|
PR PHTFAC SNGL PIGMENT
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 00081
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Aetna Medicare |
$18.00
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
| Rate for Payer: UMR Bronson Commercial |
$16.56
|
|
|
PR PHYSICAL PERFORMANCE TEST/MEAS W/REPRT EA 15 MIN
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 97750
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$45.69 |
| Rate for Payer: Aetna Commercial |
$42.52
|
| Rate for Payer: Aetna Medicare |
$33.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.69
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: BCBS MAPPO |
$31.73
|
| Rate for Payer: BCN Medicare Advantage |
$31.73
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$42.52
|
| Rate for Payer: Cofinity Commercial |
$45.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.32
|
| Rate for Payer: Nomi Health Commercial |
$38.08
|
| Rate for Payer: PACE SWMI |
$31.73
|
| Rate for Payer: PHP Commercial |
$44.42
|
| Rate for Payer: PHP Medicare Advantage |
$31.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health Medicare |
$31.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.73
|
| Rate for Payer: UHC Medicare Advantage |
$31.73
|
| Rate for Payer: UMR Bronson Commercial |
$24.84
|
|
|
PR PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASU
|
Professional
|
Both
|
$183.00
|
|
|
Service Code
|
HCPCS 93464
|
| Min. Negotiated Rate |
$73.20 |
| Max. Negotiated Rate |
$282.14 |
| Rate for Payer: Aetna Commercial |
$262.55
|
| Rate for Payer: Aetna Medicare |
$203.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$282.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.55
|
| Rate for Payer: BCBS Complete |
$73.20
|
| Rate for Payer: BCBS MAPPO |
$195.93
|
| Rate for Payer: BCN Medicare Advantage |
$195.93
|
| Rate for Payer: Cash Price |
$146.40
|
| Rate for Payer: Cash Price |
$146.40
|
| Rate for Payer: Cofinity Commercial |
$282.14
|
| Rate for Payer: Cofinity Commercial |
$262.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$205.73
|
| Rate for Payer: Nomi Health Commercial |
$235.12
|
| Rate for Payer: PACE SWMI |
$195.93
|
| Rate for Payer: PHP Commercial |
$274.30
|
| Rate for Payer: PHP Medicare Advantage |
$195.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.95
|
| Rate for Payer: Priority Health Medicare |
$195.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$195.93
|
| Rate for Payer: UHC Medicare Advantage |
$195.93
|
| Rate for Payer: UMR Bronson Commercial |
$84.18
|
|
|
PR PHYSIOL SUPPORT HARVEST ORGAN FROM BRAIN-DEAD PT
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS 01990
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$4.55 |
| Rate for Payer: Aetna Medicare |
$3.50
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.55
|
| Rate for Payer: UMR Bronson Commercial |
$3.22
|
|
|
PR PHYS/QHP ATTN&SUPVJ HYPRBARIC OXYGEN TX/SESSION
|
Professional
|
Both
|
$373.00
|
|
|
Service Code
|
HCPCS 99183
|
| Min. Negotiated Rate |
$101.48 |
| Max. Negotiated Rate |
$242.45 |
| Rate for Payer: Aetna Commercial |
$135.98
|
| Rate for Payer: Aetna Medicare |
$105.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.13
|
| Rate for Payer: BCBS Complete |
$149.20
|
| Rate for Payer: BCBS MAPPO |
$101.48
|
| Rate for Payer: BCN Medicare Advantage |
$101.48
|
| Rate for Payer: Cash Price |
$298.40
|
| Rate for Payer: Cash Price |
$298.40
|
| Rate for Payer: Cofinity Commercial |
$135.98
|
| Rate for Payer: Cofinity Commercial |
$146.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.55
|
| Rate for Payer: Nomi Health Commercial |
$121.78
|
| Rate for Payer: PACE SWMI |
$101.48
|
| Rate for Payer: PHP Commercial |
$142.07
|
| Rate for Payer: PHP Medicare Advantage |
$101.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$242.45
|
| Rate for Payer: Priority Health Medicare |
$101.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.48
|
| Rate for Payer: UHC Medicare Advantage |
$101.48
|
| Rate for Payer: UMR Bronson Commercial |
$171.58
|
|
|
PR PHYS/QHP DIRECTION EMERGENCY MEDICAL SYSTEMS
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 99288
|
| Min. Negotiated Rate |
$100.00 |
| Max. Negotiated Rate |
$162.50 |
| Rate for Payer: Aetna Medicare |
$125.00
|
| Rate for Payer: BCBS Complete |
$100.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.50
|
| Rate for Payer: UMR Bronson Commercial |
$115.00
|
|
|
PR PHYS/QHP EDUCATION SVCS RENDERED PTS GRP SETTING
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 99078
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$29.25 |
| Rate for Payer: Aetna Medicare |
$22.50
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: UMR Bronson Commercial |
$20.70
|
|
|
PR PHYS/QHP ONLINE EVALUATION & MANAGEMENT SERVICE
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 99444
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$32.50 |
| Rate for Payer: Aetna Medicare |
$25.00
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
| Rate for Payer: UMR Bronson Commercial |
$23.00
|
|
|
PR PHYS/QHP O/P CARDIAC RHAB W/O CONT ECG MONITOR
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 93797
|
| Min. Negotiated Rate |
$7.97 |
| Max. Negotiated Rate |
$21.45 |
| Rate for Payer: Aetna Commercial |
$10.68
|
| Rate for Payer: Aetna Medicare |
$8.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.68
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$7.97
|
| Rate for Payer: BCN Medicare Advantage |
$7.97
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$10.68
|
| Rate for Payer: Cofinity Commercial |
$11.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.37
|
| Rate for Payer: Nomi Health Commercial |
$9.56
|
| Rate for Payer: PACE SWMI |
$7.97
|
| Rate for Payer: PHP Commercial |
$11.16
|
| Rate for Payer: PHP Medicare Advantage |
$7.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health Medicare |
$7.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.97
|
| Rate for Payer: UHC Medicare Advantage |
$7.97
|
| Rate for Payer: UMR Bronson Commercial |
$15.18
|
|
|
PR PHYS/QHP TELEPHONE EVALUATION 11-20 MIN
|
Professional
|
Both
|
$149.00
|
|
|
Service Code
|
HCPCS 99442
|
| Min. Negotiated Rate |
$59.60 |
| Max. Negotiated Rate |
$96.85 |
| Rate for Payer: Aetna Medicare |
$74.50
|
| Rate for Payer: BCBS Complete |
$59.60
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.85
|
| Rate for Payer: UMR Bronson Commercial |
$68.54
|
|
|
PR PHYS/QHP TELEPHONE EVALUATION 21-30 MIN
|
Professional
|
Both
|
$216.00
|
|
|
Service Code
|
HCPCS 99443
|
| Min. Negotiated Rate |
$86.40 |
| Max. Negotiated Rate |
$140.40 |
| Rate for Payer: Aetna Medicare |
$108.00
|
| Rate for Payer: BCBS Complete |
$86.40
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.40
|
| Rate for Payer: UMR Bronson Commercial |
$99.36
|
|
|
PR PHYS/QHP TELEPHONE EVALUATION 5-10 MIN
|
Professional
|
Both
|
$90.00
|
|
|
Service Code
|
HCPCS 99441
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Aetna Medicare |
$45.00
|
| Rate for Payer: BCBS Complete |
$36.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.50
|
| Rate for Payer: UMR Bronson Commercial |
$41.40
|
|
|
PR PHYS STANDBY SVC PROLNG PHYS ATTN EA 30 MINUTES
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 99360
|
| Min. Negotiated Rate |
$104.40 |
| Max. Negotiated Rate |
$169.65 |
| Rate for Payer: Aetna Medicare |
$130.50
|
| Rate for Payer: BCBS Complete |
$104.40
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.65
|
| Rate for Payer: UMR Bronson Commercial |
$120.06
|
|
|
PR PINCH GRAFT 1/MLT SM ULCER TIP/OTH AR UP TO 2 CM
|
Professional
|
Both
|
$917.00
|
|
|
Service Code
|
HCPCS 15050
|
| Min. Negotiated Rate |
$366.80 |
| Max. Negotiated Rate |
$626.99 |
| Rate for Payer: Aetna Commercial |
$583.45
|
| Rate for Payer: Aetna Medicare |
$452.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$583.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$626.99
|
| Rate for Payer: BCBS Complete |
$366.80
|
| Rate for Payer: BCBS MAPPO |
$435.41
|
| Rate for Payer: BCN Medicare Advantage |
$435.41
|
| Rate for Payer: Cash Price |
$733.60
|
| Rate for Payer: Cash Price |
$733.60
|
| Rate for Payer: Cofinity Commercial |
$626.99
|
| Rate for Payer: Cofinity Commercial |
$583.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$435.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$457.18
|
| Rate for Payer: Nomi Health Commercial |
$522.49
|
| Rate for Payer: PACE SWMI |
$435.41
|
| Rate for Payer: PHP Commercial |
$609.57
|
| Rate for Payer: PHP Medicare Advantage |
$435.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.05
|
| Rate for Payer: Priority Health Medicare |
$435.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$435.41
|
| Rate for Payer: UHC Medicare Advantage |
$435.41
|
| Rate for Payer: UMR Bronson Commercial |
$421.82
|
|
|
PR PLACE CATH BRACHIAL ART
|
Professional
|
Both
|
$761.00
|
|
|
Service Code
|
HCPCS 36120
|
| Min. Negotiated Rate |
$304.40 |
| Max. Negotiated Rate |
$494.65 |
| Rate for Payer: Aetna Medicare |
$380.50
|
| Rate for Payer: BCBS Complete |
$304.40
|
| Rate for Payer: Cash Price |
$608.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$494.65
|
| Rate for Payer: UMR Bronson Commercial |
$350.06
|
|
|
PR PLACE DRAIN PERIPANCREATIC ACUTE PANCREATITIS
|
Professional
|
Both
|
$3,283.00
|
|
|
Service Code
|
HCPCS 48000
|
| Min. Negotiated Rate |
$1,313.20 |
| Max. Negotiated Rate |
$2,634.36 |
| Rate for Payer: Aetna Commercial |
$2,451.42
|
| Rate for Payer: Aetna Medicare |
$1,902.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,451.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,634.36
|
| Rate for Payer: BCBS Complete |
$1,313.20
|
| Rate for Payer: BCBS MAPPO |
$1,829.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,829.42
|
| Rate for Payer: Cash Price |
$2,626.40
|
| Rate for Payer: Cash Price |
$2,626.40
|
| Rate for Payer: Cofinity Commercial |
$2,451.42
|
| Rate for Payer: Cofinity Commercial |
$2,634.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,829.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,920.89
|
| Rate for Payer: Nomi Health Commercial |
$2,195.30
|
| Rate for Payer: PACE SWMI |
$1,829.42
|
| Rate for Payer: PHP Commercial |
$2,561.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,829.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,133.95
|
| Rate for Payer: Priority Health Medicare |
$1,829.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,829.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,829.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,510.18
|
|
|
PR PLACEMENT CHOLEDOCHAL STENT
|
Professional
|
Both
|
$2,547.00
|
|
|
Service Code
|
HCPCS 47801
|
| Min. Negotiated Rate |
$1,018.80 |
| Max. Negotiated Rate |
$1,655.55 |
| Rate for Payer: Aetna Commercial |
$1,436.37
|
| Rate for Payer: Aetna Medicare |
$1,114.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,543.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,436.37
|
| Rate for Payer: BCBS Complete |
$1,018.80
|
| Rate for Payer: BCBS MAPPO |
$1,071.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,071.92
|
| Rate for Payer: Cash Price |
$2,037.60
|
| Rate for Payer: Cash Price |
$2,037.60
|
| Rate for Payer: Cofinity Commercial |
$1,543.56
|
| Rate for Payer: Cofinity Commercial |
$1,436.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,071.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,125.52
|
| Rate for Payer: Nomi Health Commercial |
$1,286.30
|
| Rate for Payer: PACE SWMI |
$1,071.92
|
| Rate for Payer: PHP Commercial |
$1,500.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,071.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,655.55
|
| Rate for Payer: Priority Health Medicare |
$1,071.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,071.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,071.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,171.62
|
|
|
PR PLACEMENT ENTEROSTOMY/CECOSTOMY TUBE OPEN
|
Professional
|
Both
|
$1,971.00
|
|
|
Service Code
|
HCPCS 44300
|
| Min. Negotiated Rate |
$788.40 |
| Max. Negotiated Rate |
$1,281.15 |
| Rate for Payer: Aetna Commercial |
$1,094.95
|
| Rate for Payer: Aetna Medicare |
$849.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,176.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,094.95
|
| Rate for Payer: BCBS Complete |
$788.40
|
| Rate for Payer: BCBS MAPPO |
$817.13
|
| Rate for Payer: BCN Medicare Advantage |
$817.13
|
| Rate for Payer: Cash Price |
$1,576.80
|
| Rate for Payer: Cash Price |
$1,576.80
|
| Rate for Payer: Cofinity Commercial |
$1,176.67
|
| Rate for Payer: Cofinity Commercial |
$1,094.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$817.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$857.99
|
| Rate for Payer: Nomi Health Commercial |
$980.56
|
| Rate for Payer: PACE SWMI |
$817.13
|
| Rate for Payer: PHP Commercial |
$1,143.98
|
| Rate for Payer: PHP Medicare Advantage |
$817.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,281.15
|
| Rate for Payer: Priority Health Medicare |
$817.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$817.13
|
| Rate for Payer: UHC Medicare Advantage |
$817.13
|
| Rate for Payer: UMR Bronson Commercial |
$906.66
|
|
|
PR PLACEMENT NEEDLE INTRAOSSEOUS INFUSION
|
Professional
|
Both
|
$565.00
|
|
|
Service Code
|
HCPCS 36680
|
| Min. Negotiated Rate |
$57.69 |
| Max. Negotiated Rate |
$367.25 |
| Rate for Payer: Aetna Commercial |
$77.30
|
| Rate for Payer: Aetna Medicare |
$60.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.30
|
| Rate for Payer: BCBS Complete |
$226.00
|
| Rate for Payer: BCBS MAPPO |
$57.69
|
| Rate for Payer: BCN Medicare Advantage |
$57.69
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cofinity Commercial |
$83.07
|
| Rate for Payer: Cofinity Commercial |
$77.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.57
|
| Rate for Payer: Nomi Health Commercial |
$69.23
|
| Rate for Payer: PACE SWMI |
$57.69
|
| Rate for Payer: PHP Commercial |
$80.77
|
| Rate for Payer: PHP Medicare Advantage |
$57.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.25
|
| Rate for Payer: Priority Health Medicare |
$57.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.69
|
| Rate for Payer: UHC Medicare Advantage |
$57.69
|
| Rate for Payer: UMR Bronson Commercial |
$259.90
|
|
|
PR PLACEMENT SETON
|
Professional
|
Both
|
$390.00
|
|
|
Service Code
|
HCPCS 46020
|
| Min. Negotiated Rate |
$112.34 |
| Max. Negotiated Rate |
$253.50 |
| Rate for Payer: Aetna Commercial |
$150.54
|
| Rate for Payer: Aetna Medicare |
$116.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.54
|
| Rate for Payer: BCBS Complete |
$156.00
|
| Rate for Payer: BCBS MAPPO |
$112.34
|
| Rate for Payer: BCN Medicare Advantage |
$112.34
|
| Rate for Payer: Cash Price |
$312.00
|
| Rate for Payer: Cash Price |
$312.00
|
| Rate for Payer: Cofinity Commercial |
$161.77
|
| Rate for Payer: Cofinity Commercial |
$150.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.96
|
| Rate for Payer: Nomi Health Commercial |
$134.81
|
| Rate for Payer: PACE SWMI |
$112.34
|
| Rate for Payer: PHP Commercial |
$157.28
|
| Rate for Payer: PHP Medicare Advantage |
$112.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.50
|
| Rate for Payer: Priority Health Medicare |
$112.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.34
|
| Rate for Payer: UHC Medicare Advantage |
$112.34
|
| Rate for Payer: UMR Bronson Commercial |
$179.40
|
|
|
PR PLACEMENT XTN PROSTH FOR ENDOVASCULAR RPR
|
Professional
|
Both
|
$681.00
|
|
|
Service Code
|
HCPCS 34709
|
| Min. Negotiated Rate |
$272.40 |
| Max. Negotiated Rate |
$444.86 |
| Rate for Payer: Aetna Commercial |
$413.97
|
| Rate for Payer: Aetna Medicare |
$321.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$413.97
|
| Rate for Payer: BCBS Complete |
$272.40
|
| Rate for Payer: BCBS MAPPO |
$308.93
|
| Rate for Payer: BCN Medicare Advantage |
$308.93
|
| Rate for Payer: Cash Price |
$544.80
|
| Rate for Payer: Cash Price |
$544.80
|
| Rate for Payer: Cofinity Commercial |
$444.86
|
| Rate for Payer: Cofinity Commercial |
$413.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.38
|
| Rate for Payer: Nomi Health Commercial |
$370.72
|
| Rate for Payer: PACE SWMI |
$308.93
|
| Rate for Payer: PHP Commercial |
$432.50
|
| Rate for Payer: PHP Medicare Advantage |
$308.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.65
|
| Rate for Payer: Priority Health Medicare |
$308.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.93
|
| Rate for Payer: UHC Medicare Advantage |
$308.93
|
| Rate for Payer: UMR Bronson Commercial |
$313.26
|
|
|
PR PLACE NEEDLE/CATH A-V DIALYSIS SHUNT,1ST ACCESS W/ RAD EVAL
|
Professional
|
Both
|
$1,510.00
|
|
|
Service Code
|
HCPCS 36147
|
| Min. Negotiated Rate |
$604.00 |
| Max. Negotiated Rate |
$981.50 |
| Rate for Payer: Aetna Medicare |
$755.00
|
| Rate for Payer: BCBS Complete |
$604.00
|
| Rate for Payer: Cash Price |
$1,208.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$981.50
|
| Rate for Payer: UMR Bronson Commercial |
$694.60
|
|
|
PR PLACE NEEDLE/CATH A-V DIALYSIS SHUNT,ADDL ACCESS FOR THERAPY
|
Professional
|
Both
|
$673.00
|
|
|
Service Code
|
HCPCS 36148
|
| Min. Negotiated Rate |
$269.20 |
| Max. Negotiated Rate |
$437.45 |
| Rate for Payer: Aetna Medicare |
$336.50
|
| Rate for Payer: BCBS Complete |
$269.20
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
| Rate for Payer: UMR Bronson Commercial |
$309.58
|
|
|
PR PLASTIC OPERATION PENIS INJURY
|
Professional
|
Both
|
$1,983.00
|
|
|
Service Code
|
HCPCS 54440
|
| Min. Negotiated Rate |
$793.20 |
| Max. Negotiated Rate |
$1,288.95 |
| Rate for Payer: Aetna Medicare |
$991.50
|
| Rate for Payer: BCBS Complete |
$793.20
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,288.95
|
| Rate for Payer: UMR Bronson Commercial |
$912.18
|
|
|
PR PLASTIC REPAIR INTROITUS
|
Professional
|
Both
|
$899.00
|
|
|
Service Code
|
HCPCS 56800
|
| Min. Negotiated Rate |
$242.46 |
| Max. Negotiated Rate |
$584.35 |
| Rate for Payer: Aetna Commercial |
$324.90
|
| Rate for Payer: Aetna Medicare |
$252.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$349.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.90
|
| Rate for Payer: BCBS Complete |
$359.60
|
| Rate for Payer: BCBS MAPPO |
$242.46
|
| Rate for Payer: BCN Medicare Advantage |
$242.46
|
| Rate for Payer: Cash Price |
$719.20
|
| Rate for Payer: Cash Price |
$719.20
|
| Rate for Payer: Cofinity Commercial |
$349.14
|
| Rate for Payer: Cofinity Commercial |
$324.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$254.58
|
| Rate for Payer: Nomi Health Commercial |
$290.95
|
| Rate for Payer: PACE SWMI |
$242.46
|
| Rate for Payer: PHP Commercial |
$339.44
|
| Rate for Payer: PHP Medicare Advantage |
$242.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$584.35
|
| Rate for Payer: Priority Health Medicare |
$242.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$242.46
|
| Rate for Payer: UHC Medicare Advantage |
$242.46
|
| Rate for Payer: UMR Bronson Commercial |
$413.54
|
|
