP Commercial |
$202.54
|
| Rate for Payer: PHP Medicare Advantage |
$144.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$239.66
|
| Rate for Payer: Priority Health Medicare |
$144.67
|
| Rate for Payer: Priority Health Narrow Network |
$239.66
|
| Rate for Payer: Priority Health SBD |
$239.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.67
|
| Rate for Payer: UHC Medicare Advantage |
$144.67
|
| Rate for Payer: UHCCP Medicaid |
$96.70
|
| Rate for Payer: UMR Bronson Commercial |
$110.40
|
|
|
PR NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH
|
Professional
|
Both
|
$575.00
|
|
|
Service Code
|
HCPCS 36005
|
| Min. Negotiated Rate |
$29.82 |
| Max. Negotiated Rate |
$1,201.88 |
| Rate for Payer: Aetna Commercial |
$60.77
|
| Rate for Payer: Aetna Medicare |
$47.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.30
|
| Rate for Payer: BCBS Complete |
$31.31
|
| Rate for Payer: BCBS MAPPO |
$45.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,201.88
|
| Rate for Payer: BCN Commercial |
$414.85
|
| Rate for Payer: BCN Medicare Advantage |
$45.35
|
| Rate for Payer: Cash Price |
$460.00
|
| Rate for Payer: Cash Price |
$460.00
|
| Rate for Payer: Cofinity Commercial |
$60.77
|
| Rate for Payer: Cofinity Commercial |
$65.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.62
|
| Rate for Payer: Meridian Medicaid |
$31.31
|
| Rate for Payer: Nomi Health Commercial |
$54.42
|
| Rate for Payer: PACE SWMI |
$45.35
|
| Rate for Payer: PHP Commercial |
$63.49
|
| Rate for Payer: PHP Medicare Advantage |
$45.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.92
|
| Rate for Payer: Priority Health Medicare |
$45.35
|
| Rate for Payer: Priority Health Narrow Network |
$73.92
|
| Rate for Payer: Priority Health SBD |
$73.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.35
|
| Rate for Payer: UHC Medicare Advantage |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$29.82
|
| Rate for Payer: UMR Bronson Commercial |
$264.50
|
|
|
PR NJX RETROGRADE URETHROCSTOGRAPY
|
Professional
|
Both
|
$717.00
|
|
|
Service Code
|
HCPCS 51610
|
| Min. Negotiated Rate |
$41.54 |
| Max. Negotiated Rate |
$1,159.09 |
| Rate for Payer: Aetna Commercial |
$82.53
|
| Rate for Payer: Aetna Medicare |
$64.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.69
|
| Rate for Payer: BCBS Complete |
$43.62
|
| Rate for Payer: BCBS MAPPO |
$61.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,159.09
|
| Rate for Payer: BCN Commercial |
$189.12
|
| Rate for Payer: BCN Medicare Advantage |
$61.59
|
| Rate for Payer: Cash Price |
$573.60
|
| Rate for Payer: Cash Price |
$573.60
|
| Rate for Payer: Cofinity Commercial |
$82.53
|
| Rate for Payer: Cofinity Commercial |
$88.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.67
|
| Rate for Payer: Meridian Medicaid |
$43.62
|
| Rate for Payer: Nomi Health Commercial |
$73.91
|
| Rate for Payer: PACE SWMI |
$61.59
|
| Rate for Payer: PHP Commercial |
$86.23
|
| Rate for Payer: PHP Medicare Advantage |
$61.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$466.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.73
|
| Rate for Payer: Priority Health Medicare |
$61.59
|
| Rate for Payer: Priority Health Narrow Network |
$101.73
|
| Rate for Payer: Priority Health SBD |
$101.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.59
|
| Rate for Payer: UHC Medicare Advantage |
$61.59
|
| Rate for Payer: UHCCP Medicaid |
$41.54
|
| Rate for Payer: UMR Bronson Commercial |
$329.82
|
|
|
PR NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG
|
Professional
|
Both
|
$213.00
|
|
|
Service Code
|
HCPCS 50690
|
| Min. Negotiated Rate |
$44.94 |
| Max. Negotiated Rate |
$3,404.37 |
| Rate for Payer: Aetna Commercial |
$89.27
|
| Rate for Payer: Aetna Medicare |
$69.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.93
|
| Rate for Payer: BCBS Complete |
$47.19
|
| Rate for Payer: BCBS MAPPO |
$66.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,404.37
|
| Rate for Payer: BCN Commercial |
$174.46
|
| Rate for Payer: BCN Medicare Advantage |
$66.62
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$89.27
|
| Rate for Payer: Cofinity Commercial |
$95.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.95
|
| Rate for Payer: Meridian Medicaid |
$47.19
|
| Rate for Payer: Nomi Health Commercial |
$79.94
|
| Rate for Payer: PACE SWMI |
$66.62
|
| Rate for Payer: PHP Commercial |
$93.27
|
| Rate for Payer: PHP Medicare Advantage |
$66.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.26
|
| Rate for Payer: Priority Health Medicare |
$66.62
|
| Rate for Payer: Priority Health Narrow Network |
$110.26
|
| Rate for Payer: Priority Health SBD |
$110.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.62
|
| Rate for Payer: UHC Medicare Advantage |
$66.62
|
| Rate for Payer: UHCCP Medicaid |
$44.94
|
| Rate for Payer: UMR Bronson Commercial |
$97.98
|
|
|
PR NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST
|
Professional
|
Both
|
$235.00
|
|
|
Service Code
|
HCPCS 54250
|
| Min. Negotiated Rate |
$94.00 |
| Max. Negotiated Rate |
$1,901.35 |
| Rate for Payer: Aetna Commercial |
$154.45
|
| Rate for Payer: Aetna Medicare |
$119.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.97
|
| Rate for Payer: BCBS Complete |
$94.00
|
| Rate for Payer: BCBS MAPPO |
$115.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,901.35
|
| Rate for Payer: BCN Commercial |
$176.42
|
| Rate for Payer: BCN Medicare Advantage |
$115.26
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cofinity Commercial |
$154.45
|
| Rate for Payer: Cofinity Commercial |
$165.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.02
|
| Rate for Payer: Nomi Health Commercial |
$138.31
|
| Rate for Payer: PACE SWMI |
$115.26
|
| Rate for Payer: PHP Commercial |
$161.36
|
| Rate for Payer: PHP Medicare Advantage |
$115.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.33
|
| Rate for Payer: Priority Health Medicare |
$115.26
|
| Rate for Payer: Priority Health Narrow Network |
$193.33
|
| Rate for Payer: Priority Health SBD |
$169.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.26
|
| Rate for Payer: UHC Medicare Advantage |
$115.26
|
| Rate for Payer: UMR Bronson Commercial |
$108.10
|
|
|
PR NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 94761
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$498.19 |
| Rate for Payer: Aetna Commercial |
$4.85
|
| Rate for Payer: Aetna Medicare |
$3.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.21
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: BCBS MAPPO |
$3.62
|
| Rate for Payer: BCBS Trust/PPO |
$498.19
|
| Rate for Payer: BCN Commercial |
$5.37
|
| Rate for Payer: BCN Medicare Advantage |
$3.62
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$5.21
|
| Rate for Payer: Cofinity Commercial |
$4.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.80
|
| Rate for Payer: Nomi Health Commercial |
$4.34
|
| Rate for Payer: PACE SWMI |
$3.62
|
| Rate for Payer: PHP Commercial |
$5.07
|
| Rate for Payer: PHP Medicare Advantage |
$3.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.42
|
| Rate for Payer: Priority Health Medicare |
$3.62
|
| Rate for Payer: Priority Health Narrow Network |
$5.42
|
| Rate for Payer: Priority Health SBD |
$5.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.62
|
| Rate for Payer: UHC Medicare Advantage |
$3.62
|
| Rate for Payer: UMR Bronson Commercial |
$22.08
|
|
|
PR NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 94762
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$235.09 |
| Rate for Payer: Aetna Commercial |
$29.33
|
| Rate for Payer: Aetna Medicare |
$22.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.52
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: BCBS MAPPO |
$21.89
|
| Rate for Payer: BCBS Trust/PPO |
$235.09
|
| Rate for Payer: BCN Commercial |
$37.14
|
| Rate for Payer: BCN Medicare Advantage |
$21.89
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$29.33
|
| Rate for Payer: Cofinity Commercial |
$31.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.98
|
| Rate for Payer: Nomi Health Commercial |
$26.27
|
| Rate for Payer: PACE SWMI |
$21.89
|
| Rate for Payer: PHP Commercial |
$30.65
|
| Rate for Payer: PHP Medicare Advantage |
$21.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.38
|
| Rate for Payer: Priority Health Medicare |
$21.89
|
| Rate for Payer: Priority Health Narrow Network |
$34.38
|
| Rate for Payer: Priority Health SBD |
$34.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.89
|
| Rate for Payer: UHC Medicare Advantage |
$21.89
|
| Rate for Payer: UMR Bronson Commercial |
$19.32
|
|
|
PR NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 94760
|
| Min. Negotiated Rate |
$3.33 |
| Max. Negotiated Rate |
$407.32 |
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: Aetna Medicare |
$3.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.80
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS MAPPO |
$3.33
|
| Rate for Payer: BCBS Trust/PPO |
$407.32
|
| Rate for Payer: BCN Commercial |
$3.42
|
| Rate for Payer: BCN Medicare Advantage |
$3.33
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$4.80
|
| Rate for Payer: Cofinity Commercial |
$4.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.50
|
| Rate for Payer: Nomi Health Commercial |
$4.00
|
| Rate for Payer: PACE SWMI |
$3.33
|
| Rate for Payer: PHP Commercial |
$4.66
|
| Rate for Payer: PHP Medicare Advantage |
$3.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.61
|
| Rate for Payer: Priority Health Medicare |
$3.33
|
| Rate for Payer: Priority Health Narrow Network |
$3.61
|
| Rate for Payer: Priority Health SBD |
$3.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.33
|
| Rate for Payer: UHC Medicare Advantage |
$3.33
|
| Rate for Payer: UMR Bronson Commercial |
$20.70
|
|
|
PR NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 93923
|
| Min. Negotiated Rate |
$13.42 |
| Max. Negotiated Rate |
$415.24 |
| Rate for Payer: Aetna Commercial |
$156.24
|
| Rate for Payer: Aetna Commercial |
$156.24
|
| Rate for Payer: Aetna Medicare |
$121.26
|
| Rate for Payer: Aetna Medicare |
$121.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.24
|
| Rate for Payer: BCBS Complete |
$14.09
|
| Rate for Payer: BCBS Complete |
$14.09
|
| Rate for Payer: BCBS MAPPO |
$116.60
|
| Rate for Payer: BCBS MAPPO |
$116.60
|
| Rate for Payer: BCBS Trust/PPO |
$415.24
|
| Rate for Payer: BCBS Trust/PPO |
$415.24
|
| Rate for Payer: BCN Commercial |
$187.65
|
| Rate for Payer: BCN Commercial |
$187.65
|
| Rate for Payer: BCN Medicare Advantage |
$116.60
|
| Rate for Payer: BCN Medicare Advantage |
$116.60
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$156.24
|
| Rate for Payer: Cofinity Commercial |
$167.90
|
| Rate for Payer: Cofinity Commercial |
$167.90
|
| Rate for Payer: Cofinity Commercial |
$156.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.43
|
| Rate for Payer: Meridian Medicaid |
$14.09
|
| Rate for Payer: Meridian Medicaid |
$14.09
|
| Rate for Payer: Nomi Health Commercial |
$139.92
|
| Rate for Payer: Nomi Health Commercial |
$139.92
|
| Rate for Payer: PACE SWMI |
$116.60
|
| Rate for Payer: PACE SWMI |
$116.60
|
| Rate for Payer: PHP Commercial |
$163.24
|
| Rate for Payer: PHP Commercial |
$163.24
|
| Rate for Payer: PHP Medicare Advantage |
$116.60
|
| Rate for Payer: PHP Medicare Advantage |
$116.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$204.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.85
|
| Rate for Payer: Priority Health Medicare |
$116.60
|
| Rate for Payer: Priority Health Medicare |
$116.60
|
| Rate for Payer: Priority Health Narrow Network |
$176.85
|
| Rate for Payer: Priority Health Narrow Network |
$176.85
|
| Rate for Payer: Priority Health SBD |
$28.94
|
| Rate for Payer: Priority Health SBD |
$28.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.60
|
| Rate for Payer: UHC Medicare Advantage |
$116.60
|
| Rate for Payer: UHC Medicare Advantage |
$116.60
|
| Rate for Payer: UHCCP Medicaid |
$13.42
|
| Rate for Payer: UHCCP Medicaid |
$13.42
|
| Rate for Payer: UMR Bronson Commercial |
$144.90
|
| Rate for Payer: UMR Bronson Commercial |
$20.70
|
|
|
PR NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 93922
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$131.55 |
| Rate for Payer: Aetna Commercial |
$98.28
|
| Rate for Payer: Aetna Commercial |
$98.28
|
| Rate for Payer: Aetna Medicare |
$76.27
|
| Rate for Payer: Aetna Medicare |
$76.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.61
|
| Rate for Payer: BCBS Complete |
$7.83
|
| Rate for Payer: BCBS Complete |
$7.83
|
| Rate for Payer: BCBS MAPPO |
$73.34
|
| Rate for Payer: BCBS MAPPO |
$73.34
|
| Rate for Payer: BCBS Trust/PPO |
$131.55
|
| Rate for Payer: BCBS Trust/PPO |
$131.55
|
| Rate for Payer: BCN Commercial |
$120.21
|
| Rate for Payer: BCN Commercial |
$120.21
|
| Rate for Payer: BCN Medicare Advantage |
$73.34
|
| Rate for Payer: BCN Medicare Advantage |
$73.34
|
| Rate for Payer: Cash Price |
$164.00
|
| Rate for Payer: Cash Price |
$164.00
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cofinity Commercial |
$105.61
|
| Rate for Payer: Cofinity Commercial |
$98.28
|
| Rate for Payer: Cofinity Commercial |
$98.28
|
| Rate for Payer: Cofinity Commercial |
$105.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.01
|
| Rate for Payer: Meridian Medicaid |
$7.83
|
| Rate for Payer: Meridian Medicaid |
$7.83
|
| Rate for Payer: Nomi Health Commercial |
$88.01
|
| Rate for Payer: Nomi Health Commercial |
$88.01
|
| Rate for Payer: PACE SWMI |
$73.34
|
| Rate for Payer: PACE SWMI |
$73.34
|
| Rate for Payer: PHP Commercial |
$102.68
|
| Rate for Payer: PHP Commercial |
$102.68
|
| Rate for Payer: PHP Medicare Advantage |
$73.34
|
| Rate for Payer: PHP Medicare Advantage |
$73.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.72
|
| Rate for Payer: Priority Health Medicare |
$73.34
|
| Rate for Payer: Priority Health Medicare |
$73.34
|
| Rate for Payer: Priority Health Narrow Network |
$111.72
|
| Rate for Payer: Priority Health Narrow Network |
$111.72
|
| Rate for Payer: Priority Health SBD |
$15.83
|
| Rate for Payer: Priority Health SBD |
$15.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.34
|
| Rate for Payer: UHC Medicare Advantage |
$73.34
|
| Rate for Payer: UHC Medicare Advantage |
$73.34
|
| Rate for Payer: UHCCP Medicaid |
$7.46
|
| Rate for Payer: UHCCP Medicaid |
$7.46
|
| Rate for Payer: UMR Bronson Commercial |
$94.30
|
| Rate for Payer: UMR Bronson Commercial |
$12.42
|
|
|
PR NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART
|
Professional
|
Both
|
$1,140.00
|
|
|
Service Code
|
HCPCS 36221
|
| Min. Negotiated Rate |
$125.03 |
| Max. Negotiated Rate |
$1,452.84 |
| Rate for Payer: Aetna Commercial |
$256.78
|
| Rate for Payer: Aetna Medicare |
$199.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.95
|
| Rate for Payer: BCBS Complete |
$131.28
|
| Rate for Payer: BCBS MAPPO |
$191.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,320.46
|
| Rate for Payer: BCN Commercial |
$1,452.84
|
| Rate for Payer: BCN Medicare Advantage |
$191.63
|
| Rate for Payer: Cash Price |
$912.00
|
| Rate for Payer: Cash Price |
$912.00
|
| Rate for Payer: Cofinity Commercial |
$275.95
|
| Rate for Payer: Cofinity Commercial |
$256.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.21
|
| Rate for Payer: Meridian Medicaid |
$131.28
|
| Rate for Payer: Nomi Health Commercial |
$229.96
|
| Rate for Payer: PACE SWMI |
$191.63
|
| Rate for Payer: PHP Commercial |
$268.28
|
| Rate for Payer: PHP Medicare Advantage |
$191.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$741.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$311.11
|
| Rate for Payer: Priority Health Medicare |
$191.63
|
| Rate for Payer: Priority Health Narrow Network |
$311.11
|
| Rate for Payer: Priority Health SBD |
$311.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.63
|
| Rate for Payer: UHC Medicare Advantage |
$191.63
|
| Rate for Payer: UHCCP Medicaid |
$125.03
|
| Rate for Payer: UMR Bronson Commercial |
$524.40
|
|
|
PR NORMAL SALINE SOLUTION INFUS
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J7030
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Aetna Commercial |
$3.05
|
| Rate for Payer: Aetna Medicare |
$2.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.28
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$2.28
|
| Rate for Payer: BCBS Trust/PPO |
$0.64
|
| Rate for Payer: BCN Commercial |
$0.52
|
| Rate for Payer: BCN Medicare Advantage |
$2.28
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$3.05
|
| Rate for Payer: Cofinity Commercial |
$3.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.39
|
| Rate for Payer: Nomi Health Commercial |
$2.73
|
| Rate for Payer: PACE SWMI |
$2.28
|
| Rate for Payer: PHP Commercial |
$3.19
|
| Rate for Payer: PHP Medicare Advantage |
$2.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: Priority Health Medicare |
$2.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.28
|
| Rate for Payer: UHC Medicare Advantage |
$2.28
|
| Rate for Payer: UMR Bronson Commercial |
$4.60
|
|
|
PR NORMAL SALINE SOLUTION INFUS
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS J7050
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$3.25 |
| Rate for Payer: Aetna Commercial |
$0.95
|
| Rate for Payer: Aetna Medicare |
$0.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.02
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: BCBS MAPPO |
$0.71
|
| Rate for Payer: BCBS Trust/PPO |
$0.39
|
| Rate for Payer: BCN Commercial |
$0.38
|
| Rate for Payer: BCN Medicare Advantage |
$0.71
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cofinity Commercial |
$0.95
|
| Rate for Payer: Cofinity Commercial |
$1.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.75
|
| Rate for Payer: Nomi Health Commercial |
$0.85
|
| Rate for Payer: PACE SWMI |
$0.71
|
| Rate for Payer: PHP Commercial |
$1.00
|
| Rate for Payer: PHP Medicare Advantage |
$0.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.25
|
| Rate for Payer: Priority Health Medicare |
$0.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.71
|
| Rate for Payer: UHC Medicare Advantage |
$0.71
|
| Rate for Payer: UMR Bronson Commercial |
$2.30
|
|
|
PR NORMAL SALINE SOLUTION INFUS
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS J7040
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$5.20 |
| Rate for Payer: Aetna Commercial |
$1.84
|
| Rate for Payer: Aetna Medicare |
$1.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.98
|
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: BCBS MAPPO |
$1.38
|
| Rate for Payer: BCBS Trust/PPO |
$0.40
|
| Rate for Payer: BCN Commercial |
$0.39
|
| Rate for Payer: BCN Medicare Advantage |
$1.38
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cofinity Commercial |
$1.84
|
| Rate for Payer: Cofinity Commercial |
$1.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.44
|
| Rate for Payer: Nomi Health Commercial |
$1.65
|
| Rate for Payer: PACE SWMI |
$1.38
|
| Rate for Payer: PHP Commercial |
$1.93
|
| Rate for Payer: PHP Medicare Advantage |
$1.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.20
|
| Rate for Payer: Priority Health Medicare |
$1.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.38
|
| Rate for Payer: UHC Medicare Advantage |
$1.38
|
| Rate for Payer: UMR Bronson Commercial |
$3.68
|
|
