|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 30 MIN
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 99402
|
| Min. Negotiated Rate |
$26.84 |
| Max. Negotiated Rate |
$87.75 |
| Rate for Payer: Aetna Commercial |
$51.32
|
| Rate for Payer: Aetna Medicare |
$58.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.32
|
| Rate for Payer: BCBS Complete |
$28.18
|
| Rate for Payer: BCN Commercial |
$70.22
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Meridian Medicaid |
$28.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$63.16
|
| Rate for Payer: Priority Health SBD |
$63.16
|
| Rate for Payer: Priority Health Tiered Network |
$63.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.65
|
| Rate for Payer: UHC Core |
$72.65
|
| Rate for Payer: UHC Exchange |
$72.65
|
| Rate for Payer: UHC Medicaid |
$26.84
|
| Rate for Payer: UHCCP Medicaid |
$26.84
|
| Rate for Payer: UMR Bronson Commercial |
$53.82
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 45 MIN
|
Professional
|
Both
|
$151.00
|
|
|
Service Code
|
HCPCS 99403
|
| Min. Negotiated Rate |
$39.62 |
| Max. Negotiated Rate |
$113.25 |
| Rate for Payer: Aetna Commercial |
$76.44
|
| Rate for Payer: Aetna Medicare |
$75.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.44
|
| Rate for Payer: BCBS Complete |
$41.60
|
| Rate for Payer: BCN Commercial |
$105.08
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Meridian Medicaid |
$41.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$94.51
|
| Rate for Payer: Priority Health SBD |
$94.51
|
| Rate for Payer: Priority Health Tiered Network |
$94.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.71
|
| Rate for Payer: UHC Core |
$106.71
|
| Rate for Payer: UHC Exchange |
$106.71
|
| Rate for Payer: UHC Medicaid |
$39.62
|
| Rate for Payer: UHCCP Medicaid |
$39.62
|
| Rate for Payer: UMR Bronson Commercial |
$69.46
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 60 MIN
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 99404
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$145.50 |
| Rate for Payer: Aetna Commercial |
$101.22
|
| Rate for Payer: Aetna Medicare |
$97.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.22
|
| Rate for Payer: BCBS Complete |
$55.69
|
| Rate for Payer: BCN Commercial |
$141.92
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Meridian Medicaid |
$55.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$127.67
|
| Rate for Payer: Priority Health SBD |
$127.67
|
| Rate for Payer: Priority Health Tiered Network |
$127.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.78
|
| Rate for Payer: UHC Core |
$142.78
|
| Rate for Payer: UHC Exchange |
$142.78
|
| Rate for Payer: UHC Medicaid |
$53.04
|
| Rate for Payer: UHCCP Medicaid |
$53.04
|
| Rate for Payer: UMR Bronson Commercial |
$89.24
|
|
|
PR PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 60 M
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 99412
|
| Min. Negotiated Rate |
$13.09 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Aetna Commercial |
$13.09
|
| Rate for Payer: Aetna Medicare |
$17.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.09
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: BCN Commercial |
$18.43
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.58
|
| Rate for Payer: Priority Health SBD |
$16.58
|
| Rate for Payer: Priority Health Tiered Network |
$16.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.53
|
| Rate for Payer: UHC Core |
$18.53
|
| Rate for Payer: UHC Exchange |
$18.53
|
| Rate for Payer: UMR Bronson Commercial |
$15.64
|
|
|
PR PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP
|
Professional
|
Both
|
$173.00
|
|
|
Service Code
|
HCPCS 93279
|
| Min. Negotiated Rate |
$63.04 |
| Max. Negotiated Rate |
$129.75 |
| Rate for Payer: Aetna Commercial |
$84.47
|
| Rate for Payer: Aetna Medicare |
$65.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.78
|
| Rate for Payer: BCBS MAPPO |
$63.04
|
| Rate for Payer: BCN Commercial |
$99.10
|
| Rate for Payer: BCN Medicare Advantage |
$63.04
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cofinity Commercial |
$84.47
|
| Rate for Payer: Cofinity Commercial |
$90.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.34
|
| Rate for Payer: Nomi Health Commercial |
$75.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.75
|
| Rate for Payer: PACE SWMI |
$63.04
|
| Rate for Payer: PHP Commercial |
$88.26
|
| Rate for Payer: PHP Medicare Advantage |
$63.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$94.19
|
| Rate for Payer: Priority Health Medicare |
$63.04
|
| Rate for Payer: Priority Health SBD |
$94.19
|
| Rate for Payer: Priority Health Tiered Network |
$94.19
|
| Rate for Payer: Railroad Medicare Medicare |
$63.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.80
|
| Rate for Payer: UHC Core |
$94.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$63.04
|
| Rate for Payer: UHC Exchange |
$94.80
|
| Rate for Payer: UMR Bronson Commercial |
$79.58
|
|
|
PR PRGRMG DEV EVAL LDLS PM SINGLE CAR CHAMBER IP
|
Professional
|
Both
|
$96.00
|
|
|
Service Code
|
HCPCS 0826T
|
| Min. Negotiated Rate |
$34.87 |
| Max. Negotiated Rate |
$109.77 |
| Rate for Payer: Aetna Medicare |
$48.00
|
| Rate for Payer: BCBS Complete |
$38.40
|
| Rate for Payer: BCN Commercial |
$34.87
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.77
|
| Rate for Payer: UHC Core |
$109.77
|
| Rate for Payer: UHC Exchange |
$109.77
|
| Rate for Payer: UMR Bronson Commercial |
$44.16
|
|
|
PR PRGRMG DEV EVAL LDLS PM SYS 2CHMBR IN PERSON
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 0804T
|
| Min. Negotiated Rate |
$67.20 |
| Max. Negotiated Rate |
$131.01 |
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: BCN Commercial |
$115.53
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.01
|
| Rate for Payer: UHC Core |
$131.01
|
| Rate for Payer: UHC Exchange |
$131.01
|
| Rate for Payer: UMR Bronson Commercial |
$77.28
|
|
|
PR PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$90.00
|
|
|
Service Code
|
HCPCS 93285
|
| Min. Negotiated Rate |
$41.40 |
| Max. Negotiated Rate |
$87.65 |
| Rate for Payer: Aetna Commercial |
$75.01
|
| Rate for Payer: Aetna Commercial |
$75.01
|
| Rate for Payer: Aetna Medicare |
$58.22
|
| Rate for Payer: Aetna Medicare |
$58.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.01
|
| Rate for Payer: BCBS MAPPO |
$55.98
|
| Rate for Payer: BCBS MAPPO |
$55.98
|
| Rate for Payer: BCN Commercial |
$87.65
|
| Rate for Payer: BCN Commercial |
$87.65
|
| Rate for Payer: BCN Medicare Advantage |
$55.98
|
| Rate for Payer: BCN Medicare Advantage |
$55.98
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cofinity Commercial |
$75.01
|
| Rate for Payer: Cofinity Commercial |
$80.61
|
| Rate for Payer: Cofinity Commercial |
$75.01
|
| Rate for Payer: Cofinity Commercial |
$80.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.58
|
| Rate for Payer: Nomi Health Commercial |
$67.18
|
| Rate for Payer: Nomi Health Commercial |
$67.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.50
|
| Rate for Payer: PACE SWMI |
$55.98
|
| Rate for Payer: PACE SWMI |
$55.98
|
| Rate for Payer: PHP Commercial |
$78.37
|
| Rate for Payer: PHP Commercial |
$78.37
|
| Rate for Payer: PHP Medicare Advantage |
$55.98
|
| Rate for Payer: PHP Medicare Advantage |
$55.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$83.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$83.30
|
| Rate for Payer: Priority Health Medicare |
$55.98
|
| Rate for Payer: Priority Health Medicare |
$55.98
|
| Rate for Payer: Priority Health SBD |
$83.30
|
| Rate for Payer: Priority Health SBD |
$83.30
|
| Rate for Payer: Priority Health Tiered Network |
$83.30
|
| Rate for Payer: Priority Health Tiered Network |
$83.30
|
| Rate for Payer: Railroad Medicare Medicare |
$55.98
|
| Rate for Payer: Railroad Medicare Medicare |
$55.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.53
|
| Rate for Payer: UHC Core |
$83.53
|
| Rate for Payer: UHC Core |
$83.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$55.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$55.98
|
| Rate for Payer: UHC Exchange |
$83.53
|
| Rate for Payer: UHC Exchange |
$83.53
|
| Rate for Payer: UMR Bronson Commercial |
$57.96
|
| Rate for Payer: UMR Bronson Commercial |
$41.40
|
|
|
PR PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB
|
Professional
|
Both
|
$175.00
|
|
|
Service Code
|
HCPCS 93284
|
| Min. Negotiated Rate |
$80.50 |
| Max. Negotiated Rate |
$155.86 |
| Rate for Payer: Aetna Commercial |
$132.73
|
| Rate for Payer: Aetna Medicare |
$103.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.63
|
| Rate for Payer: BCBS MAPPO |
$99.05
|
| Rate for Payer: BCN Commercial |
$155.37
|
| Rate for Payer: BCN Medicare Advantage |
$99.05
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cofinity Commercial |
$132.73
|
| Rate for Payer: Cofinity Commercial |
$142.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.95
|
| Rate for Payer: Nomi Health Commercial |
$118.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$131.25
|
| Rate for Payer: PACE SWMI |
$99.05
|
| Rate for Payer: PHP Commercial |
$138.67
|
| Rate for Payer: PHP Medicare Advantage |
$99.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$147.67
|
| Rate for Payer: Priority Health Medicare |
$99.05
|
| Rate for Payer: Priority Health SBD |
$147.67
|
| Rate for Payer: Priority Health Tiered Network |
$147.67
|
| Rate for Payer: Railroad Medicare Medicare |
$99.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.86
|
| Rate for Payer: UHC Core |
$155.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$99.05
|
| Rate for Payer: UHC Exchange |
$155.86
|
| Rate for Payer: UMR Bronson Commercial |
$80.50
|
|
|
PR PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB
|
Professional
|
Both
|
$163.00
|
|
|
Service Code
|
HCPCS 93283
|
| Min. Negotiated Rate |
$74.98 |
| Max. Negotiated Rate |
$144.21 |
| Rate for Payer: Aetna Commercial |
$122.94
|
| Rate for Payer: Aetna Medicare |
$95.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.12
|
| Rate for Payer: BCBS MAPPO |
$91.75
|
| Rate for Payer: BCN Commercial |
$143.92
|
| Rate for Payer: BCN Medicare Advantage |
$91.75
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Cofinity Commercial |
$132.12
|
| Rate for Payer: Cofinity Commercial |
$122.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.92
|
| Rate for Payer: Nomi Health Commercial |
$110.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.25
|
| Rate for Payer: PACE SWMI |
$91.75
|
| Rate for Payer: PHP Commercial |
$128.45
|
| Rate for Payer: PHP Medicare Advantage |
$91.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$136.78
|
| Rate for Payer: Priority Health Medicare |
$91.75
|
| Rate for Payer: Priority Health SBD |
$136.78
|
| Rate for Payer: Priority Health Tiered Network |
$136.78
|
| Rate for Payer: Railroad Medicare Medicare |
$91.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.21
|
| Rate for Payer: UHC Core |
$144.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$91.75
|
| Rate for Payer: UHC Exchange |
$144.21
|
| Rate for Payer: UMR Bronson Commercial |
$74.98
|
|
|
PR PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 93282
|
| Min. Negotiated Rate |
$58.88 |
| Max. Negotiated Rate |
$117.02 |
| Rate for Payer: Aetna Commercial |
$99.64
|
| Rate for Payer: Aetna Medicare |
$77.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.64
|
| Rate for Payer: BCBS MAPPO |
$74.36
|
| Rate for Payer: BCN Commercial |
$117.02
|
| Rate for Payer: BCN Medicare Advantage |
$74.36
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$107.08
|
| Rate for Payer: Cofinity Commercial |
$99.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$81.80
|
| Rate for Payer: Nomi Health Commercial |
$89.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.00
|
| Rate for Payer: PACE SWMI |
$74.36
|
| Rate for Payer: PHP Commercial |
$104.10
|
| Rate for Payer: PHP Medicare Advantage |
$74.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$111.22
|
| Rate for Payer: Priority Health Medicare |
$74.36
|
| Rate for Payer: Priority Health SBD |
$111.22
|
| Rate for Payer: Priority Health Tiered Network |
$111.22
|
| Rate for Payer: Railroad Medicare Medicare |
$74.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.97
|
| Rate for Payer: UHC Core |
$114.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$74.36
|
| Rate for Payer: UHC Exchange |
$114.97
|
| Rate for Payer: UMR Bronson Commercial |
$58.88
|
|
|
PR PRICARDIECTOMY STOT/COMPL W/CARDPULM BYPASS
|
Professional
|
Both
|
$5,898.00
|
|
|
Service Code
|
HCPCS 33031
|
| Min. Negotiated Rate |
$1,474.17 |
| Max. Negotiated Rate |
$4,423.50 |
| Rate for Payer: Aetna Commercial |
$3,104.20
|
| Rate for Payer: Aetna Medicare |
$2,409.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,104.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,335.86
|
| Rate for Payer: BCBS Complete |
$1,547.88
|
| Rate for Payer: BCBS MAPPO |
$2,316.57
|
| Rate for Payer: BCN Commercial |
$3,634.26
|
| Rate for Payer: BCN Medicare Advantage |
$2,316.57
|
| Rate for Payer: Cash Price |
$4,718.40
|
| Rate for Payer: Cash Price |
$4,718.40
|
| Rate for Payer: Cofinity Commercial |
$3,335.86
|
| Rate for Payer: Cofinity Commercial |
$3,104.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,316.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,432.40
|
| Rate for Payer: Meridian Medicaid |
$1,547.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,548.23
|
| Rate for Payer: Nomi Health Commercial |
$2,779.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,423.50
|
| Rate for Payer: PACE SWMI |
$2,316.57
|
| Rate for Payer: PHP Commercial |
$3,243.20
|
| Rate for Payer: PHP Medicare Advantage |
$2,316.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,474.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,908.20
|
| Rate for Payer: Priority Health Medicare |
$2,316.57
|
| Rate for Payer: Priority Health SBD |
$3,908.20
|
| Rate for Payer: Priority Health Tiered Network |
$3,908.20
|
| Rate for Payer: Railroad Medicare Medicare |
$2,316.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,414.01
|
| Rate for Payer: UHC Core |
$4,414.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,316.57
|
| Rate for Payer: UHC Exchange |
$4,414.01
|
| Rate for Payer: UHC Medicaid |
$1,474.17
|
| Rate for Payer: UHCCP Medicaid |
$1,474.17
|
| Rate for Payer: UMR Bronson Commercial |
$2,713.08
|
|
|
PR PRICARDIECTOMY STOT/COMPL W/O CARDPULM BYPASS
|
Professional
|
Both
|
$3,522.00
|
|
|
Service Code
|
HCPCS 33030
|
| Min. Negotiated Rate |
$1,197.49 |
| Max. Negotiated Rate |
$3,560.35 |
| Rate for Payer: Aetna Commercial |
$2,518.11
|
| Rate for Payer: Aetna Medicare |
$1,954.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,518.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,706.03
|
| Rate for Payer: BCBS Complete |
$1,257.36
|
| Rate for Payer: BCBS MAPPO |
$1,879.19
|
| Rate for Payer: BCN Commercial |
$2,945.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,879.19
|
| Rate for Payer: Cash Price |
$2,817.60
|
| Rate for Payer: Cash Price |
$2,817.60
|
| Rate for Payer: Cofinity Commercial |
$2,518.11
|
| Rate for Payer: Cofinity Commercial |
$2,706.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,879.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,973.15
|
| Rate for Payer: Meridian Medicaid |
$1,257.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,067.11
|
| Rate for Payer: Nomi Health Commercial |
$2,255.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,641.50
|
| Rate for Payer: PACE SWMI |
$1,879.19
|
| Rate for Payer: PHP Commercial |
$2,630.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,879.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,197.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,167.58
|
| Rate for Payer: Priority Health Medicare |
$1,879.19
|
| Rate for Payer: Priority Health SBD |
$3,167.58
|
| Rate for Payer: Priority Health Tiered Network |
$3,167.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,879.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,560.35
|
| Rate for Payer: UHC Core |
$3,560.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,879.19
|
| Rate for Payer: UHC Exchange |
$3,560.35
|
| Rate for Payer: UHC Medicaid |
$1,197.49
|
| Rate for Payer: UHCCP Medicaid |
$1,197.49
|
| Rate for Payer: UMR Bronson Commercial |
$1,620.12
|
|
|
PR PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST
|
Professional
|
Both
|
$4,257.00
|
|
|
Service Code
|
HCPCS 37184
|
| Min. Negotiated Rate |
$240.05 |
| Max. Negotiated Rate |
$3,192.75 |
| Rate for Payer: Aetna Commercial |
$507.06
|
| Rate for Payer: Aetna Medicare |
$393.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$507.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$544.90
|
| Rate for Payer: BCBS Complete |
$252.05
|
| Rate for Payer: BCBS MAPPO |
$378.40
|
| Rate for Payer: BCN Commercial |
$628.45
|
| Rate for Payer: BCN Medicare Advantage |
$378.40
|
| Rate for Payer: Cash Price |
$3,405.60
|
| Rate for Payer: Cash Price |
$3,405.60
|
| Rate for Payer: Cofinity Commercial |
$507.06
|
| Rate for Payer: Cofinity Commercial |
$544.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$378.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$397.32
|
| Rate for Payer: Meridian Medicaid |
$252.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$416.24
|
| Rate for Payer: Nomi Health Commercial |
$454.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,192.75
|
| Rate for Payer: PACE SWMI |
$378.40
|
| Rate for Payer: PHP Commercial |
$529.76
|
| Rate for Payer: PHP Medicare Advantage |
$378.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$675.82
|
| Rate for Payer: Priority Health Medicare |
$378.40
|
| Rate for Payer: Priority Health SBD |
$675.82
|
| Rate for Payer: Priority Health Tiered Network |
$675.82
|
| Rate for Payer: Railroad Medicare Medicare |
$378.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$779.82
|
| Rate for Payer: UHC Core |
$779.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$378.40
|
| Rate for Payer: UHC Exchange |
$779.82
|
| Rate for Payer: UHC Medicaid |
$240.05
|
| Rate for Payer: UHCCP Medicaid |
$240.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,958.22
|
|
|
PR PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ
|
Professional
|
Both
|
$3,543.00
|
|
|
Service Code
|
HCPCS 37185
|
| Min. Negotiated Rate |
$90.10 |
| Max. Negotiated Rate |
$2,657.25 |
| Rate for Payer: Aetna Commercial |
$191.02
|
| Rate for Payer: Aetna Medicare |
$148.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.27
|
| Rate for Payer: BCBS Complete |
$94.61
|
| Rate for Payer: BCBS MAPPO |
$142.55
|
| Rate for Payer: BCN Commercial |
$237.04
|
| Rate for Payer: BCN Medicare Advantage |
$142.55
|
| Rate for Payer: Cash Price |
$2,834.40
|
| Rate for Payer: Cash Price |
$2,834.40
|
| Rate for Payer: Cofinity Commercial |
$191.02
|
| Rate for Payer: Cofinity Commercial |
$205.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.68
|
| Rate for Payer: Meridian Medicaid |
$94.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$156.81
|
| Rate for Payer: Nomi Health Commercial |
$171.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,657.25
|
| Rate for Payer: PACE SWMI |
$142.55
|
| Rate for Payer: PHP Commercial |
$199.57
|
| Rate for Payer: PHP Medicare Advantage |
$142.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$254.91
|
| Rate for Payer: Priority Health Medicare |
$142.55
|
| Rate for Payer: Priority Health SBD |
$254.91
|
| Rate for Payer: Priority Health Tiered Network |
$254.91
|
| Rate for Payer: Railroad Medicare Medicare |
$142.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$294.96
|
| Rate for Payer: UHC Core |
$294.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$142.55
|
| Rate for Payer: UHC Exchange |
$294.96
|
| Rate for Payer: UHC Medicaid |
$90.10
|
| Rate for Payer: UHCCP Medicaid |
$90.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,629.78
|
|
|
PR PRINCIPAL CARE MGMT SVC 1ST 30 PHYS/QHP CAL MO
|
Professional
|
Both
|
$171.00
|
|
|
Service Code
|
HCPCS 99424
|
| Min. Negotiated Rate |
$41.32 |
| Max. Negotiated Rate |
$128.25 |
| Rate for Payer: Aetna Commercial |
$85.99
|
| Rate for Payer: Aetna Medicare |
$66.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.40
|
| Rate for Payer: BCBS Complete |
$43.39
|
| Rate for Payer: BCBS MAPPO |
$64.17
|
| Rate for Payer: BCN Commercial |
$111.05
|
| Rate for Payer: BCN Medicare Advantage |
$64.17
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cofinity Commercial |
$85.99
|
| Rate for Payer: Cofinity Commercial |
$92.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.38
|
| Rate for Payer: Meridian Medicaid |
$43.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$70.59
|
| Rate for Payer: Nomi Health Commercial |
$77.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$128.25
|
| Rate for Payer: PACE SWMI |
$64.17
|
| Rate for Payer: PHP Commercial |
$89.84
|
| Rate for Payer: PHP Medicare Advantage |
$64.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$84.54
|
| Rate for Payer: Priority Health Medicare |
$64.17
|
| Rate for Payer: Priority Health SBD |
$84.54
|
| Rate for Payer: Priority Health Tiered Network |
$84.54
|
| Rate for Payer: Railroad Medicare Medicare |
$64.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.97
|
| Rate for Payer: UHC Core |
$108.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$64.17
|
| Rate for Payer: UHC Exchange |
$108.97
|
| Rate for Payer: UHC Medicaid |
$41.32
|
| Rate for Payer: UHCCP Medicaid |
$41.32
|
| Rate for Payer: UMR Bronson Commercial |
$78.66
|
|
|
PR PRINCIPAL CARE MGMT SVC 1ST 30 STAFF CAL MO
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS 99426
|
| Min. Negotiated Rate |
$28.12 |
| Max. Negotiated Rate |
$97.50 |
| Rate for Payer: Aetna Commercial |
$58.50
|
| Rate for Payer: Aetna Medicare |
$45.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.87
|
| Rate for Payer: BCBS Complete |
$29.53
|
| Rate for Payer: BCBS MAPPO |
$43.66
|
| Rate for Payer: BCN Commercial |
$73.20
|
| Rate for Payer: BCN Medicare Advantage |
$43.66
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cofinity Commercial |
$58.50
|
| Rate for Payer: Cofinity Commercial |
$62.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.84
|
| Rate for Payer: Meridian Medicaid |
$29.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.03
|
| Rate for Payer: Nomi Health Commercial |
$52.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.50
|
| Rate for Payer: PACE SWMI |
$43.66
|
| Rate for Payer: PHP Commercial |
$61.12
|
| Rate for Payer: PHP Medicare Advantage |
$43.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$55.72
|
| Rate for Payer: Priority Health Medicare |
$43.66
|
| Rate for Payer: Priority Health SBD |
$55.72
|
| Rate for Payer: Priority Health Tiered Network |
$55.72
|
| Rate for Payer: Railroad Medicare Medicare |
$43.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.16
|
| Rate for Payer: UHC Core |
$73.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43.66
|
| Rate for Payer: UHC Exchange |
$73.16
|
| Rate for Payer: UHC Medicaid |
$28.12
|
| Rate for Payer: UHCCP Medicaid |
$28.12
|
| Rate for Payer: UMR Bronson Commercial |
$59.80
|
|
|
PR PRINCIPAL CARE MGMT SVC EA ADDL 30 STAFF CAL MO
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
HCPCS 99427
|
| Min. Negotiated Rate |
$20.02 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Aetna Commercial |
$41.66
|
| Rate for Payer: Aetna Medicare |
$32.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.77
|
| Rate for Payer: BCBS Complete |
$21.02
|
| Rate for Payer: BCBS MAPPO |
$31.09
|
| Rate for Payer: BCN Commercial |
$52.79
|
| Rate for Payer: BCN Medicare Advantage |
$31.09
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$41.66
|
| Rate for Payer: Cofinity Commercial |
$44.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.64
|
| Rate for Payer: Meridian Medicaid |
$21.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.20
|
| Rate for Payer: Nomi Health Commercial |
$37.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.00
|
| Rate for Payer: PACE SWMI |
$31.09
|
| Rate for Payer: PHP Commercial |
$43.53
|
| Rate for Payer: PHP Medicare Advantage |
$31.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$40.18
|
| Rate for Payer: Priority Health Medicare |
$31.09
|
| Rate for Payer: Priority Health SBD |
$40.18
|
| Rate for Payer: Priority Health Tiered Network |
$40.18
|
| Rate for Payer: Railroad Medicare Medicare |
$31.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.60
|
| Rate for Payer: UHC Core |
$51.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.09
|
| Rate for Payer: UHC Exchange |
$51.60
|
| Rate for Payer: UHC Medicaid |
$20.02
|
| Rate for Payer: UHCCP Medicaid |
$20.02
|
| Rate for Payer: UMR Bronson Commercial |
$46.00
|
|
|
PR PRINCIPAL CARE MGMT SVC EA ADL 30 PHY/QHP CAL MO
|
Professional
|
Both
|
$124.00
|
|
|
Service Code
|
HCPCS 99425
|
| Min. Negotiated Rate |
$28.12 |
| Max. Negotiated Rate |
$93.00 |
| Rate for Payer: Aetna Commercial |
$58.50
|
| Rate for Payer: Aetna Medicare |
$45.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.87
|
| Rate for Payer: BCBS Complete |
$29.53
|
| Rate for Payer: BCBS MAPPO |
$43.66
|
| Rate for Payer: BCN Commercial |
$75.70
|
| Rate for Payer: BCN Medicare Advantage |
$43.66
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Commercial |
$58.50
|
| Rate for Payer: Cofinity Commercial |
$62.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.84
|
| Rate for Payer: Meridian Medicaid |
$29.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.03
|
| Rate for Payer: Nomi Health Commercial |
$52.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.00
|
| Rate for Payer: PACE SWMI |
$43.66
|
| Rate for Payer: PHP Commercial |
$61.12
|
| Rate for Payer: PHP Medicare Advantage |
$43.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$57.62
|
| Rate for Payer: Priority Health Medicare |
$43.66
|
| Rate for Payer: Priority Health SBD |
$57.62
|
| Rate for Payer: Priority Health Tiered Network |
$57.62
|
| Rate for Payer: Railroad Medicare Medicare |
$43.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.97
|
| Rate for Payer: UHC Core |
$75.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43.66
|
| Rate for Payer: UHC Exchange |
$75.97
|
| Rate for Payer: UHC Medicaid |
$28.12
|
| Rate for Payer: UHCCP Medicaid |
$28.12
|
| Rate for Payer: UMR Bronson Commercial |
$57.04
|
|
|
PR PROBE NASOLACRIMAL DUCT W/WO IRRIGATION
|
Professional
|
Both
|
$293.00
|
|
|
Service Code
|
HCPCS 68810
|
| Min. Negotiated Rate |
$71.57 |
| Max. Negotiated Rate |
$223.41 |
| Rate for Payer: Aetna Commercial |
$144.30
|
| Rate for Payer: Aetna Medicare |
$112.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.07
|
| Rate for Payer: BCBS Complete |
$75.15
|
| Rate for Payer: BCBS MAPPO |
$107.69
|
| Rate for Payer: BCN Commercial |
$150.40
|
| Rate for Payer: BCN Medicare Advantage |
$107.69
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cofinity Commercial |
$144.30
|
| Rate for Payer: Cofinity Commercial |
$155.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.07
|
| Rate for Payer: Meridian Medicaid |
$75.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$118.46
|
| Rate for Payer: Nomi Health Commercial |
$129.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.75
|
| Rate for Payer: PACE SWMI |
$107.69
|
| Rate for Payer: PHP Commercial |
$150.77
|
| Rate for Payer: PHP Medicare Advantage |
$107.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$223.41
|
| Rate for Payer: Priority Health Medicare |
$107.69
|
| Rate for Payer: Priority Health SBD |
$223.41
|
| Rate for Payer: Priority Health Tiered Network |
$223.41
|
| Rate for Payer: Railroad Medicare Medicare |
$107.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.66
|
| Rate for Payer: UHC Core |
$215.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$107.69
|
| Rate for Payer: UHC Exchange |
$215.66
|
| Rate for Payer: UHC Medicaid |
$71.57
|
| Rate for Payer: UHCCP Medicaid |
$71.57
|
| Rate for Payer: UMR Bronson Commercial |
$134.78
|
|
|
PR PROCHLORPERAZINE INJECTION
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS J0780
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$15.75 |
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: Aetna Medicare |
$3.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.46
|
| Rate for Payer: BCBS MAPPO |
$3.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.60
|
| Rate for Payer: BCN Commercial |
$1.77
|
| Rate for Payer: BCN Medicare Advantage |
$3.33
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$4.46
|
| Rate for Payer: Cofinity Commercial |
$4.80
|
| 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: Molina Medicare/Medicaid |
$3.66
|
| Rate for Payer: Nomi Health Commercial |
$4.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
| 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 Medicare |
$3.33
|
| Rate for Payer: Railroad Medicare Medicare |
$3.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.52
|
| Rate for Payer: UHC Core |
$2.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.33
|
| Rate for Payer: UHC Exchange |
$2.52
|
| Rate for Payer: UMR Bronson Commercial |
$9.66
|
|
|
PR PROCTOPEXY ABDOMINAL APPROACH
|
Professional
|
Both
|
$3,174.00
|
|
|
Service Code
|
HCPCS 45540
|
| Min. Negotiated Rate |
$621.32 |
| Max. Negotiated Rate |
$2,380.50 |
| Rate for Payer: Aetna Commercial |
$1,291.53
|
| Rate for Payer: Aetna Medicare |
$1,002.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,387.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,291.53
|
| Rate for Payer: BCBS Complete |
$652.39
|
| Rate for Payer: BCBS MAPPO |
$963.83
|
| Rate for Payer: BCN Commercial |
$1,568.14
|
| Rate for Payer: BCN Medicare Advantage |
$963.83
|
| Rate for Payer: Cash Price |
$2,539.20
|
| Rate for Payer: Cash Price |
$2,539.20
|
| Rate for Payer: Cofinity Commercial |
$1,387.92
|
| Rate for Payer: Cofinity Commercial |
$1,291.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$963.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,012.02
|
| Rate for Payer: Meridian Medicaid |
$652.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,060.21
|
| Rate for Payer: Nomi Health Commercial |
$1,156.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,380.50
|
| Rate for Payer: PACE SWMI |
$963.83
|
| Rate for Payer: PHP Commercial |
$1,349.36
|
| Rate for Payer: PHP Medicare Advantage |
$963.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,910.68
|
| Rate for Payer: Priority Health Medicare |
$963.83
|
| Rate for Payer: Priority Health SBD |
$1,910.68
|
| Rate for Payer: Priority Health Tiered Network |
$1,910.68
|
| Rate for Payer: Railroad Medicare Medicare |
$963.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,874.54
|
| Rate for Payer: UHC Core |
$1,874.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$963.83
|
| Rate for Payer: UHC Exchange |
$1,874.54
|
| Rate for Payer: UHC Medicaid |
$621.32
|
| Rate for Payer: UHCCP Medicaid |
$621.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,460.04
|
|
|
PR PROCTOPEXY PERINEAL APPROACH
|
Professional
|
Both
|
$1,708.00
|
|
|
Service Code
|
HCPCS 45541
|
| Min. Negotiated Rate |
$568.07 |
| Max. Negotiated Rate |
$1,718.95 |
| Rate for Payer: Aetna Commercial |
$1,174.54
|
| Rate for Payer: Aetna Medicare |
$911.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,174.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,262.19
|
| Rate for Payer: BCBS Complete |
$596.47
|
| Rate for Payer: BCBS MAPPO |
$876.52
|
| Rate for Payer: BCN Commercial |
$1,410.78
|
| Rate for Payer: BCN Medicare Advantage |
$876.52
|
| Rate for Payer: Cash Price |
$1,366.40
|
| Rate for Payer: Cash Price |
$1,366.40
|
| Rate for Payer: Cofinity Commercial |
$1,174.54
|
| Rate for Payer: Cofinity Commercial |
$1,262.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$876.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$920.35
|
| Rate for Payer: Meridian Medicaid |
$596.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$964.17
|
| Rate for Payer: Nomi Health Commercial |
$1,051.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,281.00
|
| Rate for Payer: PACE SWMI |
$876.52
|
| Rate for Payer: PHP Commercial |
$1,227.13
|
| Rate for Payer: PHP Medicare Advantage |
$876.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$568.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,718.95
|
| Rate for Payer: Priority Health Medicare |
$876.52
|
| Rate for Payer: Priority Health SBD |
$1,718.95
|
| Rate for Payer: Priority Health Tiered Network |
$1,718.95
|
| Rate for Payer: Railroad Medicare Medicare |
$876.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,665.62
|
| Rate for Payer: UHC Core |
$1,665.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$876.52
|
| Rate for Payer: UHC Exchange |
$1,665.62
|
| Rate for Payer: UHC Medicaid |
$568.07
|
| Rate for Payer: UHCCP Medicaid |
$568.07
|
| Rate for Payer: UMR Bronson Commercial |
$785.68
|
|
|
PR PROCTOPEXY W/SIGMOID RESCJ ABDL APPR
|
Professional
|
Both
|
$3,801.00
|
|
|
Service Code
|
HCPCS 45550
|
| Min. Negotiated Rate |
$862.44 |
| Max. Negotiated Rate |
$2,850.75 |
| Rate for Payer: Aetna Commercial |
$1,792.99
|
| Rate for Payer: Aetna Medicare |
$1,391.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,792.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,926.79
|
| Rate for Payer: BCBS Complete |
$905.56
|
| Rate for Payer: BCBS MAPPO |
$1,338.05
|
| Rate for Payer: BCN Commercial |
$2,168.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,338.05
|
| Rate for Payer: Cash Price |
$3,040.80
|
| Rate for Payer: Cash Price |
$3,040.80
|
| Rate for Payer: Cofinity Commercial |
$1,792.99
|
| Rate for Payer: Cofinity Commercial |
$1,926.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,338.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,404.95
|
| Rate for Payer: Meridian Medicaid |
$905.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,471.86
|
| Rate for Payer: Nomi Health Commercial |
$1,605.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,850.75
|
| Rate for Payer: PACE SWMI |
$1,338.05
|
| Rate for Payer: PHP Commercial |
$1,873.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,338.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$862.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,642.43
|
| Rate for Payer: Priority Health Medicare |
$1,338.05
|
| Rate for Payer: Priority Health SBD |
$2,642.43
|
| Rate for Payer: Priority Health Tiered Network |
$2,642.43
|
| Rate for Payer: Railroad Medicare Medicare |
$1,338.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,590.56
|
| Rate for Payer: UHC Core |
$2,590.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,338.05
|
| Rate for Payer: UHC Exchange |
$2,590.56
|
| Rate for Payer: UHC Medicaid |
$862.44
|
| Rate for Payer: UHCCP Medicaid |
$862.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,748.46
|
|
|
PR PROCTOPLASTY PROLAPSE MUCOUS MEMBRANE
|
Professional
|
Both
|
$1,738.00
|
|
|
Service Code
|
HCPCS 45505
|
| Min. Negotiated Rate |
$378.93 |
| Max. Negotiated Rate |
$1,303.50 |
| Rate for Payer: Aetna Commercial |
$772.80
|
| Rate for Payer: Aetna Medicare |
$599.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$772.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$830.48
|
| Rate for Payer: BCBS Complete |
$397.88
|
| Rate for Payer: BCBS MAPPO |
$576.72
|
| Rate for Payer: BCN Commercial |
$909.81
|
| Rate for Payer: BCN Medicare Advantage |
$576.72
|
| Rate for Payer: Cash Price |
$1,390.40
|
| Rate for Payer: Cash Price |
$1,390.40
|
| Rate for Payer: Cofinity Commercial |
$772.80
|
| Rate for Payer: Cofinity Commercial |
$830.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$576.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$605.56
|
| Rate for Payer: Meridian Medicaid |
$397.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$634.39
|
| Rate for Payer: Nomi Health Commercial |
$692.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,303.50
|
| Rate for Payer: PACE SWMI |
$576.72
|
| Rate for Payer: PHP Commercial |
$807.41
|
| Rate for Payer: PHP Medicare Advantage |
$576.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$378.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,108.54
|
| Rate for Payer: Priority Health Medicare |
$576.72
|
| Rate for Payer: Priority Health SBD |
$1,108.54
|
| Rate for Payer: Priority Health Tiered Network |
$1,108.54
|
| Rate for Payer: Railroad Medicare Medicare |
$576.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,042.75
|
| Rate for Payer: UHC Core |
$1,042.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$576.72
|
| Rate for Payer: UHC Exchange |
$1,042.75
|
| Rate for Payer: UHC Medicaid |
$378.93
|
| Rate for Payer: UHCCP Medicaid |
$378.93
|
| Rate for Payer: UMR Bronson Commercial |
$799.48
|
|
