|
PR POTASSIUM HYDROXIDE PREPS
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS Q0112
|
| Min. Negotiated Rate |
$3.50 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Aetna Commercial |
$7.81
|
| Rate for Payer: Aetna Medicare |
$6.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.40
|
| Rate for Payer: BCBS MAPPO |
$5.83
|
| Rate for Payer: BCN Commercial |
$4.37
|
| Rate for Payer: BCN Medicare Advantage |
$5.83
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cofinity Commercial |
$7.81
|
| Rate for Payer: Cofinity Commercial |
$8.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.41
|
| Rate for Payer: Nomi Health Commercial |
$7.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.25
|
| Rate for Payer: PACE SWMI |
$5.83
|
| Rate for Payer: PHP Commercial |
$8.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.83
|
| Rate for Payer: Priority Health Medicare |
$5.83
|
| Rate for Payer: Railroad Medicare Medicare |
$5.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.50
|
| Rate for Payer: UHC Core |
$3.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.83
|
| Rate for Payer: UHC Exchange |
$3.50
|
| Rate for Payer: UMR Bronson Commercial |
$10.58
|
|
|
PR PPPS, INITIAL VISIT
|
Professional
|
Both
|
$267.00
|
|
|
Service Code
|
HCPCS G0438
|
| Min. Negotiated Rate |
$106.80 |
| Max. Negotiated Rate |
$247.00 |
| Rate for Payer: Aetna Commercial |
$225.08
|
| Rate for Payer: Aetna Medicare |
$174.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.88
|
| Rate for Payer: BCBS Complete |
$106.80
|
| Rate for Payer: BCBS MAPPO |
$167.97
|
| Rate for Payer: BCN Commercial |
$247.00
|
| Rate for Payer: BCN Medicare Advantage |
$167.97
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cofinity Commercial |
$241.88
|
| Rate for Payer: Cofinity Commercial |
$225.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$184.77
|
| Rate for Payer: Nomi Health Commercial |
$201.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.25
|
| Rate for Payer: PACE SWMI |
$167.97
|
| Rate for Payer: PHP Commercial |
$235.16
|
| Rate for Payer: PHP Medicare Advantage |
$167.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$216.03
|
| Rate for Payer: Priority Health Medicare |
$167.97
|
| Rate for Payer: Priority Health SBD |
$216.03
|
| Rate for Payer: Priority Health Tiered Network |
$216.03
|
| Rate for Payer: Railroad Medicare Medicare |
$167.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$235.75
|
| Rate for Payer: UHC Core |
$235.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$167.97
|
| Rate for Payer: UHC Exchange |
$235.75
|
| Rate for Payer: UMR Bronson Commercial |
$122.82
|
|
|
PR PPPS, SUBSEQ VISIT
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS G0439
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$194.71 |
| Rate for Payer: Aetna Commercial |
$177.09
|
| Rate for Payer: Aetna Medicare |
$137.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.31
|
| Rate for Payer: BCBS Complete |
$72.00
|
| Rate for Payer: BCBS MAPPO |
$132.16
|
| Rate for Payer: BCN Commercial |
$194.71
|
| Rate for Payer: BCN Medicare Advantage |
$132.16
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$190.31
|
| Rate for Payer: Cofinity Commercial |
$177.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$138.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.38
|
| Rate for Payer: Nomi Health Commercial |
$158.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.00
|
| Rate for Payer: PACE SWMI |
$132.16
|
| Rate for Payer: PHP Commercial |
$185.02
|
| Rate for Payer: PHP Medicare Advantage |
$132.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$170.29
|
| Rate for Payer: Priority Health Medicare |
$132.16
|
| Rate for Payer: Priority Health SBD |
$170.29
|
| Rate for Payer: Priority Health Tiered Network |
$170.29
|
| Rate for Payer: Railroad Medicare Medicare |
$132.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.32
|
| Rate for Payer: UHC Core |
$159.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.16
|
| Rate for Payer: UHC Exchange |
$159.32
|
| Rate for Payer: UMR Bronson Commercial |
$82.80
|
|
|
PR PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 90732
|
| Min. Negotiated Rate |
$69.00 |
| Max. Negotiated Rate |
$230.41 |
| Rate for Payer: Aetna Commercial |
$178.85
|
| Rate for Payer: Aetna Medicare |
$138.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.85
|
| Rate for Payer: BCBS MAPPO |
$133.47
|
| Rate for Payer: BCBS Trust/PPO |
$117.08
|
| Rate for Payer: BCN Commercial |
$230.41
|
| Rate for Payer: BCN Medicare Advantage |
$133.47
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$192.20
|
| Rate for Payer: Cofinity Commercial |
$178.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$146.82
|
| Rate for Payer: Nomi Health Commercial |
$160.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$112.50
|
| Rate for Payer: PACE SWMI |
$133.47
|
| Rate for Payer: PHP Commercial |
$186.86
|
| Rate for Payer: PHP Medicare Advantage |
$133.47
|
| Rate for Payer: Priority Health Medicare |
$133.47
|
| Rate for Payer: Railroad Medicare Medicare |
$133.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.08
|
| Rate for Payer: UHC Core |
$117.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$133.47
|
| Rate for Payer: UHC Exchange |
$117.08
|
| Rate for Payer: UMR Bronson Commercial |
$69.00
|
|
|
PR PRCTECT CMBN ABDOMINOPRNL PULL-THRU PX
|
Professional
|
Both
|
$4,792.00
|
|
|
Service Code
|
HCPCS 45112
|
| Min. Negotiated Rate |
$1,046.26 |
| Max. Negotiated Rate |
$3,594.00 |
| Rate for Payer: Aetna Commercial |
$2,178.22
|
| Rate for Payer: Aetna Medicare |
$1,690.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,178.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,340.78
|
| Rate for Payer: BCBS Complete |
$1,098.57
|
| Rate for Payer: BCBS MAPPO |
$1,625.54
|
| Rate for Payer: BCN Commercial |
$2,691.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,625.54
|
| Rate for Payer: Cash Price |
$3,833.60
|
| Rate for Payer: Cash Price |
$3,833.60
|
| Rate for Payer: Cofinity Commercial |
$2,178.22
|
| Rate for Payer: Cofinity Commercial |
$2,340.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,625.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,706.82
|
| Rate for Payer: Meridian Medicaid |
$1,098.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,788.09
|
| Rate for Payer: Nomi Health Commercial |
$1,950.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,594.00
|
| Rate for Payer: PACE SWMI |
$1,625.54
|
| Rate for Payer: PHP Commercial |
$2,275.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,625.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,046.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,279.53
|
| Rate for Payer: Priority Health Medicare |
$1,625.54
|
| Rate for Payer: Priority Health SBD |
$3,279.53
|
| Rate for Payer: Priority Health Tiered Network |
$3,279.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,625.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,306.30
|
| Rate for Payer: UHC Core |
$3,306.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,625.54
|
| Rate for Payer: UHC Exchange |
$3,306.30
|
| Rate for Payer: UHC Medicaid |
$1,046.26
|
| Rate for Payer: UHCCP Medicaid |
$1,046.26
|
| Rate for Payer: UMR Bronson Commercial |
$2,204.32
|
|
|
PR PRCTECT COMPL CMBN ABDOMINOPRNL W/CLST
|
Professional
|
Both
|
$4,867.00
|
|
|
Service Code
|
HCPCS 45110
|
| Min. Negotiated Rate |
$1,066.49 |
| Max. Negotiated Rate |
$3,650.25 |
| Rate for Payer: Aetna Commercial |
$2,216.27
|
| Rate for Payer: Aetna Medicare |
$1,720.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,216.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,381.66
|
| Rate for Payer: BCBS Complete |
$1,119.81
|
| Rate for Payer: BCBS MAPPO |
$1,653.93
|
| Rate for Payer: BCN Commercial |
$2,698.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,653.93
|
| Rate for Payer: Cash Price |
$3,893.60
|
| Rate for Payer: Cash Price |
$3,893.60
|
| Rate for Payer: Cofinity Commercial |
$2,216.27
|
| Rate for Payer: Cofinity Commercial |
$2,381.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,653.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,736.63
|
| Rate for Payer: Meridian Medicaid |
$1,119.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,819.32
|
| Rate for Payer: Nomi Health Commercial |
$1,984.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,650.25
|
| Rate for Payer: PACE SWMI |
$1,653.93
|
| Rate for Payer: PHP Commercial |
$2,315.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,653.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,066.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,288.02
|
| Rate for Payer: Priority Health Medicare |
$1,653.93
|
| Rate for Payer: Priority Health SBD |
$3,288.02
|
| Rate for Payer: Priority Health Tiered Network |
$3,288.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,653.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,246.37
|
| Rate for Payer: UHC Core |
$3,246.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,653.93
|
| Rate for Payer: UHC Exchange |
$3,246.37
|
| Rate for Payer: UHC Medicaid |
$1,066.49
|
| Rate for Payer: UHCCP Medicaid |
$1,066.49
|
| Rate for Payer: UMR Bronson Commercial |
$2,238.82
|
|
|
PR PRCTECT COMPL W/PULL-THRU PX & ANASTOMOSIS
|
Professional
|
Both
|
$5,143.00
|
|
|
Service Code
|
HCPCS 45120
|
| Min. Negotiated Rate |
$955.31 |
| Max. Negotiated Rate |
$3,857.25 |
| Rate for Payer: Aetna Commercial |
$1,999.36
|
| Rate for Payer: Aetna Medicare |
$1,551.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,999.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,148.57
|
| Rate for Payer: BCBS Complete |
$1,003.08
|
| Rate for Payer: BCBS MAPPO |
$1,492.06
|
| Rate for Payer: BCN Commercial |
$2,403.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,492.06
|
| Rate for Payer: Cash Price |
$4,114.40
|
| Rate for Payer: Cash Price |
$4,114.40
|
| Rate for Payer: Cofinity Commercial |
$1,999.36
|
| Rate for Payer: Cofinity Commercial |
$2,148.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,492.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,566.66
|
| Rate for Payer: Meridian Medicaid |
$1,003.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,641.27
|
| Rate for Payer: Nomi Health Commercial |
$1,790.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,857.25
|
| Rate for Payer: PACE SWMI |
$1,492.06
|
| Rate for Payer: PHP Commercial |
$2,088.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,492.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$955.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,928.83
|
| Rate for Payer: Priority Health Medicare |
$1,492.06
|
| Rate for Payer: Priority Health SBD |
$2,928.83
|
| Rate for Payer: Priority Health Tiered Network |
$2,928.83
|
| Rate for Payer: Railroad Medicare Medicare |
$1,492.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,849.41
|
| Rate for Payer: UHC Core |
$2,849.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,492.06
|
| Rate for Payer: UHC Exchange |
$2,849.41
|
| Rate for Payer: UHC Medicaid |
$955.31
|
| Rate for Payer: UHCCP Medicaid |
$955.31
|
| Rate for Payer: UMR Bronson Commercial |
$2,365.78
|
|
|
PR PRCTECT COMPL W/STOT/TOT COLCT W/MLT BXS
|
Professional
|
Both
|
$5,047.00
|
|
|
Service Code
|
HCPCS 45121
|
| Min. Negotiated Rate |
$1,039.65 |
| Max. Negotiated Rate |
$3,785.25 |
| Rate for Payer: Aetna Commercial |
$2,178.30
|
| Rate for Payer: Aetna Medicare |
$1,690.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,178.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,340.86
|
| Rate for Payer: BCBS Complete |
$1,091.63
|
| Rate for Payer: BCBS MAPPO |
$1,625.60
|
| Rate for Payer: BCN Commercial |
$2,620.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,625.60
|
| Rate for Payer: Cash Price |
$4,037.60
|
| Rate for Payer: Cash Price |
$4,037.60
|
| Rate for Payer: Cofinity Commercial |
$2,178.30
|
| Rate for Payer: Cofinity Commercial |
$2,340.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,625.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,706.88
|
| Rate for Payer: Meridian Medicaid |
$1,091.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,788.16
|
| Rate for Payer: Nomi Health Commercial |
$1,950.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,785.25
|
| Rate for Payer: PACE SWMI |
$1,625.60
|
| Rate for Payer: PHP Commercial |
$2,275.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,625.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,039.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,192.75
|
| Rate for Payer: Priority Health Medicare |
$1,625.60
|
| Rate for Payer: Priority Health SBD |
$3,192.75
|
| Rate for Payer: Priority Health Tiered Network |
$3,192.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,625.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,114.90
|
| Rate for Payer: UHC Core |
$3,114.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,625.60
|
| Rate for Payer: UHC Exchange |
$3,114.90
|
| Rate for Payer: UHC Medicaid |
$1,039.65
|
| Rate for Payer: UHCCP Medicaid |
$1,039.65
|
| Rate for Payer: UMR Bronson Commercial |
$2,321.62
|
|
|
PR PRCTECT PRTL RESCJ RECTUM TABDL APPR
|
Professional
|
Both
|
$2,032.00
|
|
|
Service Code
|
HCPCS 45111
|
| Min. Negotiated Rate |
$644.54 |
| Max. Negotiated Rate |
$1,977.42 |
| Rate for Payer: Aetna Commercial |
$1,340.00
|
| Rate for Payer: Aetna Medicare |
$1,040.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,340.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,440.00
|
| Rate for Payer: BCBS Complete |
$676.77
|
| Rate for Payer: BCBS MAPPO |
$1,000.00
|
| Rate for Payer: BCN Commercial |
$1,622.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,000.00
|
| Rate for Payer: Cash Price |
$1,625.60
|
| Rate for Payer: Cash Price |
$1,625.60
|
| Rate for Payer: Cofinity Commercial |
$1,340.00
|
| Rate for Payer: Cofinity Commercial |
$1,440.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,000.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,050.00
|
| Rate for Payer: Meridian Medicaid |
$676.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,100.00
|
| Rate for Payer: Nomi Health Commercial |
$1,200.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,524.00
|
| Rate for Payer: PACE SWMI |
$1,000.00
|
| Rate for Payer: PHP Commercial |
$1,400.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,000.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$644.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,977.42
|
| Rate for Payer: Priority Health Medicare |
$1,000.00
|
| Rate for Payer: Priority Health SBD |
$1,977.42
|
| Rate for Payer: Priority Health Tiered Network |
$1,977.42
|
| Rate for Payer: Railroad Medicare Medicare |
$1,000.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,924.58
|
| Rate for Payer: UHC Core |
$1,924.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,000.00
|
| Rate for Payer: UHC Exchange |
$1,924.58
|
| Rate for Payer: UHC Medicaid |
$644.54
|
| Rate for Payer: UHCCP Medicaid |
$644.54
|
| Rate for Payer: UMR Bronson Commercial |
$934.72
|
|
|
PR PRCTECT PRTL W/ANAST ABDL & TRANSSAC APPROACH
|
Professional
|
Both
|
$3,357.00
|
|
|
Service Code
|
HCPCS 45114
|
| Min. Negotiated Rate |
$1,076.72 |
| Max. Negotiated Rate |
$3,318.36 |
| Rate for Payer: Aetna Commercial |
$2,260.16
|
| Rate for Payer: Aetna Medicare |
$1,754.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,260.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,428.83
|
| Rate for Payer: BCBS Complete |
$1,130.56
|
| Rate for Payer: BCBS MAPPO |
$1,686.69
|
| Rate for Payer: BCN Commercial |
$2,723.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,686.69
|
| Rate for Payer: Cash Price |
$2,685.60
|
| Rate for Payer: Cash Price |
$2,685.60
|
| Rate for Payer: Cofinity Commercial |
$2,260.16
|
| Rate for Payer: Cofinity Commercial |
$2,428.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,686.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,771.02
|
| Rate for Payer: Meridian Medicaid |
$1,130.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,855.36
|
| Rate for Payer: Nomi Health Commercial |
$2,024.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,517.75
|
| Rate for Payer: PACE SWMI |
$1,686.69
|
| Rate for Payer: PHP Commercial |
$2,361.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,686.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,076.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,318.36
|
| Rate for Payer: Priority Health Medicare |
$1,686.69
|
| Rate for Payer: Priority Health SBD |
$3,318.36
|
| Rate for Payer: Priority Health Tiered Network |
$3,318.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1,686.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,250.86
|
| Rate for Payer: UHC Core |
$3,250.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,686.69
|
| Rate for Payer: UHC Exchange |
$3,250.86
|
| Rate for Payer: UHC Medicaid |
$1,076.72
|
| Rate for Payer: UHCCP Medicaid |
$1,076.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,544.22
|
|
|
PR PRCTECT PRTL W/ANAST TRANSSAC APPR ONLY
|
Professional
|
Both
|
$3,925.00
|
|
|
Service Code
|
HCPCS 45116
|
| Min. Negotiated Rate |
$897.16 |
| Max. Negotiated Rate |
$2,943.75 |
| Rate for Payer: Aetna Commercial |
$1,864.02
|
| Rate for Payer: Aetna Medicare |
$1,446.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,864.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,003.13
|
| Rate for Payer: BCBS Complete |
$942.02
|
| Rate for Payer: BCBS MAPPO |
$1,391.06
|
| Rate for Payer: BCN Commercial |
$2,295.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,391.06
|
| Rate for Payer: Cash Price |
$3,140.00
|
| Rate for Payer: Cash Price |
$3,140.00
|
| Rate for Payer: Cofinity Commercial |
$1,864.02
|
| Rate for Payer: Cofinity Commercial |
$2,003.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,391.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,460.61
|
| Rate for Payer: Meridian Medicaid |
$942.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,530.17
|
| Rate for Payer: Nomi Health Commercial |
$1,669.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,943.75
|
| Rate for Payer: PACE SWMI |
$1,391.06
|
| Rate for Payer: PHP Commercial |
$1,947.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,391.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$897.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,797.14
|
| Rate for Payer: Priority Health Medicare |
$1,391.06
|
| Rate for Payer: Priority Health SBD |
$2,797.14
|
| Rate for Payer: Priority Health Tiered Network |
$2,797.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,391.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,734.18
|
| Rate for Payer: UHC Core |
$2,734.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,391.06
|
| Rate for Payer: UHC Exchange |
$2,734.18
|
| Rate for Payer: UHC Medicaid |
$897.16
|
| Rate for Payer: UHCCP Medicaid |
$897.16
|
| Rate for Payer: UMR Bronson Commercial |
$1,805.50
|
|
|
PR PRCTECT PRTL W/MUCOSEC ILEOANAL ANAST RSVR
|
Professional
|
Both
|
$5,619.00
|
|
|
Service Code
|
HCPCS 45113
|
| Min. Negotiated Rate |
$1,081.19 |
| Max. Negotiated Rate |
$4,214.25 |
| Rate for Payer: Aetna Commercial |
$2,245.40
|
| Rate for Payer: Aetna Medicare |
$1,742.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,245.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,412.96
|
| Rate for Payer: BCBS Complete |
$1,135.25
|
| Rate for Payer: BCBS MAPPO |
$1,675.67
|
| Rate for Payer: BCN Commercial |
$2,763.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,675.67
|
| Rate for Payer: Cash Price |
$4,495.20
|
| Rate for Payer: Cash Price |
$4,495.20
|
| Rate for Payer: Cofinity Commercial |
$2,245.40
|
| Rate for Payer: Cofinity Commercial |
$2,412.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,675.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,759.45
|
| Rate for Payer: Meridian Medicaid |
$1,135.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,843.24
|
| Rate for Payer: Nomi Health Commercial |
$2,010.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,214.25
|
| Rate for Payer: PACE SWMI |
$1,675.67
|
| Rate for Payer: PHP Commercial |
$2,345.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,675.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,081.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,367.50
|
| Rate for Payer: Priority Health Medicare |
$1,675.67
|
| Rate for Payer: Priority Health SBD |
$3,367.50
|
| Rate for Payer: Priority Health Tiered Network |
$3,367.50
|
| Rate for Payer: Railroad Medicare Medicare |
$1,675.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,314.28
|
| Rate for Payer: UHC Core |
$3,314.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,675.67
|
| Rate for Payer: UHC Exchange |
$3,314.28
|
| Rate for Payer: UHC Medicaid |
$1,081.19
|
| Rate for Payer: UHCCP Medicaid |
$1,081.19
|
| Rate for Payer: UMR Bronson Commercial |
$2,584.74
|
|
|
PR PRCTECT PRTL W/O ANAST PRNL APPR
|
Professional
|
Both
|
$3,138.00
|
|
|
Service Code
|
HCPCS 45123
|
| Min. Negotiated Rate |
$658.60 |
| Max. Negotiated Rate |
$2,353.50 |
| Rate for Payer: Aetna Commercial |
$1,366.81
|
| Rate for Payer: Aetna Medicare |
$1,060.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,366.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,468.81
|
| Rate for Payer: BCBS Complete |
$691.53
|
| Rate for Payer: BCBS MAPPO |
$1,020.01
|
| Rate for Payer: BCN Commercial |
$1,661.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,020.01
|
| Rate for Payer: Cash Price |
$2,510.40
|
| Rate for Payer: Cash Price |
$2,510.40
|
| Rate for Payer: Cofinity Commercial |
$1,366.81
|
| Rate for Payer: Cofinity Commercial |
$1,468.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,020.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,071.01
|
| Rate for Payer: Meridian Medicaid |
$691.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,122.01
|
| Rate for Payer: Nomi Health Commercial |
$1,224.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,353.50
|
| Rate for Payer: PACE SWMI |
$1,020.01
|
| Rate for Payer: PHP Commercial |
$1,428.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,020.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$658.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,024.74
|
| Rate for Payer: Priority Health Medicare |
$1,020.01
|
| Rate for Payer: Priority Health SBD |
$2,024.74
|
| Rate for Payer: Priority Health Tiered Network |
$2,024.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1,020.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,969.47
|
| Rate for Payer: UHC Core |
$1,969.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,020.01
|
| Rate for Payer: UHC Exchange |
$1,969.47
|
| Rate for Payer: UHC Medicaid |
$658.60
|
| Rate for Payer: UHCCP Medicaid |
$658.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,443.48
|
|
|
PR PREDNISONE IR OR DR ORAL 1MG
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
HCPCS J7512
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.75 |
| Rate for Payer: BCBS Complete |
$0.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: UHC Exchange |
$0.01
|
| Rate for Payer: UMR Bronson Commercial |
$0.46
|
|
|
PR PREDNISONE ORAL
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
HCPCS J7506
|
| Min. Negotiated Rate |
$0.40 |
| Max. Negotiated Rate |
$0.75 |
| Rate for Payer: Aetna Medicare |
$0.50
|
| Rate for Payer: BCBS Complete |
$0.40
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.75
|
| Rate for Payer: UMR Bronson Commercial |
$0.46
|
|
|
PR PREPARATION SKIN CELL SSP AGRFT 1ST 25 SQ CM/<
|
Professional
|
Both
|
$9,709.00
|
|
|
Service Code
|
HCPCS 15013
|
| Min. Negotiated Rate |
$41.99 |
| Max. Negotiated Rate |
$9,376.33 |
| Rate for Payer: Aetna Medicare |
$4,854.50
|
| Rate for Payer: BCBS Complete |
$44.09
|
| Rate for Payer: BCN Commercial |
$6,779.22
|
| Rate for Payer: Cash Price |
$7,767.20
|
| Rate for Payer: Cash Price |
$7,767.20
|
| Rate for Payer: Meridian Medicaid |
$44.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,281.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,376.33
|
| Rate for Payer: Priority Health SBD |
$9,376.33
|
| Rate for Payer: Priority Health Tiered Network |
$9,376.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.65
|
| Rate for Payer: UHC Core |
$148.65
|
| Rate for Payer: UHC Exchange |
$148.65
|
| Rate for Payer: UHC Medicaid |
$41.99
|
| Rate for Payer: UHCCP Medicaid |
$41.99
|
| Rate for Payer: UMR Bronson Commercial |
$4,466.14
|
|
|
PR PREPARATION SKIN CELL SSP AGRFT EA ADDL 25 SQ CM
|
Professional
|
Both
|
$9,709.00
|
|
|
Service Code
|
HCPCS 15014
|
| Min. Negotiated Rate |
$41.99 |
| Max. Negotiated Rate |
$7,281.75 |
| Rate for Payer: Aetna Medicare |
$4,854.50
|
| Rate for Payer: BCBS Complete |
$44.09
|
| Rate for Payer: Cash Price |
$7,767.20
|
| Rate for Payer: Cash Price |
$7,767.20
|
| Rate for Payer: Meridian Medicaid |
$44.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,281.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.65
|
| Rate for Payer: UHC Core |
$148.65
|
| Rate for Payer: UHC Exchange |
$148.65
|
| Rate for Payer: UHC Medicaid |
$41.99
|
| Rate for Payer: UHCCP Medicaid |
$41.99
|
| Rate for Payer: UMR Bronson Commercial |
$4,466.14
|
|
|
PR PREPARE FECAL MICROBIOTA FOR INSTILLATION
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 44705
|
| Min. Negotiated Rate |
$39.19 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$96.49
|
| Rate for Payer: Aetna Medicare |
$105.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.49
|
| Rate for Payer: BCBS Complete |
$41.15
|
| Rate for Payer: BCN Commercial |
$106.57
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Meridian Medicaid |
$41.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$129.84
|
| Rate for Payer: Priority Health SBD |
$129.84
|
| Rate for Payer: Priority Health Tiered Network |
$129.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.68
|
| Rate for Payer: UHC Core |
$127.68
|
| Rate for Payer: UHC Exchange |
$127.68
|
| Rate for Payer: UHC Medicaid |
$39.19
|
| Rate for Payer: UHCCP Medicaid |
$39.19
|
| Rate for Payer: UMR Bronson Commercial |
$96.60
|
|
|
PR PREPERITONEAL PEL PACK F/HEMRRG ASSOC PEL TRMA
|
Professional
|
Both
|
$970.00
|
|
|
Service Code
|
HCPCS 49013
|
| Min. Negotiated Rate |
$261.56 |
| Max. Negotiated Rate |
$826.40 |
| Rate for Payer: Aetna Commercial |
$554.48
|
| Rate for Payer: Aetna Medicare |
$430.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$595.86
|
| Rate for Payer: BCBS Complete |
$274.64
|
| Rate for Payer: BCBS MAPPO |
$413.79
|
| Rate for Payer: BCN Commercial |
$678.25
|
| Rate for Payer: BCN Medicare Advantage |
$413.79
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Cash Price |
$776.00
|
| Rate for Payer: Cofinity Commercial |
$554.48
|
| Rate for Payer: Cofinity Commercial |
$595.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$434.48
|
| Rate for Payer: Meridian Medicaid |
$274.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$455.17
|
| Rate for Payer: Nomi Health Commercial |
$496.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$727.50
|
| Rate for Payer: PACE SWMI |
$413.79
|
| Rate for Payer: PHP Commercial |
$579.31
|
| Rate for Payer: PHP Medicare Advantage |
$413.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$826.40
|
| Rate for Payer: Priority Health Medicare |
$413.79
|
| Rate for Payer: Priority Health SBD |
$826.40
|
| Rate for Payer: Priority Health Tiered Network |
$826.40
|
| Rate for Payer: Railroad Medicare Medicare |
$413.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$782.41
|
| Rate for Payer: UHC Core |
$782.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$413.79
|
| Rate for Payer: UHC Exchange |
$782.41
|
| Rate for Payer: UHC Medicaid |
$261.56
|
| Rate for Payer: UHCCP Medicaid |
$261.56
|
| Rate for Payer: UMR Bronson Commercial |
$446.20
|
|
|
PR PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT
|
Professional
|
Both
|
$690.00
|
|
|
Service Code
|
HCPCS 15004
|
| Min. Negotiated Rate |
$145.91 |
| Max. Negotiated Rate |
$517.50 |
| Rate for Payer: Aetna Commercial |
$303.31
|
| Rate for Payer: Aetna Medicare |
$235.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.94
|
| Rate for Payer: BCBS Complete |
$153.21
|
| Rate for Payer: BCBS MAPPO |
$226.35
|
| Rate for Payer: BCN Commercial |
$388.92
|
| Rate for Payer: BCN Medicare Advantage |
$226.35
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Cofinity Commercial |
$303.31
|
| Rate for Payer: Cofinity Commercial |
$325.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.67
|
| Rate for Payer: Meridian Medicaid |
$153.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$248.99
|
| Rate for Payer: Nomi Health Commercial |
$271.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$517.50
|
| Rate for Payer: PACE SWMI |
$226.35
|
| Rate for Payer: PHP Commercial |
$316.89
|
| Rate for Payer: PHP Medicare Advantage |
$226.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$355.97
|
| Rate for Payer: Priority Health Medicare |
$226.35
|
| Rate for Payer: Priority Health SBD |
$355.97
|
| Rate for Payer: Priority Health Tiered Network |
$355.97
|
| Rate for Payer: Railroad Medicare Medicare |
$226.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$467.28
|
| Rate for Payer: UHC Core |
$467.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$226.35
|
| Rate for Payer: UHC Exchange |
$467.28
|
| Rate for Payer: UHC Medicaid |
$145.91
|
| Rate for Payer: UHCCP Medicaid |
$145.91
|
| Rate for Payer: UMR Bronson Commercial |
$317.40
|
|
|
PR PREP SITE F/S/N/H/F/G/M/D GT ADDL 100 SQ CM/1PCT
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 15005
|
| Min. Negotiated Rate |
$49.84 |
| Max. Negotiated Rate |
$163.07 |
| Rate for Payer: Aetna Commercial |
$104.98
|
| Rate for Payer: Aetna Medicare |
$81.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.81
|
| Rate for Payer: BCBS Complete |
$52.33
|
| Rate for Payer: BCBS MAPPO |
$78.34
|
| Rate for Payer: BCN Commercial |
$133.46
|
| Rate for Payer: BCN Medicare Advantage |
$78.34
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$104.98
|
| Rate for Payer: Cofinity Commercial |
$112.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.26
|
| Rate for Payer: Meridian Medicaid |
$52.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.17
|
| Rate for Payer: Nomi Health Commercial |
$94.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: PACE SWMI |
$78.34
|
| Rate for Payer: PHP Commercial |
$109.68
|
| Rate for Payer: PHP Medicare Advantage |
$78.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$122.15
|
| Rate for Payer: Priority Health Medicare |
$78.34
|
| Rate for Payer: Priority Health SBD |
$122.15
|
| Rate for Payer: Priority Health Tiered Network |
$122.15
|
| Rate for Payer: Railroad Medicare Medicare |
$78.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.07
|
| Rate for Payer: UHC Core |
$163.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$78.34
|
| Rate for Payer: UHC Exchange |
$163.07
|
| Rate for Payer: UHC Medicaid |
$49.84
|
| Rate for Payer: UHCCP Medicaid |
$49.84
|
| Rate for Payer: UMR Bronson Commercial |
$96.60
|
|
|
PR PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT
|
Professional
|
Both
|
$579.00
|
|
|
Service Code
|
HCPCS 15002
|
| Min. Negotiated Rate |
$125.67 |
| Max. Negotiated Rate |
$434.25 |
| Rate for Payer: Aetna Commercial |
$261.25
|
| Rate for Payer: Aetna Medicare |
$202.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$280.74
|
| Rate for Payer: BCBS Complete |
$131.95
|
| Rate for Payer: BCBS MAPPO |
$194.96
|
| Rate for Payer: BCN Commercial |
$328.67
|
| Rate for Payer: BCN Medicare Advantage |
$194.96
|
| Rate for Payer: Cash Price |
$463.20
|
| Rate for Payer: Cash Price |
$463.20
|
| Rate for Payer: Cofinity Commercial |
$261.25
|
| Rate for Payer: Cofinity Commercial |
$280.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.71
|
| Rate for Payer: Meridian Medicaid |
$131.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$214.46
|
| Rate for Payer: Nomi Health Commercial |
$233.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$434.25
|
| Rate for Payer: PACE SWMI |
$194.96
|
| Rate for Payer: PHP Commercial |
$272.94
|
| Rate for Payer: PHP Medicare Advantage |
$194.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$300.82
|
| Rate for Payer: Priority Health Medicare |
$194.96
|
| Rate for Payer: Priority Health SBD |
$300.82
|
| Rate for Payer: Priority Health Tiered Network |
$300.82
|
| Rate for Payer: Railroad Medicare Medicare |
$194.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$393.47
|
| Rate for Payer: UHC Core |
$393.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$194.96
|
| Rate for Payer: UHC Exchange |
$393.47
|
| Rate for Payer: UHC Medicaid |
$125.67
|
| Rate for Payer: UHCCP Medicaid |
$125.67
|
| Rate for Payer: UMR Bronson Commercial |
$266.34
|
|
|
PR PREP SITE TRUNK/ARM/LEG ADDL 100 SQ CM/1PCT
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 15003
|
| Min. Negotiated Rate |
$25.35 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$53.40
|
| Rate for Payer: Aetna Medicare |
$41.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.38
|
| Rate for Payer: BCBS Complete |
$26.62
|
| Rate for Payer: BCBS MAPPO |
$39.85
|
| Rate for Payer: BCN Commercial |
$66.24
|
| Rate for Payer: BCN Medicare Advantage |
$39.85
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$53.40
|
| Rate for Payer: Cofinity Commercial |
$57.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.84
|
| Rate for Payer: Meridian Medicaid |
$26.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.84
|
| Rate for Payer: Nomi Health Commercial |
$47.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.00
|
| Rate for Payer: PACE SWMI |
$39.85
|
| Rate for Payer: PHP Commercial |
$55.79
|
| Rate for Payer: PHP Medicare Advantage |
$39.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$60.62
|
| Rate for Payer: Priority Health Medicare |
$39.85
|
| Rate for Payer: Priority Health SBD |
$60.62
|
| Rate for Payer: Priority Health Tiered Network |
$60.62
|
| Rate for Payer: Railroad Medicare Medicare |
$39.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.96
|
| Rate for Payer: UHC Core |
$80.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.85
|
| Rate for Payer: UHC Exchange |
$80.96
|
| Rate for Payer: UHC Medicaid |
$25.35
|
| Rate for Payer: UHCCP Medicaid |
$25.35
|
| Rate for Payer: UMR Bronson Commercial |
$60.72
|
|
|
PR PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 94640
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$29.25 |
| Rate for Payer: Aetna Commercial |
$10.72
|
| Rate for Payer: Aetna Medicare |
$8.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.72
|
| Rate for Payer: BCBS MAPPO |
$8.00
|
| Rate for Payer: BCN Commercial |
$11.95
|
| Rate for Payer: BCN Medicare Advantage |
$8.00
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$11.52
|
| Rate for Payer: Cofinity Commercial |
$10.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.80
|
| Rate for Payer: Nomi Health Commercial |
$9.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.25
|
| Rate for Payer: PACE SWMI |
$8.00
|
| Rate for Payer: PHP Commercial |
$11.20
|
| Rate for Payer: PHP Medicare Advantage |
$8.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.02
|
| Rate for Payer: Priority Health Medicare |
$8.00
|
| Rate for Payer: Priority Health SBD |
$11.02
|
| Rate for Payer: Priority Health Tiered Network |
$11.02
|
| Rate for Payer: Railroad Medicare Medicare |
$8.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.63
|
| Rate for Payer: UHC Core |
$26.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.00
|
| Rate for Payer: UHC Exchange |
$26.63
|
| Rate for Payer: UMR Bronson Commercial |
$17.94
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 15 MIN
|
Professional
|
Both
|
$68.00
|
|
|
Service Code
|
HCPCS 99401
|
| Min. Negotiated Rate |
$13.21 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Aetna Commercial |
$25.12
|
| Rate for Payer: Aetna Medicare |
$34.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.12
|
| Rate for Payer: BCBS Complete |
$13.87
|
| Rate for Payer: BCN Commercial |
$34.86
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Meridian Medicaid |
$13.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$31.35
|
| Rate for Payer: Priority Health SBD |
$31.35
|
| Rate for Payer: Priority Health Tiered Network |
$31.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.60
|
| Rate for Payer: UHC Core |
$35.60
|
| Rate for Payer: UHC Exchange |
$35.60
|
| Rate for Payer: UHC Medicaid |
$13.21
|
| Rate for Payer: UHCCP Medicaid |
$13.21
|
| Rate for Payer: UMR Bronson Commercial |
$31.28
|
|
