|
PR PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX
|
Professional
|
Both
|
$558.00
|
|
|
Service Code
|
HCPCS 37188
|
| Min. Negotiated Rate |
$159.75 |
| Max. Negotiated Rate |
$499.08 |
| Rate for Payer: Aetna Commercial |
$337.44
|
| Rate for Payer: Aetna Medicare |
$261.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$362.62
|
| Rate for Payer: BCBS Complete |
$167.74
|
| Rate for Payer: BCBS MAPPO |
$251.82
|
| Rate for Payer: BCN Commercial |
$412.33
|
| Rate for Payer: BCN Medicare Advantage |
$251.82
|
| Rate for Payer: Cash Price |
$446.40
|
| Rate for Payer: Cash Price |
$446.40
|
| Rate for Payer: Cofinity Commercial |
$337.44
|
| Rate for Payer: Cofinity Commercial |
$362.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$251.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$264.41
|
| Rate for Payer: Meridian Medicaid |
$167.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$277.00
|
| Rate for Payer: Nomi Health Commercial |
$302.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$418.50
|
| Rate for Payer: PACE SWMI |
$251.82
|
| Rate for Payer: PHP Commercial |
$352.55
|
| Rate for Payer: PHP Medicare Advantage |
$251.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$443.41
|
| Rate for Payer: Priority Health Medicare |
$251.82
|
| Rate for Payer: Priority Health SBD |
$443.41
|
| Rate for Payer: Priority Health Tiered Network |
$443.41
|
| Rate for Payer: Railroad Medicare Medicare |
$251.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$499.08
|
| Rate for Payer: UHC Core |
$499.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$251.82
|
| Rate for Payer: UHC Exchange |
$499.08
|
| Rate for Payer: UHC Medicaid |
$159.75
|
| Rate for Payer: UHCCP Medicaid |
$159.75
|
| Rate for Payer: UMR Bronson Commercial |
$256.68
|
|
|
PR PRTL ESOPHAGECTOMY CERVICAL W/FREE INTSTINAL GRF
|
Professional
|
Both
|
$9,742.00
|
|
|
Service Code
|
HCPCS 43116
|
| Min. Negotiated Rate |
$2,919.59 |
| Max. Negotiated Rate |
$8,946.87 |
| Rate for Payer: Aetna Commercial |
$6,175.39
|
| Rate for Payer: Aetna Medicare |
$4,792.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,175.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,636.24
|
| Rate for Payer: BCBS Complete |
$3,065.57
|
| Rate for Payer: BCBS MAPPO |
$4,608.50
|
| Rate for Payer: BCN Commercial |
$7,290.44
|
| Rate for Payer: BCN Medicare Advantage |
$4,608.50
|
| Rate for Payer: Cash Price |
$7,793.60
|
| Rate for Payer: Cash Price |
$7,793.60
|
| Rate for Payer: Cofinity Commercial |
$6,175.39
|
| Rate for Payer: Cofinity Commercial |
$6,636.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,608.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,838.93
|
| Rate for Payer: Meridian Medicaid |
$3,065.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,069.35
|
| Rate for Payer: Nomi Health Commercial |
$5,530.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,306.50
|
| Rate for Payer: PACE SWMI |
$4,608.50
|
| Rate for Payer: PHP Commercial |
$6,451.90
|
| Rate for Payer: PHP Medicare Advantage |
$4,608.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,919.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8,882.93
|
| Rate for Payer: Priority Health Medicare |
$4,608.50
|
| Rate for Payer: Priority Health SBD |
$8,882.93
|
| Rate for Payer: Priority Health Tiered Network |
$8,882.93
|
| Rate for Payer: Railroad Medicare Medicare |
$4,608.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,946.87
|
| Rate for Payer: UHC Core |
$8,946.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4,608.50
|
| Rate for Payer: UHC Exchange |
$8,946.87
|
| Rate for Payer: UHC Medicaid |
$2,919.59
|
| Rate for Payer: UHCCP Medicaid |
$2,919.59
|
| Rate for Payer: UMR Bronson Commercial |
$4,481.32
|
|
|
PR PRTL ESOPHAGEC W/WO PROX GASTREC/PYLOROPLASTY
|
Professional
|
Both
|
$6,190.00
|
|
|
Service Code
|
HCPCS 43121
|
| Min. Negotiated Rate |
$1,708.26 |
| Max. Negotiated Rate |
$5,133.16 |
| Rate for Payer: Aetna Commercial |
$3,594.87
|
| Rate for Payer: Aetna Medicare |
$2,790.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,594.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,863.15
|
| Rate for Payer: BCBS Complete |
$1,793.67
|
| Rate for Payer: BCBS MAPPO |
$2,682.74
|
| Rate for Payer: BCN Commercial |
$4,212.92
|
| Rate for Payer: BCN Medicare Advantage |
$2,682.74
|
| Rate for Payer: Cash Price |
$4,952.00
|
| Rate for Payer: Cash Price |
$4,952.00
|
| Rate for Payer: Cofinity Commercial |
$3,594.87
|
| Rate for Payer: Cofinity Commercial |
$3,863.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,682.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,816.88
|
| Rate for Payer: Meridian Medicaid |
$1,793.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,951.01
|
| Rate for Payer: Nomi Health Commercial |
$3,219.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,642.50
|
| Rate for Payer: PACE SWMI |
$2,682.74
|
| Rate for Payer: PHP Commercial |
$3,755.84
|
| Rate for Payer: PHP Medicare Advantage |
$2,682.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,708.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,133.16
|
| Rate for Payer: Priority Health Medicare |
$2,682.74
|
| Rate for Payer: Priority Health SBD |
$5,133.16
|
| Rate for Payer: Priority Health Tiered Network |
$5,133.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,682.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,094.88
|
| Rate for Payer: UHC Core |
$5,094.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,682.74
|
| Rate for Payer: UHC Exchange |
$5,094.88
|
| Rate for Payer: UHC Medicaid |
$1,708.26
|
| Rate for Payer: UHCCP Medicaid |
$1,708.26
|
| Rate for Payer: UMR Bronson Commercial |
$2,847.40
|
|
|
PR PRTL ESOPHECT DSTL W/WO PROX GASTRECT/PYLORPLSTY
|
Professional
|
Both
|
$6,524.00
|
|
|
Service Code
|
HCPCS 43117
|
| Min. Negotiated Rate |
$1,931.27 |
| Max. Negotiated Rate |
$5,864.31 |
| Rate for Payer: Aetna Commercial |
$4,059.97
|
| Rate for Payer: Aetna Medicare |
$3,151.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,059.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,362.96
|
| Rate for Payer: BCBS Complete |
$2,027.83
|
| Rate for Payer: BCBS MAPPO |
$3,029.83
|
| Rate for Payer: BCN Commercial |
$4,812.99
|
| Rate for Payer: BCN Medicare Advantage |
$3,029.83
|
| Rate for Payer: Cash Price |
$5,219.20
|
| Rate for Payer: Cash Price |
$5,219.20
|
| Rate for Payer: Cofinity Commercial |
$4,059.97
|
| Rate for Payer: Cofinity Commercial |
$4,362.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,029.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,181.32
|
| Rate for Payer: Meridian Medicaid |
$2,027.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,332.81
|
| Rate for Payer: Nomi Health Commercial |
$3,635.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,893.00
|
| Rate for Payer: PACE SWMI |
$3,029.83
|
| Rate for Payer: PHP Commercial |
$4,241.76
|
| Rate for Payer: PHP Medicare Advantage |
$3,029.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,931.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,864.31
|
| Rate for Payer: Priority Health Medicare |
$3,029.83
|
| Rate for Payer: Priority Health SBD |
$5,864.31
|
| Rate for Payer: Priority Health Tiered Network |
$5,864.31
|
| Rate for Payer: Railroad Medicare Medicare |
$3,029.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,799.47
|
| Rate for Payer: UHC Core |
$5,799.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,029.83
|
| Rate for Payer: UHC Exchange |
$5,799.47
|
| Rate for Payer: UHC Medicaid |
$1,931.27
|
| Rate for Payer: UHCCP Medicaid |
$1,931.27
|
| Rate for Payer: UMR Bronson Commercial |
$3,001.04
|
|
|
PR PRTL EXC B1 TARSAL/METAR B1 XCP TALUS/CALCANEUS
|
Professional
|
Both
|
$1,282.00
|
|
|
Service Code
|
HCPCS 28122
|
| Min. Negotiated Rate |
$265.61 |
| Max. Negotiated Rate |
$961.50 |
| Rate for Payer: Aetna Commercial |
$542.47
|
| Rate for Payer: Aetna Medicare |
$421.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$542.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$582.96
|
| Rate for Payer: BCBS Complete |
$278.89
|
| Rate for Payer: BCBS MAPPO |
$404.83
|
| Rate for Payer: BCN Commercial |
$667.80
|
| Rate for Payer: BCN Medicare Advantage |
$404.83
|
| Rate for Payer: Cash Price |
$1,025.60
|
| Rate for Payer: Cash Price |
$1,025.60
|
| Rate for Payer: Cofinity Commercial |
$542.47
|
| Rate for Payer: Cofinity Commercial |
$582.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$404.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.07
|
| Rate for Payer: Meridian Medicaid |
$278.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.31
|
| Rate for Payer: Nomi Health Commercial |
$485.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$961.50
|
| Rate for Payer: PACE SWMI |
$404.83
|
| Rate for Payer: PHP Commercial |
$566.76
|
| Rate for Payer: PHP Medicare Advantage |
$404.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$713.86
|
| Rate for Payer: Priority Health Medicare |
$404.83
|
| Rate for Payer: Priority Health SBD |
$713.86
|
| Rate for Payer: Priority Health Tiered Network |
$713.86
|
| Rate for Payer: Railroad Medicare Medicare |
$404.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$764.90
|
| Rate for Payer: UHC Core |
$764.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$404.83
|
| Rate for Payer: UHC Exchange |
$764.90
|
| Rate for Payer: UHC Medicaid |
$265.61
|
| Rate for Payer: UHCCP Medicaid |
$265.61
|
| Rate for Payer: UMR Bronson Commercial |
$589.72
|
|
|
PR PRTL EXC BONE FEMUR PROX TIBIA&/FIBULA
|
Professional
|
Both
|
$3,402.00
|
|
|
Service Code
|
HCPCS 27360
|
| Min. Negotiated Rate |
$546.35 |
| Max. Negotiated Rate |
$2,551.50 |
| Rate for Payer: Aetna Commercial |
$1,114.65
|
| Rate for Payer: Aetna Medicare |
$865.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,114.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,197.84
|
| Rate for Payer: BCBS Complete |
$573.67
|
| Rate for Payer: BCBS MAPPO |
$831.83
|
| Rate for Payer: BCN Commercial |
$1,367.95
|
| Rate for Payer: BCN Medicare Advantage |
$831.83
|
| Rate for Payer: Cash Price |
$2,721.60
|
| Rate for Payer: Cash Price |
$2,721.60
|
| Rate for Payer: Cofinity Commercial |
$1,114.65
|
| Rate for Payer: Cofinity Commercial |
$1,197.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$831.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$873.42
|
| Rate for Payer: Meridian Medicaid |
$573.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$915.01
|
| Rate for Payer: Nomi Health Commercial |
$998.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,551.50
|
| Rate for Payer: PACE SWMI |
$831.83
|
| Rate for Payer: PHP Commercial |
$1,164.56
|
| Rate for Payer: PHP Medicare Advantage |
$831.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$546.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,462.31
|
| Rate for Payer: Priority Health Medicare |
$831.83
|
| Rate for Payer: Priority Health SBD |
$1,462.31
|
| Rate for Payer: Priority Health Tiered Network |
$1,462.31
|
| Rate for Payer: Railroad Medicare Medicare |
$831.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,528.45
|
| Rate for Payer: UHC Core |
$1,528.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$831.83
|
| Rate for Payer: UHC Exchange |
$1,528.45
|
| Rate for Payer: UHC Medicaid |
$546.35
|
| Rate for Payer: UHCCP Medicaid |
$546.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,564.92
|
|
|
PR PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM CRV
|
Professional
|
Both
|
$1,823.00
|
|
|
Service Code
|
HCPCS 22100
|
| Min. Negotiated Rate |
$634.10 |
| Max. Negotiated Rate |
$1,554.40 |
| Rate for Payer: Aetna Commercial |
$1,301.88
|
| Rate for Payer: Aetna Medicare |
$1,010.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,301.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,399.03
|
| Rate for Payer: BCBS Complete |
$665.80
|
| Rate for Payer: BCBS MAPPO |
$971.55
|
| Rate for Payer: BCN Commercial |
$1,454.10
|
| Rate for Payer: BCN Medicare Advantage |
$971.55
|
| Rate for Payer: Cash Price |
$1,458.40
|
| Rate for Payer: Cash Price |
$1,458.40
|
| Rate for Payer: Cofinity Commercial |
$1,301.88
|
| Rate for Payer: Cofinity Commercial |
$1,399.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$971.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,020.13
|
| Rate for Payer: Meridian Medicaid |
$665.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,068.70
|
| Rate for Payer: Nomi Health Commercial |
$1,165.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,367.25
|
| Rate for Payer: PACE SWMI |
$971.55
|
| Rate for Payer: PHP Commercial |
$1,360.17
|
| Rate for Payer: PHP Medicare Advantage |
$971.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$634.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,554.40
|
| Rate for Payer: Priority Health Medicare |
$971.55
|
| Rate for Payer: Priority Health SBD |
$1,554.40
|
| Rate for Payer: Priority Health Tiered Network |
$1,554.40
|
| Rate for Payer: Railroad Medicare Medicare |
$971.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,492.66
|
| Rate for Payer: UHC Core |
$1,492.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$971.55
|
| Rate for Payer: UHC Exchange |
$1,492.66
|
| Rate for Payer: UHC Medicaid |
$634.10
|
| Rate for Payer: UHCCP Medicaid |
$634.10
|
| Rate for Payer: UMR Bronson Commercial |
$838.58
|
|
|
PR PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM EA
|
Professional
|
Both
|
$676.00
|
|
|
Service Code
|
HCPCS 22103
|
| Min. Negotiated Rate |
$73.91 |
| Max. Negotiated Rate |
$507.00 |
| Rate for Payer: Aetna Commercial |
$155.51
|
| Rate for Payer: Aetna Medicare |
$120.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.11
|
| Rate for Payer: BCBS Complete |
$77.61
|
| Rate for Payer: BCBS MAPPO |
$116.05
|
| Rate for Payer: BCN Commercial |
$198.70
|
| Rate for Payer: BCN Medicare Advantage |
$116.05
|
| Rate for Payer: Cash Price |
$540.80
|
| Rate for Payer: Cash Price |
$540.80
|
| Rate for Payer: Cofinity Commercial |
$155.51
|
| Rate for Payer: Cofinity Commercial |
$167.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.85
|
| Rate for Payer: Meridian Medicaid |
$77.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$127.66
|
| Rate for Payer: Nomi Health Commercial |
$139.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$507.00
|
| Rate for Payer: PACE SWMI |
$116.05
|
| Rate for Payer: PHP Commercial |
$162.47
|
| Rate for Payer: PHP Medicare Advantage |
$116.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$212.39
|
| Rate for Payer: Priority Health Medicare |
$116.05
|
| Rate for Payer: Priority Health SBD |
$212.39
|
| Rate for Payer: Priority Health Tiered Network |
$212.39
|
| Rate for Payer: Railroad Medicare Medicare |
$116.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.87
|
| Rate for Payer: UHC Core |
$250.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$116.05
|
| Rate for Payer: UHC Exchange |
$250.87
|
| Rate for Payer: UHC Medicaid |
$73.91
|
| Rate for Payer: UHCCP Medicaid |
$73.91
|
| Rate for Payer: UMR Bronson Commercial |
$310.96
|
|
|
PR PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM LMBR
|
Professional
|
Both
|
$2,266.00
|
|
|
Service Code
|
HCPCS 22102
|
| Min. Negotiated Rate |
$447.73 |
| Max. Negotiated Rate |
$1,699.50 |
| Rate for Payer: Aetna Commercial |
$917.91
|
| Rate for Payer: Aetna Medicare |
$712.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$917.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$986.41
|
| Rate for Payer: BCBS Complete |
$470.12
|
| Rate for Payer: BCBS MAPPO |
$685.01
|
| Rate for Payer: BCN Commercial |
$1,155.31
|
| Rate for Payer: BCN Medicare Advantage |
$685.01
|
| Rate for Payer: Cash Price |
$1,812.80
|
| Rate for Payer: Cash Price |
$1,812.80
|
| Rate for Payer: Cofinity Commercial |
$917.91
|
| Rate for Payer: Cofinity Commercial |
$986.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$685.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$719.26
|
| Rate for Payer: Meridian Medicaid |
$470.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$753.51
|
| Rate for Payer: Nomi Health Commercial |
$822.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,699.50
|
| Rate for Payer: PACE SWMI |
$685.01
|
| Rate for Payer: PHP Commercial |
$959.01
|
| Rate for Payer: PHP Medicare Advantage |
$685.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,235.00
|
| Rate for Payer: Priority Health Medicare |
$685.01
|
| Rate for Payer: Priority Health SBD |
$1,235.00
|
| Rate for Payer: Priority Health Tiered Network |
$1,235.00
|
| Rate for Payer: Railroad Medicare Medicare |
$685.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,431.53
|
| Rate for Payer: UHC Core |
$1,431.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$685.01
|
| Rate for Payer: UHC Exchange |
$1,431.53
|
| Rate for Payer: UHC Medicaid |
$447.73
|
| Rate for Payer: UHCCP Medicaid |
$447.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,042.36
|
|
|
PR PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM THRC
|
Professional
|
Both
|
$2,338.00
|
|
|
Service Code
|
HCPCS 22101
|
| Min. Negotiated Rate |
$553.37 |
| Max. Negotiated Rate |
$1,753.50 |
| Rate for Payer: Aetna Commercial |
$1,136.84
|
| Rate for Payer: Aetna Medicare |
$882.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,136.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,221.68
|
| Rate for Payer: BCBS Complete |
$581.04
|
| Rate for Payer: BCBS MAPPO |
$848.39
|
| Rate for Payer: BCN Commercial |
$1,361.48
|
| Rate for Payer: BCN Medicare Advantage |
$848.39
|
| Rate for Payer: Cash Price |
$1,870.40
|
| Rate for Payer: Cash Price |
$1,870.40
|
| Rate for Payer: Cofinity Commercial |
$1,136.84
|
| Rate for Payer: Cofinity Commercial |
$1,221.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$848.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$890.81
|
| Rate for Payer: Meridian Medicaid |
$581.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$933.23
|
| Rate for Payer: Nomi Health Commercial |
$1,018.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,753.50
|
| Rate for Payer: PACE SWMI |
$848.39
|
| Rate for Payer: PHP Commercial |
$1,187.75
|
| Rate for Payer: PHP Medicare Advantage |
$848.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$553.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,455.38
|
| Rate for Payer: Priority Health Medicare |
$848.39
|
| Rate for Payer: Priority Health SBD |
$1,455.38
|
| Rate for Payer: Priority Health Tiered Network |
$1,455.38
|
| Rate for Payer: Railroad Medicare Medicare |
$848.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,520.73
|
| Rate for Payer: UHC Core |
$1,520.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$848.39
|
| Rate for Payer: UHC Exchange |
$1,520.73
|
| Rate for Payer: UHC Medicaid |
$553.37
|
| Rate for Payer: UHCCP Medicaid |
$553.37
|
| Rate for Payer: UMR Bronson Commercial |
$1,075.48
|
|
|
PR PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM CRV
|
Professional
|
Both
|
$3,362.00
|
|
|
Service Code
|
HCPCS 22110
|
| Min. Negotiated Rate |
$649.86 |
| Max. Negotiated Rate |
$2,521.50 |
| Rate for Payer: Aetna Commercial |
$1,342.43
|
| Rate for Payer: Aetna Medicare |
$1,041.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,342.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,442.61
|
| Rate for Payer: BCBS Complete |
$682.35
|
| Rate for Payer: BCBS MAPPO |
$1,001.81
|
| Rate for Payer: BCN Commercial |
$1,770.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,001.81
|
| Rate for Payer: Cash Price |
$2,689.60
|
| Rate for Payer: Cash Price |
$2,689.60
|
| Rate for Payer: Cofinity Commercial |
$1,342.43
|
| Rate for Payer: Cofinity Commercial |
$1,442.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,001.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,051.90
|
| Rate for Payer: Meridian Medicaid |
$682.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,101.99
|
| Rate for Payer: Nomi Health Commercial |
$1,202.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,521.50
|
| Rate for Payer: PACE SWMI |
$1,001.81
|
| Rate for Payer: PHP Commercial |
$1,402.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,001.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$649.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,723.15
|
| Rate for Payer: Priority Health Medicare |
$1,001.81
|
| Rate for Payer: Priority Health SBD |
$1,723.15
|
| Rate for Payer: Priority Health Tiered Network |
$1,723.15
|
| Rate for Payer: Railroad Medicare Medicare |
$1,001.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,825.90
|
| Rate for Payer: UHC Core |
$1,825.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,001.81
|
| Rate for Payer: UHC Exchange |
$1,825.90
|
| Rate for Payer: UHC Medicaid |
$649.86
|
| Rate for Payer: UHCCP Medicaid |
$649.86
|
| Rate for Payer: UMR Bronson Commercial |
$1,546.52
|
|
|
PR PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM EA
|
Professional
|
Both
|
$827.00
|
|
|
Service Code
|
HCPCS 22116
|
| Min. Negotiated Rate |
$80.30 |
| Max. Negotiated Rate |
$620.25 |
| Rate for Payer: Aetna Commercial |
$170.21
|
| Rate for Payer: Aetna Medicare |
$132.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.91
|
| Rate for Payer: BCBS Complete |
$84.31
|
| Rate for Payer: BCBS MAPPO |
$127.02
|
| Rate for Payer: BCN Commercial |
$213.13
|
| Rate for Payer: BCN Medicare Advantage |
$127.02
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cofinity Commercial |
$170.21
|
| Rate for Payer: Cofinity Commercial |
$182.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.37
|
| Rate for Payer: Meridian Medicaid |
$84.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$139.72
|
| Rate for Payer: Nomi Health Commercial |
$152.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$620.25
|
| Rate for Payer: PACE SWMI |
$127.02
|
| Rate for Payer: PHP Commercial |
$177.83
|
| Rate for Payer: PHP Medicare Advantage |
$127.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$227.83
|
| Rate for Payer: Priority Health Medicare |
$127.02
|
| Rate for Payer: Priority Health SBD |
$227.83
|
| Rate for Payer: Priority Health Tiered Network |
$227.83
|
| Rate for Payer: Railroad Medicare Medicare |
$127.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.30
|
| Rate for Payer: UHC Core |
$250.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$127.02
|
| Rate for Payer: UHC Exchange |
$250.30
|
| Rate for Payer: UHC Medicaid |
$80.30
|
| Rate for Payer: UHCCP Medicaid |
$80.30
|
| Rate for Payer: UMR Bronson Commercial |
$380.42
|
|
|
PR PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM LMBR
|
Professional
|
Both
|
$2,505.00
|
|
|
Service Code
|
HCPCS 22114
|
| Min. Negotiated Rate |
$746.78 |
| Max. Negotiated Rate |
$1,958.49 |
| Rate for Payer: Aetna Commercial |
$1,541.87
|
| Rate for Payer: Aetna Medicare |
$1,196.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,541.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,656.94
|
| Rate for Payer: BCBS Complete |
$784.12
|
| Rate for Payer: BCBS MAPPO |
$1,150.65
|
| Rate for Payer: BCN Commercial |
$1,744.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,150.65
|
| Rate for Payer: Cash Price |
$2,004.00
|
| Rate for Payer: Cash Price |
$2,004.00
|
| Rate for Payer: Cofinity Commercial |
$1,541.87
|
| Rate for Payer: Cofinity Commercial |
$1,656.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,150.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,208.18
|
| Rate for Payer: Meridian Medicaid |
$784.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,265.71
|
| Rate for Payer: Nomi Health Commercial |
$1,380.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,878.75
|
| Rate for Payer: PACE SWMI |
$1,150.65
|
| Rate for Payer: PHP Commercial |
$1,610.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,150.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$746.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,865.27
|
| Rate for Payer: Priority Health Medicare |
$1,150.65
|
| Rate for Payer: Priority Health SBD |
$1,865.27
|
| Rate for Payer: Priority Health Tiered Network |
$1,865.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,150.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,958.49
|
| Rate for Payer: UHC Core |
$1,958.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,150.65
|
| Rate for Payer: UHC Exchange |
$1,958.49
|
| Rate for Payer: UHC Medicaid |
$746.78
|
| Rate for Payer: UHCCP Medicaid |
$746.78
|
| Rate for Payer: UMR Bronson Commercial |
$1,152.30
|
|
|
PR PRTL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY
|
Professional
|
Both
|
$4,087.00
|
|
|
Service Code
|
HCPCS 60210
|
| Min. Negotiated Rate |
$412.79 |
| Max. Negotiated Rate |
$3,065.25 |
| Rate for Payer: Aetna Commercial |
$856.61
|
| Rate for Payer: Aetna Medicare |
$664.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$856.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$920.53
|
| Rate for Payer: BCBS Complete |
$433.43
|
| Rate for Payer: BCBS MAPPO |
$639.26
|
| Rate for Payer: BCN Commercial |
$1,069.16
|
| Rate for Payer: BCN Medicare Advantage |
$639.26
|
| Rate for Payer: Cash Price |
$3,269.60
|
| Rate for Payer: Cash Price |
$3,269.60
|
| Rate for Payer: Cofinity Commercial |
$856.61
|
| Rate for Payer: Cofinity Commercial |
$920.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$639.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$671.22
|
| Rate for Payer: Meridian Medicaid |
$433.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$703.19
|
| Rate for Payer: Nomi Health Commercial |
$767.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,065.25
|
| Rate for Payer: PACE SWMI |
$639.26
|
| Rate for Payer: PHP Commercial |
$894.96
|
| Rate for Payer: PHP Medicare Advantage |
$639.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,159.34
|
| Rate for Payer: Priority Health Medicare |
$639.26
|
| Rate for Payer: Priority Health SBD |
$1,159.34
|
| Rate for Payer: Priority Health Tiered Network |
$1,159.34
|
| Rate for Payer: Railroad Medicare Medicare |
$639.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,243.54
|
| Rate for Payer: UHC Core |
$1,243.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$639.26
|
| Rate for Payer: UHC Exchange |
$1,243.54
|
| Rate for Payer: UHC Medicaid |
$412.79
|
| Rate for Payer: UHCCP Medicaid |
$412.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,880.02
|
|
|
PR PRTL THYROID LOBEC UNI W/CONTRATLAT STOT LOBEC
|
Professional
|
Both
|
$1,886.00
|
|
|
Service Code
|
HCPCS 60212
|
| Min. Negotiated Rate |
$620.47 |
| Max. Negotiated Rate |
$1,823.82 |
| Rate for Payer: Aetna Commercial |
$1,294.11
|
| Rate for Payer: Aetna Medicare |
$1,004.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,294.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,390.68
|
| Rate for Payer: BCBS Complete |
$651.49
|
| Rate for Payer: BCBS MAPPO |
$965.75
|
| Rate for Payer: BCN Commercial |
$1,545.24
|
| Rate for Payer: BCN Medicare Advantage |
$965.75
|
| Rate for Payer: Cash Price |
$1,508.80
|
| Rate for Payer: Cash Price |
$1,508.80
|
| Rate for Payer: Cofinity Commercial |
$1,294.11
|
| Rate for Payer: Cofinity Commercial |
$1,390.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$965.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,014.04
|
| Rate for Payer: Meridian Medicaid |
$651.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,062.33
|
| Rate for Payer: Nomi Health Commercial |
$1,158.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,414.50
|
| Rate for Payer: PACE SWMI |
$965.75
|
| Rate for Payer: PHP Commercial |
$1,352.05
|
| Rate for Payer: PHP Medicare Advantage |
$965.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$620.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,675.56
|
| Rate for Payer: Priority Health Medicare |
$965.75
|
| Rate for Payer: Priority Health SBD |
$1,675.56
|
| Rate for Payer: Priority Health Tiered Network |
$1,675.56
|
| Rate for Payer: Railroad Medicare Medicare |
$965.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,823.82
|
| Rate for Payer: UHC Core |
$1,823.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$965.75
|
| Rate for Payer: UHC Exchange |
$1,823.82
|
| Rate for Payer: UHC Medicaid |
$620.47
|
| Rate for Payer: UHCCP Medicaid |
$620.47
|
| Rate for Payer: UMR Bronson Commercial |
$867.56
|
|
|
PR PSA SCREENING
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS G0103
|
| Min. Negotiated Rate |
$8.11 |
| Max. Negotiated Rate |
$47.25 |
| Rate for Payer: Aetna Commercial |
$25.88
|
| Rate for Payer: Aetna Medicare |
$20.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.81
|
| Rate for Payer: BCBS MAPPO |
$19.31
|
| Rate for Payer: BCN Commercial |
$14.48
|
| Rate for Payer: BCN Medicare Advantage |
$19.31
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$25.88
|
| Rate for Payer: Cofinity Commercial |
$27.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.24
|
| Rate for Payer: Nomi Health Commercial |
$23.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
| Rate for Payer: PACE SWMI |
$19.31
|
| Rate for Payer: PHP Commercial |
$27.03
|
| Rate for Payer: PHP Medicare Advantage |
$19.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20.18
|
| Rate for Payer: Priority Health Medicare |
$19.31
|
| Rate for Payer: Priority Health SBD |
$20.18
|
| Rate for Payer: Priority Health Tiered Network |
$20.18
|
| Rate for Payer: Railroad Medicare Medicare |
$19.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.11
|
| Rate for Payer: UHC Core |
$8.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.31
|
| Rate for Payer: UHC Exchange |
$8.11
|
| Rate for Payer: UMR Bronson Commercial |
$28.98
|
|
|
PR PSYCHIATRIC DIAGNOSTIC EVALUATION
|
Professional
|
Both
|
$273.00
|
|
|
Service Code
|
HCPCS 90791
|
| Min. Negotiated Rate |
$125.58 |
| Max. Negotiated Rate |
$204.75 |
| Rate for Payer: Aetna Commercial |
$183.10
|
| Rate for Payer: Aetna Medicare |
$142.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.76
|
| Rate for Payer: BCBS Complete |
$143.47
|
| Rate for Payer: BCBS MAPPO |
$136.64
|
| Rate for Payer: BCN Commercial |
$173.57
|
| Rate for Payer: BCN Medicare Advantage |
$136.64
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cofinity Commercial |
$196.76
|
| Rate for Payer: Cofinity Commercial |
$183.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.47
|
| Rate for Payer: Meridian Medicaid |
$143.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$150.30
|
| Rate for Payer: Nomi Health Commercial |
$163.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.75
|
| Rate for Payer: PACE SWMI |
$136.64
|
| Rate for Payer: PHP Commercial |
$191.30
|
| Rate for Payer: PHP Medicare Advantage |
$136.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$194.98
|
| Rate for Payer: Priority Health Medicare |
$136.64
|
| Rate for Payer: Priority Health SBD |
$194.98
|
| Rate for Payer: Priority Health Tiered Network |
$194.98
|
| Rate for Payer: Railroad Medicare Medicare |
$136.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.55
|
| Rate for Payer: UHC Core |
$203.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$136.64
|
| Rate for Payer: UHC Exchange |
$203.55
|
| Rate for Payer: UHC Medicaid |
$136.64
|
| Rate for Payer: UHCCP Medicaid |
$136.64
|
| Rate for Payer: UMR Bronson Commercial |
$125.58
|
|
|
PR PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES
|
Professional
|
Both
|
$272.00
|
|
|
Service Code
|
HCPCS 90792
|
| Min. Negotiated Rate |
$125.12 |
| Max. Negotiated Rate |
$228.64 |
| Rate for Payer: Aetna Commercial |
$212.77
|
| Rate for Payer: Aetna Medicare |
$165.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.64
|
| Rate for Payer: BCBS Complete |
$166.72
|
| Rate for Payer: BCBS MAPPO |
$158.78
|
| Rate for Payer: BCN Commercial |
$198.71
|
| Rate for Payer: BCN Medicare Advantage |
$158.78
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cofinity Commercial |
$212.77
|
| Rate for Payer: Cofinity Commercial |
$228.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.72
|
| Rate for Payer: Meridian Medicaid |
$166.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$174.66
|
| Rate for Payer: Nomi Health Commercial |
$190.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.00
|
| Rate for Payer: PACE SWMI |
$158.78
|
| Rate for Payer: PHP Commercial |
$222.29
|
| Rate for Payer: PHP Medicare Advantage |
$158.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$213.34
|
| Rate for Payer: Priority Health Medicare |
$158.78
|
| Rate for Payer: Priority Health SBD |
$213.34
|
| Rate for Payer: Priority Health Tiered Network |
$213.34
|
| Rate for Payer: Railroad Medicare Medicare |
$158.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.12
|
| Rate for Payer: UHC Core |
$227.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$158.78
|
| Rate for Payer: UHC Exchange |
$227.12
|
| Rate for Payer: UHC Medicaid |
$158.78
|
| Rate for Payer: UHCCP Medicaid |
$158.78
|
| Rate for Payer: UMR Bronson Commercial |
$125.12
|
|
|
PR PSYCHOANALYSIS
|
Professional
|
Both
|
$207.00
|
|
|
Service Code
|
HCPCS 90845
|
| Min. Negotiated Rate |
$82.80 |
| Max. Negotiated Rate |
$155.25 |
| Rate for Payer: Aetna Commercial |
$117.61
|
| Rate for Payer: Aetna Medicare |
$91.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.39
|
| Rate for Payer: BCBS Complete |
$82.80
|
| Rate for Payer: BCBS MAPPO |
$87.77
|
| Rate for Payer: BCN Commercial |
$98.08
|
| Rate for Payer: BCN Medicare Advantage |
$87.77
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cofinity Commercial |
$126.39
|
| Rate for Payer: Cofinity Commercial |
$117.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$96.55
|
| Rate for Payer: Nomi Health Commercial |
$105.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$155.25
|
| Rate for Payer: PACE SWMI |
$87.77
|
| Rate for Payer: PHP Commercial |
$122.88
|
| Rate for Payer: PHP Medicare Advantage |
$87.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$115.44
|
| Rate for Payer: Priority Health Medicare |
$87.77
|
| Rate for Payer: Priority Health SBD |
$115.44
|
| Rate for Payer: Priority Health Tiered Network |
$115.44
|
| Rate for Payer: Railroad Medicare Medicare |
$87.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.32
|
| Rate for Payer: UHC Core |
$145.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$87.77
|
| Rate for Payer: UHC Exchange |
$145.32
|
| Rate for Payer: UMR Bronson Commercial |
$95.22
|
|
|
PR PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR
|
Professional
|
Both
|
$187.00
|
|
|
Service Code
|
HCPCS 96131
|
| Min. Negotiated Rate |
$44.73 |
| Max. Negotiated Rate |
$140.25 |
| Rate for Payer: Aetna Commercial |
$93.55
|
| Rate for Payer: Aetna Medicare |
$72.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.55
|
| Rate for Payer: BCBS Complete |
$46.97
|
| Rate for Payer: BCBS MAPPO |
$69.81
|
| Rate for Payer: BCN Commercial |
$127.49
|
| Rate for Payer: BCN Medicare Advantage |
$69.81
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cofinity Commercial |
$93.55
|
| Rate for Payer: Cofinity Commercial |
$100.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.30
|
| Rate for Payer: Meridian Medicaid |
$46.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$76.79
|
| Rate for Payer: Nomi Health Commercial |
$83.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.25
|
| Rate for Payer: PACE SWMI |
$69.81
|
| Rate for Payer: PHP Commercial |
$97.73
|
| Rate for Payer: PHP Medicare Advantage |
$69.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$102.88
|
| Rate for Payer: Priority Health Medicare |
$69.81
|
| Rate for Payer: Priority Health SBD |
$102.88
|
| Rate for Payer: Priority Health Tiered Network |
$102.88
|
| Rate for Payer: Railroad Medicare Medicare |
$69.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.13
|
| Rate for Payer: UHC Core |
$136.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$69.81
|
| Rate for Payer: UHC Exchange |
$136.13
|
| Rate for Payer: UHC Medicaid |
$44.73
|
| Rate for Payer: UHCCP Medicaid |
$44.73
|
| Rate for Payer: UMR Bronson Commercial |
$86.02
|
|
|
PR PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR
|
Professional
|
Both
|
$246.00
|
|
|
Service Code
|
HCPCS 96130
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$184.50 |
| Rate for Payer: Aetna Commercial |
$132.61
|
| Rate for Payer: Aetna Medicare |
$102.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.50
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCBS MAPPO |
$98.96
|
| Rate for Payer: BCN Commercial |
$180.76
|
| Rate for Payer: BCN Medicare Advantage |
$98.96
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cofinity Commercial |
$132.61
|
| Rate for Payer: Cofinity Commercial |
$142.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.91
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.86
|
| Rate for Payer: Nomi Health Commercial |
$118.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$184.50
|
| Rate for Payer: PACE SWMI |
$98.96
|
| Rate for Payer: PHP Commercial |
$138.54
|
| Rate for Payer: PHP Medicare Advantage |
$98.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$150.64
|
| Rate for Payer: Priority Health Medicare |
$98.96
|
| Rate for Payer: Priority Health SBD |
$150.64
|
| Rate for Payer: Priority Health Tiered Network |
$150.64
|
| Rate for Payer: Railroad Medicare Medicare |
$98.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.83
|
| Rate for Payer: UHC Core |
$176.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.96
|
| Rate for Payer: UHC Exchange |
$176.83
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
| Rate for Payer: UMR Bronson Commercial |
$113.16
|
|
|
PR PSYCHOLOGIC TESTING ADMIN BY COMPUTER
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 96103
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$42.75 |
| Rate for Payer: Aetna Medicare |
$28.50
|
| Rate for Payer: BCBS Complete |
$22.80
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.75
|
| Rate for Payer: UMR Bronson Commercial |
$26.22
|
|
|
PR PSYCHOLOGIC TESTING BY PSYCH/PHYS
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 96101
|
| Min. Negotiated Rate |
$61.20 |
| Max. Negotiated Rate |
$114.75 |
| Rate for Payer: Aetna Medicare |
$76.50
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.75
|
| Rate for Payer: UMR Bronson Commercial |
$70.38
|
|
|
PR PSYCHOTHERAPY COMPLEX INTERACTIVE
|
Professional
|
Both
|
$148.00
|
|
|
Service Code
|
HCPCS 90785
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$111.00 |
| Rate for Payer: Aetna Commercial |
$15.58
|
| Rate for Payer: Aetna Medicare |
$12.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.75
|
| Rate for Payer: BCBS Complete |
$7.83
|
| Rate for Payer: BCBS MAPPO |
$11.63
|
| Rate for Payer: BCN Commercial |
$14.92
|
| Rate for Payer: BCN Medicare Advantage |
$11.63
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cofinity Commercial |
$15.58
|
| Rate for Payer: Cofinity Commercial |
$16.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.21
|
| Rate for Payer: Meridian Medicaid |
$7.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.79
|
| Rate for Payer: Nomi Health Commercial |
$13.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.00
|
| Rate for Payer: PACE SWMI |
$11.63
|
| Rate for Payer: PHP Commercial |
$16.28
|
| Rate for Payer: PHP Medicare Advantage |
$11.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.55
|
| Rate for Payer: Priority Health Medicare |
$11.63
|
| Rate for Payer: Priority Health SBD |
$18.55
|
| Rate for Payer: Priority Health Tiered Network |
$18.55
|
| Rate for Payer: Railroad Medicare Medicare |
$11.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.41
|
| Rate for Payer: UHC Core |
$22.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.63
|
| Rate for Payer: UHC Exchange |
$22.41
|
| Rate for Payer: UHC Medicaid |
$7.46
|
| Rate for Payer: UHCCP Medicaid |
$7.46
|
| Rate for Payer: UMR Bronson Commercial |
$68.08
|
|
|
PR PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 90840
|
| Min. Negotiated Rate |
$42.09 |
| Max. Negotiated Rate |
$101.80 |
| Rate for Payer: Aetna Commercial |
$83.27
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.48
|
| Rate for Payer: BCBS Complete |
$44.19
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCN Commercial |
$78.54
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$83.27
|
| Rate for Payer: Cofinity Commercial |
$89.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$44.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.35
|
| Rate for Payer: Nomi Health Commercial |
$74.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.50
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$87.00
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$88.63
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health SBD |
$88.63
|
| Rate for Payer: Priority Health Tiered Network |
$88.63
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.80
|
| Rate for Payer: UHC Core |
$101.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.14
|
| Rate for Payer: UHC Exchange |
$101.80
|
| Rate for Payer: UHC Medicaid |
$42.09
|
| Rate for Payer: UHCCP Medicaid |
$42.09
|
| Rate for Payer: UMR Bronson Commercial |
$56.12
|
|
