|
PR PHARMACOLOGIC MANAGEMENT W/PSYCHOTHERAPY
|
Professional
|
Both
|
$85.00
|
|
|
Service Code
|
HCPCS 90863
|
| Min. Negotiated Rate |
$31.40 |
| Max. Negotiated Rate |
$1,062.41 |
| Rate for Payer: Aetna Commercial |
$31.40
|
| Rate for Payer: Aetna Medicare |
$42.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.40
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.41
|
| Rate for Payer: BCN Commercial |
$70.30
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.86
|
| Rate for Payer: Priority Health Narrow Network |
$41.86
|
| Rate for Payer: Priority Health SBD |
$41.86
|
| Rate for Payer: UMR Bronson Commercial |
$39.10
|
|
|
PR PHARYNGOPLASTY PLSTC/RCNSTV OPRATION PHARYNX
|
Professional
|
Both
|
$1,441.00
|
|
|
Service Code
|
HCPCS 42950
|
| Min. Negotiated Rate |
$509.50 |
| Max. Negotiated Rate |
$1,429.44 |
| Rate for Payer: Aetna Commercial |
$990.39
|
| Rate for Payer: Aetna Medicare |
$768.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,064.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$990.39
|
| Rate for Payer: BCBS Complete |
$534.98
|
| Rate for Payer: BCBS MAPPO |
$739.10
|
| Rate for Payer: BCBS Trust/PPO |
$665.13
|
| Rate for Payer: BCN Commercial |
$1,175.76
|
| Rate for Payer: BCN Medicare Advantage |
$739.10
|
| Rate for Payer: Cash Price |
$1,152.80
|
| Rate for Payer: Cash Price |
$1,152.80
|
| Rate for Payer: Cofinity Commercial |
$990.39
|
| Rate for Payer: Cofinity Commercial |
$1,064.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$739.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$776.06
|
| Rate for Payer: Meridian Medicaid |
$534.98
|
| Rate for Payer: Nomi Health Commercial |
$886.92
|
| Rate for Payer: PACE SWMI |
$739.10
|
| Rate for Payer: PHP Commercial |
$1,034.74
|
| Rate for Payer: PHP Medicare Advantage |
$739.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$509.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$936.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,429.44
|
| Rate for Payer: Priority Health Medicare |
$739.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,429.44
|
| Rate for Payer: Priority Health SBD |
$1,429.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$739.10
|
| Rate for Payer: UHC Medicare Advantage |
$739.10
|
| Rate for Payer: UHCCP Medicaid |
$509.50
|
| Rate for Payer: UMR Bronson Commercial |
$662.86
|
|
|
PR PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE
|
Professional
|
Both
|
$196.00
|
|
|
Service Code
|
HCPCS 99195
|
| Min. Negotiated Rate |
$78.40 |
| Max. Negotiated Rate |
$587.47 |
| Rate for Payer: Aetna Commercial |
$106.68
|
| Rate for Payer: Aetna Medicare |
$82.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.64
|
| Rate for Payer: BCBS Complete |
$78.40
|
| Rate for Payer: BCBS MAPPO |
$79.61
|
| Rate for Payer: BCBS Trust/PPO |
$587.47
|
| Rate for Payer: BCN Commercial |
$141.72
|
| Rate for Payer: BCN Medicare Advantage |
$79.61
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Cofinity Commercial |
$114.64
|
| Rate for Payer: Cofinity Commercial |
$106.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.59
|
| Rate for Payer: Nomi Health Commercial |
$95.53
|
| Rate for Payer: PACE SWMI |
$79.61
|
| Rate for Payer: PHP Commercial |
$111.45
|
| Rate for Payer: PHP Medicare Advantage |
$79.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.82
|
| Rate for Payer: Priority Health Medicare |
$79.61
|
| Rate for Payer: Priority Health Narrow Network |
$129.82
|
| Rate for Payer: Priority Health SBD |
$129.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.61
|
| Rate for Payer: UHC Medicare Advantage |
$79.61
|
| Rate for Payer: UMR Bronson Commercial |
$90.16
|
|
|
PR PHTFAC ARMS
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 00079
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$165.75 |
| Rate for Payer: Aetna Medicare |
$127.50
|
| Rate for Payer: BCBS Complete |
$102.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
| Rate for Payer: UMR Bronson Commercial |
$117.30
|
|
|
PR PHTFAC CHEST/SHLD
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 00077
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$51.20 |
| Max. Negotiated Rate |
$83.20 |
| Rate for Payer: Aetna Medicare |
$64.00
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: UMR Bronson Commercial |
$58.88
|
|
|
PR PHTFAC FACE & NECK/ FL ARMS
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 00076
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$165.75 |
| Rate for Payer: Aetna Medicare |
$127.50
|
| Rate for Payer: BCBS Complete |
$102.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
| Rate for Payer: UMR Bronson Commercial |
$117.30
|
|
|
PR PHTFAC FL LEGS
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 00080
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$142.80 |
| Max. Negotiated Rate |
$232.05 |
| Rate for Payer: Aetna Medicare |
$178.50
|
| Rate for Payer: BCBS Complete |
$142.80
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: UMR Bronson Commercial |
$164.22
|
|
|
PR PHTFAC HANDS
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 00078
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: UMR Bronson Commercial |
$23.46
|
|
|
PR PHTFAC HEMANGIOMAS/WARTS
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 00083
|
|
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 PHTFAC NASAL VEIN
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 00082
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$29.90 |
| Rate for Payer: Aetna Medicare |
$23.00
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.90
|
| Rate for Payer: UMR Bronson Commercial |
$21.16
|
|
|
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 |
$708.45 |
| 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: BCBS Trust/PPO |
$708.45
|
| Rate for Payer: BCN Commercial |
$32.95
|
| 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 |
$45.69
|
| Rate for Payer: Cofinity Commercial |
$42.52
|
| 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 HMO/PPO/Tiered Network |
$77.25
|
| Rate for Payer: Priority Health Medicare |
$31.73
|
| Rate for Payer: Priority Health Narrow Network |
$77.25
|
| Rate for Payer: Priority Health SBD |
$77.25
|
| 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 |
$55.81 |
| Max. Negotiated Rate |
$740.15 |
| 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 |
$58.60
|
| Rate for Payer: BCBS MAPPO |
$195.93
|
| Rate for Payer: BCBS Trust/PPO |
$740.15
|
| Rate for Payer: BCN Commercial |
$319.60
|
| 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: Meridian Medicaid |
$58.60
|
| 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 Choice Medicaid |
$55.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.46
|
| Rate for Payer: Priority Health Medicare |
$195.93
|
| Rate for Payer: Priority Health Narrow Network |
$307.46
|
| Rate for Payer: Priority Health SBD |
$121.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$195.93
|
| Rate for Payer: UHC Medicare Advantage |
$195.93
|
| Rate for Payer: UHCCP Medicaid |
$55.81
|
| 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 |
$67.31 |
| 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 |
$70.68
|
| Rate for Payer: BCBS MAPPO |
$101.48
|
| Rate for Payer: BCBS Trust/PPO |
$201.28
|
| Rate for Payer: BCN Commercial |
$153.45
|
| 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 |
$146.13
|
| Rate for Payer: Cofinity Commercial |
$135.98
|
| 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: Meridian Medicaid |
$70.68
|
| 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 Choice Medicaid |
$67.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$242.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.02
|
| Rate for Payer: Priority Health Medicare |
$101.48
|
| Rate for Payer: Priority Health Narrow Network |
$142.02
|
| Rate for Payer: Priority Health SBD |
$142.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.48
|
| Rate for Payer: UHC Medicare Advantage |
$101.48
|
| Rate for Payer: UHCCP Medicaid |
$67.31
|
| 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 |
$47.74 |
| Max. Negotiated Rate |
$1,059.24 |
| Rate for Payer: Aetna Commercial |
$48.75
|
| Rate for Payer: Aetna Medicare |
$125.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.75
|
| Rate for Payer: BCBS Complete |
$100.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,059.24
|
| Rate for Payer: BCN Commercial |
$47.74
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.00
|
| Rate for Payer: Priority Health Narrow Network |
$72.00
|
| Rate for Payer: Priority Health SBD |
$72.00
|
| 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 |
$20.70 |
| Max. Negotiated Rate |
$434.79 |
| Rate for Payer: Aetna Commercial |
$25.00
|
| Rate for Payer: Aetna Medicare |
$22.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.00
|
| Rate for Payer: BCBS Complete |
$47.25
|
| Rate for Payer: BCBS Trust/PPO |
$434.79
|
| Rate for Payer: BCN Commercial |
$34.16
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Meridian Medicaid |
$47.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.89
|
| Rate for Payer: Priority Health Narrow Network |
$31.89
|
| Rate for Payer: Priority Health SBD |
$31.89
|
| Rate for Payer: UHCCP Medicaid |
$45.00
|
| 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 |
$49.00 |
| Rate for Payer: Aetna Medicare |
$25.00
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCN Commercial |
$49.00
|
| Rate for Payer: Cash Price |
$40.00
|
| 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 |
$5.33 |
| Max. Negotiated Rate |
$118.87 |
| Rate for Payer: Aetna Commercial |
$10.68
|
| Rate for Payer: Aetna Medicare |
$8.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.48
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$7.97
|
| Rate for Payer: BCBS Trust/PPO |
$118.87
|
| Rate for Payer: BCN Commercial |
$24.44
|
| 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 |
$11.48
|
| Rate for Payer: Cofinity Commercial |
$10.68
|
| 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: Meridian Medicaid |
$5.60
|
| 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 Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.24
|
| Rate for Payer: Priority Health Medicare |
$7.97
|
| Rate for Payer: Priority Health Narrow Network |
$12.24
|
| Rate for Payer: Priority Health SBD |
$12.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.97
|
| Rate for Payer: UHC Medicare Advantage |
$7.97
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| 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 |
$39.42 |
| Max. Negotiated Rate |
$1,711.16 |
| Rate for Payer: Aetna Commercial |
$67.27
|
| Rate for Payer: Aetna Medicare |
$74.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.27
|
| Rate for Payer: BCBS Complete |
$59.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,711.16
|
| Rate for Payer: BCN Commercial |
$39.42
|
| Rate for Payer: Cash Price |
$119.20
|
| 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 |
$57.62 |
| Max. Negotiated Rate |
$1,049.20 |
| Rate for Payer: Aetna Commercial |
$99.17
|
| Rate for Payer: Aetna Medicare |
$108.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.17
|
| Rate for Payer: BCBS Complete |
$86.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,049.20
|
| Rate for Payer: BCN Commercial |
$57.62
|
| Rate for Payer: Cash Price |
$172.80
|
| 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 |
$20.21 |
| Max. Negotiated Rate |
$1,561.13 |
| Rate for Payer: Aetna Commercial |
$35.71
|
| Rate for Payer: Aetna Medicare |
$45.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.71
|
| Rate for Payer: BCBS Complete |
$36.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,561.13
|
| Rate for Payer: BCN Commercial |
$20.21
|
| Rate for Payer: Cash Price |
$72.00
|
| 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 |
$60.51 |
| Max. Negotiated Rate |
$169.65 |
| Rate for Payer: Aetna Commercial |
$60.51
|
| Rate for Payer: Aetna Medicare |
$130.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.51
|
| Rate for Payer: BCBS Complete |
$104.40
|
| Rate for Payer: BCBS Trust/PPO |
$102.49
|
| Rate for Payer: BCN Commercial |
$84.55
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.08
|
| Rate for Payer: Priority Health Narrow Network |
$78.08
|
| Rate for Payer: Priority Health SBD |
$78.08
|
| 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 |
$206.12 |
| Max. Negotiated Rate |
$870.82 |
| 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 |
$312.00
|
| Rate for Payer: BCBS MAPPO |
$435.41
|
| Rate for Payer: BCBS Trust/PPO |
$206.12
|
| Rate for Payer: BCN Commercial |
$870.82
|
| 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 |
$583.45
|
| Rate for Payer: Cofinity Commercial |
$626.99
|
| 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: Meridian Medicaid |
$312.00
|
| 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 Choice Medicaid |
$297.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$622.19
|
| Rate for Payer: Priority Health Medicare |
$435.41
|
| Rate for Payer: Priority Health Narrow Network |
$622.19
|
| Rate for Payer: Priority Health SBD |
$622.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$435.41
|
| Rate for Payer: UHC Medicare Advantage |
$435.41
|
| Rate for Payer: UHCCP Medicaid |
$297.14
|
| 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
|
|
