|
PR PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I
|
Professional
|
Both
|
$1,616.00
|
|
|
Service Code
|
HCPCS 50432
|
| Min. Negotiated Rate |
$128.01 |
| Max. Negotiated Rate |
$2,416.97 |
| Rate for Payer: Aetna Commercial |
$257.29
|
| Rate for Payer: Aetna Medicare |
$199.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.49
|
| Rate for Payer: BCBS Complete |
$134.41
|
| Rate for Payer: BCBS MAPPO |
$192.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,416.97
|
| Rate for Payer: BCN Commercial |
$1,340.94
|
| Rate for Payer: BCN Medicare Advantage |
$192.01
|
| Rate for Payer: Cash Price |
$1,292.80
|
| Rate for Payer: Cash Price |
$1,292.80
|
| Rate for Payer: Cofinity Commercial |
$257.29
|
| Rate for Payer: Cofinity Commercial |
$276.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.61
|
| Rate for Payer: Meridian Medicaid |
$134.41
|
| Rate for Payer: Nomi Health Commercial |
$230.41
|
| Rate for Payer: PACE SWMI |
$192.01
|
| Rate for Payer: PHP Commercial |
$268.81
|
| Rate for Payer: PHP Medicare Advantage |
$192.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,050.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$317.42
|
| Rate for Payer: Priority Health Medicare |
$192.01
|
| Rate for Payer: Priority Health Narrow Network |
$317.42
|
| Rate for Payer: Priority Health SBD |
$317.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.01
|
| Rate for Payer: UHC Medicare Advantage |
$192.01
|
| Rate for Payer: UHCCP Medicaid |
$128.01
|
| Rate for Payer: UMR Bronson Commercial |
$743.36
|
|
|
PR PLMT PROX XTN PROSTH EVASC RPR DTA 1ST XTN
|
Professional
|
Both
|
$2,278.00
|
|
|
Service Code
|
HCPCS 33883
|
| Min. Negotiated Rate |
$692.68 |
| Max. Negotiated Rate |
$1,732.69 |
| Rate for Payer: Aetna Commercial |
$1,422.81
|
| Rate for Payer: Aetna Medicare |
$1,104.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,422.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,528.99
|
| Rate for Payer: BCBS Complete |
$727.31
|
| Rate for Payer: BCBS MAPPO |
$1,061.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.39
|
| Rate for Payer: BCN Commercial |
$1,586.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,061.80
|
| Rate for Payer: Cash Price |
$1,822.40
|
| Rate for Payer: Cash Price |
$1,822.40
|
| Rate for Payer: Cofinity Commercial |
$1,422.81
|
| Rate for Payer: Cofinity Commercial |
$1,528.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,061.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,114.89
|
| Rate for Payer: Meridian Medicaid |
$727.31
|
| Rate for Payer: Nomi Health Commercial |
$1,274.16
|
| Rate for Payer: PACE SWMI |
$1,061.80
|
| Rate for Payer: PHP Commercial |
$1,486.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,061.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,480.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,732.69
|
| Rate for Payer: Priority Health Medicare |
$1,061.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,732.69
|
| Rate for Payer: Priority Health SBD |
$1,732.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,061.80
|
| Rate for Payer: UHC Medicare Advantage |
$1,061.80
|
| Rate for Payer: UHCCP Medicaid |
$692.68
|
| Rate for Payer: UMR Bronson Commercial |
$1,047.88
|
|
|
PR PLMT PROX XTN PROSTH EVASC RPR DTA EA PROX XTN
|
Professional
|
Both
|
$877.00
|
|
|
Service Code
|
HCPCS 33884
|
| Min. Negotiated Rate |
$245.80 |
| Max. Negotiated Rate |
$1,597.58 |
| Rate for Payer: Aetna Commercial |
$510.25
|
| Rate for Payer: Aetna Medicare |
$396.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$510.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$548.32
|
| Rate for Payer: BCBS Complete |
$258.09
|
| Rate for Payer: BCBS MAPPO |
$380.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,597.58
|
| Rate for Payer: BCN Commercial |
$561.00
|
| Rate for Payer: BCN Medicare Advantage |
$380.78
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cash Price |
$701.60
|
| Rate for Payer: Cofinity Commercial |
$510.25
|
| Rate for Payer: Cofinity Commercial |
$548.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.82
|
| Rate for Payer: Meridian Medicaid |
$258.09
|
| Rate for Payer: Nomi Health Commercial |
$456.94
|
| Rate for Payer: PACE SWMI |
$380.78
|
| Rate for Payer: PHP Commercial |
$533.09
|
| Rate for Payer: PHP Medicare Advantage |
$380.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$245.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$570.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$612.66
|
| Rate for Payer: Priority Health Medicare |
$380.78
|
| Rate for Payer: Priority Health Narrow Network |
$612.66
|
| Rate for Payer: Priority Health SBD |
$612.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$380.78
|
| Rate for Payer: UHC Medicare Advantage |
$380.78
|
| Rate for Payer: UHCCP Medicaid |
$245.80
|
| Rate for Payer: UMR Bronson Commercial |
$403.42
|
|
|
PR PLMT SFT TISS LOCLZJ DEV PERQ 1ST LESION
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 10035
|
| Min. Negotiated Rate |
$52.82 |
| Max. Negotiated Rate |
$543.90 |
| Rate for Payer: Aetna Commercial |
$106.30
|
| Rate for Payer: Aetna Medicare |
$82.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.24
|
| Rate for Payer: BCBS Complete |
$55.46
|
| Rate for Payer: BCBS MAPPO |
$79.33
|
| Rate for Payer: BCN Commercial |
$543.90
|
| Rate for Payer: BCN Medicare Advantage |
$79.33
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cofinity Commercial |
$106.30
|
| Rate for Payer: Cofinity Commercial |
$114.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.30
|
| Rate for Payer: Meridian Medicaid |
$55.46
|
| Rate for Payer: Nomi Health Commercial |
$95.20
|
| Rate for Payer: PACE SWMI |
$79.33
|
| Rate for Payer: PHP Commercial |
$111.06
|
| Rate for Payer: PHP Medicare Advantage |
$79.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.52
|
| Rate for Payer: Priority Health Medicare |
$79.33
|
| Rate for Payer: Priority Health Narrow Network |
$111.52
|
| Rate for Payer: Priority Health SBD |
$111.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.33
|
| Rate for Payer: UHC Medicare Advantage |
$79.33
|
| Rate for Payer: UHCCP Medicaid |
$52.82
|
| Rate for Payer: UMR Bronson Commercial |
$109.02
|
|
|
PR PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT
|
Professional
|
Both
|
$563.00
|
|
|
Service Code
|
HCPCS 50693
|
| Min. Negotiated Rate |
$127.37 |
| Max. Negotiated Rate |
$3,785.27 |
| Rate for Payer: Aetna Commercial |
$255.95
|
| Rate for Payer: Aetna Medicare |
$198.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.05
|
| Rate for Payer: BCBS Complete |
$133.74
|
| Rate for Payer: BCBS MAPPO |
$191.01
|
| Rate for Payer: BCBS Trust/PPO |
$3,785.27
|
| Rate for Payer: BCN Commercial |
$1,468.96
|
| Rate for Payer: BCN Medicare Advantage |
$191.01
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cofinity Commercial |
$255.95
|
| Rate for Payer: Cofinity Commercial |
$275.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$200.56
|
| Rate for Payer: Meridian Medicaid |
$133.74
|
| Rate for Payer: Nomi Health Commercial |
$229.21
|
| Rate for Payer: PACE SWMI |
$191.01
|
| Rate for Payer: PHP Commercial |
$267.41
|
| Rate for Payer: PHP Medicare Advantage |
$191.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$315.82
|
| Rate for Payer: Priority Health Medicare |
$191.01
|
| Rate for Payer: Priority Health Narrow Network |
$315.82
|
| Rate for Payer: Priority Health SBD |
$315.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.01
|
| Rate for Payer: UHC Medicare Advantage |
$191.01
|
| Rate for Payer: UHCCP Medicaid |
$127.37
|
| Rate for Payer: UMR Bronson Commercial |
$258.98
|
|
|
PR PLMT VEIN PATCH/CUFF DSTL ANAST BYP CONDUIT
|
Professional
|
Both
|
$443.00
|
|
|
Service Code
|
HCPCS 35685
|
| Min. Negotiated Rate |
$123.33 |
| Max. Negotiated Rate |
$2,230.82 |
| Rate for Payer: Aetna Commercial |
$255.56
|
| Rate for Payer: Aetna Medicare |
$198.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.64
|
| Rate for Payer: BCBS Complete |
$129.50
|
| Rate for Payer: BCBS MAPPO |
$190.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,230.82
|
| Rate for Payer: BCN Commercial |
$281.48
|
| Rate for Payer: BCN Medicare Advantage |
$190.72
|
| Rate for Payer: Cash Price |
$354.40
|
| Rate for Payer: Cash Price |
$354.40
|
| Rate for Payer: Cofinity Commercial |
$274.64
|
| Rate for Payer: Cofinity Commercial |
$255.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$200.26
|
| Rate for Payer: Meridian Medicaid |
$129.50
|
| Rate for Payer: Nomi Health Commercial |
$228.86
|
| Rate for Payer: PACE SWMI |
$190.72
|
| Rate for Payer: PHP Commercial |
$267.01
|
| Rate for Payer: PHP Medicare Advantage |
$190.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$306.86
|
| Rate for Payer: Priority Health Medicare |
$190.72
|
| Rate for Payer: Priority Health Narrow Network |
$306.86
|
| Rate for Payer: Priority Health SBD |
$306.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$190.72
|
| Rate for Payer: UHC Medicare Advantage |
$190.72
|
| Rate for Payer: UHCCP Medicaid |
$123.33
|
| Rate for Payer: UMR Bronson Commercial |
$203.78
|
|
|
PR PLNNING PT SPEC FENEST VISCERAL AORTIC GRAFT
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 34839
|
| Min. Negotiated Rate |
$81.60 |
| Max. Negotiated Rate |
$1,815.77 |
| Rate for Payer: Aetna Commercial |
$240.00
|
| Rate for Payer: Aetna Medicare |
$102.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.00
|
| Rate for Payer: BCBS Complete |
$81.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,815.77
|
| Rate for Payer: BCN Commercial |
$145.07
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: UMR Bronson Commercial |
$93.84
|
|
|
PR PL REJUV/PERFECT
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 00071
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$48.80 |
| Max. Negotiated Rate |
$79.30 |
| Rate for Payer: Aetna Medicare |
$61.00
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: UMR Bronson Commercial |
$56.12
|
|
|
PR PLSTC RPR CL LIP/NSL DFRM SEC RECRTJ DFCT & RECL
|
Professional
|
Both
|
$1,883.00
|
|
|
Service Code
|
HCPCS 40720
|
| Min. Negotiated Rate |
$662.43 |
| Max. Negotiated Rate |
$1,837.52 |
| Rate for Payer: Aetna Commercial |
$1,315.25
|
| Rate for Payer: Aetna Medicare |
$1,020.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,315.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,413.40
|
| Rate for Payer: BCBS Complete |
$695.55
|
| Rate for Payer: BCBS MAPPO |
$981.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,487.69
|
| Rate for Payer: BCN Commercial |
$1,500.24
|
| Rate for Payer: BCN Medicare Advantage |
$981.53
|
| Rate for Payer: Cash Price |
$1,506.40
|
| Rate for Payer: Cash Price |
$1,506.40
|
| Rate for Payer: Cofinity Commercial |
$1,413.40
|
| Rate for Payer: Cofinity Commercial |
$1,315.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$981.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,030.61
|
| Rate for Payer: Meridian Medicaid |
$695.55
|
| Rate for Payer: Nomi Health Commercial |
$1,177.84
|
| Rate for Payer: PACE SWMI |
$981.53
|
| Rate for Payer: PHP Commercial |
$1,374.14
|
| Rate for Payer: PHP Medicare Advantage |
$981.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$662.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,223.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,837.52
|
| Rate for Payer: Priority Health Medicare |
$981.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,837.52
|
| Rate for Payer: Priority Health SBD |
$1,837.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$981.53
|
| Rate for Payer: UHC Medicare Advantage |
$981.53
|
| Rate for Payer: UHCCP Medicaid |
$662.43
|
| Rate for Payer: UMR Bronson Commercial |
$866.18
|
|
|
PR PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY PRIM
|
Professional
|
Both
|
$872.00
|
|
|
Service Code
|
HCPCS 42500
|
| Min. Negotiated Rate |
$223.86 |
| Max. Negotiated Rate |
$1,052.90 |
| Rate for Payer: Aetna Commercial |
$438.98
|
| Rate for Payer: Aetna Medicare |
$340.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$438.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$471.74
|
| Rate for Payer: BCBS Complete |
$235.05
|
| Rate for Payer: BCBS MAPPO |
$327.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,052.90
|
| Rate for Payer: BCN Commercial |
$664.60
|
| Rate for Payer: BCN Medicare Advantage |
$327.60
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cofinity Commercial |
$438.98
|
| Rate for Payer: Cofinity Commercial |
$471.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$327.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$343.98
|
| Rate for Payer: Meridian Medicaid |
$235.05
|
| Rate for Payer: Nomi Health Commercial |
$393.12
|
| Rate for Payer: PACE SWMI |
$327.60
|
| Rate for Payer: PHP Commercial |
$458.64
|
| Rate for Payer: PHP Medicare Advantage |
$327.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$624.63
|
| Rate for Payer: Priority Health Medicare |
$327.60
|
| Rate for Payer: Priority Health Narrow Network |
$624.63
|
| Rate for Payer: Priority Health SBD |
$624.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$327.60
|
| Rate for Payer: UHC Medicare Advantage |
$327.60
|
| Rate for Payer: UHCCP Medicaid |
$223.86
|
| Rate for Payer: UMR Bronson Commercial |
$401.12
|
|
|
PR PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY SEC/COMP
|
Professional
|
Both
|
$1,112.00
|
|
|
Service Code
|
HCPCS 42505
|
| Min. Negotiated Rate |
$296.07 |
| Max. Negotiated Rate |
$848.84 |
| Rate for Payer: Aetna Commercial |
$583.24
|
| Rate for Payer: Aetna Medicare |
$452.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$583.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$626.76
|
| Rate for Payer: BCBS Complete |
$310.87
|
| Rate for Payer: BCBS MAPPO |
$435.25
|
| Rate for Payer: BCBS Trust/PPO |
$318.04
|
| Rate for Payer: BCN Commercial |
$848.84
|
| Rate for Payer: BCN Medicare Advantage |
$435.25
|
| Rate for Payer: Cash Price |
$889.60
|
| Rate for Payer: Cash Price |
$889.60
|
| Rate for Payer: Cofinity Commercial |
$583.24
|
| Rate for Payer: Cofinity Commercial |
$626.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$435.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$457.01
|
| Rate for Payer: Meridian Medicaid |
$310.87
|
| Rate for Payer: Nomi Health Commercial |
$522.30
|
| Rate for Payer: PACE SWMI |
$435.25
|
| Rate for Payer: PHP Commercial |
$609.35
|
| Rate for Payer: PHP Medicare Advantage |
$435.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$722.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$829.27
|
| Rate for Payer: Priority Health Medicare |
$435.25
|
| Rate for Payer: Priority Health Narrow Network |
$829.27
|
| Rate for Payer: Priority Health SBD |
$829.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$435.25
|
| Rate for Payer: UHC Medicare Advantage |
$435.25
|
| Rate for Payer: UHCCP Medicaid |
$296.07
|
| Rate for Payer: UMR Bronson Commercial |
$511.52
|
|
|
PR PL VITALIZE
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 00070
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Medicare |
$51.00
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: UMR Bronson Commercial |
$46.92
|
|
|
PR PNCRTECT DSTL STOT W/O PNCRTCOJEJUNOSTOMY
|
Professional
|
Both
|
$3,664.00
|
|
|
Service Code
|
HCPCS 48140
|
| Min. Negotiated Rate |
$1,005.57 |
| Max. Negotiated Rate |
$2,802.80 |
| Rate for Payer: Aetna Commercial |
$2,039.06
|
| Rate for Payer: Aetna Medicare |
$1,582.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,039.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,191.23
|
| Rate for Payer: BCBS Complete |
$1,055.85
|
| Rate for Payer: BCBS MAPPO |
$1,521.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,200.30
|
| Rate for Payer: BCN Commercial |
$2,284.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,521.69
|
| Rate for Payer: Cash Price |
$2,931.20
|
| Rate for Payer: Cash Price |
$2,931.20
|
| Rate for Payer: Cofinity Commercial |
$2,191.23
|
| Rate for Payer: Cofinity Commercial |
$2,039.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,521.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,597.77
|
| Rate for Payer: Meridian Medicaid |
$1,055.85
|
| Rate for Payer: Nomi Health Commercial |
$1,826.03
|
| Rate for Payer: PACE SWMI |
$1,521.69
|
| Rate for Payer: PHP Commercial |
$2,130.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,521.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,005.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,381.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,802.80
|
| Rate for Payer: Priority Health Medicare |
$1,521.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,802.80
|
| Rate for Payer: Priority Health SBD |
$2,802.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,521.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,521.69
|
| Rate for Payer: UHCCP Medicaid |
$1,005.57
|
| Rate for Payer: UMR Bronson Commercial |
$1,685.44
|
|
|
PR PNCRTECT PROX STOT W/PANCREATOJEJUNOSTOMY
|
Professional
|
Both
|
$5,562.00
|
|
|
Service Code
|
HCPCS 48150
|
| Min. Negotiated Rate |
$711.62 |
| Max. Negotiated Rate |
$5,560.26 |
| Rate for Payer: Aetna Commercial |
$4,046.92
|
| Rate for Payer: Aetna Medicare |
$3,140.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,046.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,348.93
|
| Rate for Payer: BCBS Complete |
$2,092.69
|
| Rate for Payer: BCBS MAPPO |
$3,020.09
|
| Rate for Payer: BCBS Trust/PPO |
$711.62
|
| Rate for Payer: BCN Commercial |
$4,533.95
|
| Rate for Payer: BCN Medicare Advantage |
$3,020.09
|
| Rate for Payer: Cash Price |
$4,449.60
|
| Rate for Payer: Cash Price |
$4,449.60
|
| Rate for Payer: Cofinity Commercial |
$4,046.92
|
| Rate for Payer: Cofinity Commercial |
$4,348.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,020.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,171.09
|
| Rate for Payer: Meridian Medicaid |
$2,092.69
|
| Rate for Payer: Nomi Health Commercial |
$3,624.11
|
| Rate for Payer: PACE SWMI |
$3,020.09
|
| Rate for Payer: PHP Commercial |
$4,228.13
|
| Rate for Payer: PHP Medicare Advantage |
$3,020.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,993.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,615.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,560.26
|
| Rate for Payer: Priority Health Medicare |
$3,020.09
|
| Rate for Payer: Priority Health Narrow Network |
$5,560.26
|
| Rate for Payer: Priority Health SBD |
$5,560.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,020.09
|
| Rate for Payer: UHC Medicare Advantage |
$3,020.09
|
| Rate for Payer: UHCCP Medicaid |
$1,993.04
|
| Rate for Payer: UMR Bronson Commercial |
$2,558.52
|
|
|
PR PNCRTECT W/PANCREATOJEJUNOSTOMY
|
Professional
|
Both
|
$8,303.00
|
|
|
Service Code
|
HCPCS 48153
|
| Min. Negotiated Rate |
$747.02 |
| Max. Negotiated Rate |
$5,536.98 |
| Rate for Payer: Aetna Commercial |
$4,026.36
|
| Rate for Payer: Aetna Medicare |
$3,124.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,026.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,326.84
|
| Rate for Payer: BCBS Complete |
$2,080.40
|
| Rate for Payer: BCBS MAPPO |
$3,004.75
|
| Rate for Payer: BCBS Trust/PPO |
$747.02
|
| Rate for Payer: BCN Commercial |
$4,519.29
|
| Rate for Payer: BCN Medicare Advantage |
$3,004.75
|
| Rate for Payer: Cash Price |
$6,642.40
|
| Rate for Payer: Cash Price |
$6,642.40
|
| Rate for Payer: Cofinity Commercial |
$4,026.36
|
| Rate for Payer: Cofinity Commercial |
$4,326.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,004.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,154.99
|
| Rate for Payer: Meridian Medicaid |
$2,080.40
|
| Rate for Payer: Nomi Health Commercial |
$3,605.70
|
| Rate for Payer: PACE SWMI |
$3,004.75
|
| Rate for Payer: PHP Commercial |
$4,206.65
|
| Rate for Payer: PHP Medicare Advantage |
$3,004.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,981.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,396.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,536.98
|
| Rate for Payer: Priority Health Medicare |
$3,004.75
|
| Rate for Payer: Priority Health Narrow Network |
$5,536.98
|
| Rate for Payer: Priority Health SBD |
$5,536.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,004.75
|
| Rate for Payer: UHC Medicare Advantage |
$3,004.75
|
| Rate for Payer: UHCCP Medicaid |
$1,981.33
|
| Rate for Payer: UMR Bronson Commercial |
$3,819.38
|
|
|
PR PNEUMOCOCCAL CONJ VACCINE 7 VALENT IM
|
Professional
|
Both
|
$116.00
|
|
|
Service Code
|
HCPCS 90669
|
| Min. Negotiated Rate |
$46.40 |
| Max. Negotiated Rate |
$75.40 |
| Rate for Payer: Aetna Medicare |
$58.00
|
| Rate for Payer: BCBS Complete |
$46.40
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.40
|
| Rate for Payer: UMR Bronson Commercial |
$53.36
|
|
|
PR PNEUMONOLYSIS XTRPRIOSTEAL W/FILLING/PACKING PX
|
Professional
|
Both
|
$2,574.00
|
|
|
Service Code
|
HCPCS 32940
|
| Min. Negotiated Rate |
$780.86 |
| Max. Negotiated Rate |
$1,774.88 |
| Rate for Payer: Priority Health Medicare |
$1,185.96
|
| Rate for Payer: Aetna Commercial |
$1,589.19
|
| Rate for Payer: Aetna Medicare |
$1,233.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,589.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,707.78
|
| Rate for Payer: BCBS Complete |
$819.90
|
| Rate for Payer: BCBS MAPPO |
$1,185.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,049.20
|
| Rate for Payer: BCN Commercial |
$1,774.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,185.96
|
| Rate for Payer: Cash Price |
$2,059.20
|
| Rate for Payer: Cash Price |
$2,059.20
|
| Rate for Payer: Cofinity Commercial |
$1,707.78
|
| Rate for Payer: Cofinity Commercial |
$1,589.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,185.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,245.26
|
| Rate for Payer: Meridian Medicaid |
$819.90
|
| Rate for Payer: Nomi Health Commercial |
$1,423.15
|
| Rate for Payer: PACE SWMI |
$1,185.96
|
| Rate for Payer: PHP Commercial |
$1,660.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,185.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$780.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,673.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,691.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,691.65
|
| Rate for Payer: Priority Health SBD |
$1,691.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,185.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,185.96
|
| Rate for Payer: UHCCP Medicaid |
$780.86
|
| Rate for Payer: UMR Bronson Commercial |
$1,184.04
|
|
|
PR PNEUMONOSTOMY W/OPEN DRAINAGE ABSCESS/CYST
|
Professional
|
Both
|
$2,729.00
|
|
|
Service Code
|
HCPCS 32200
|
| Min. Negotiated Rate |
$725.48 |
| Max. Negotiated Rate |
$1,773.85 |
| Rate for Payer: Aetna Commercial |
$1,468.76
|
| Rate for Payer: Aetna Medicare |
$1,139.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,468.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,578.37
|
| Rate for Payer: BCBS Complete |
$761.75
|
| Rate for Payer: BCBS MAPPO |
$1,096.09
|
| Rate for Payer: BCBS Trust/PPO |
$897.05
|
| Rate for Payer: BCN Commercial |
$1,644.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,096.09
|
| Rate for Payer: Cash Price |
$2,183.20
|
| Rate for Payer: Cash Price |
$2,183.20
|
| Rate for Payer: Cofinity Commercial |
$1,468.76
|
| Rate for Payer: Cofinity Commercial |
$1,578.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,096.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,150.89
|
| Rate for Payer: Meridian Medicaid |
$761.75
|
| Rate for Payer: Nomi Health Commercial |
$1,315.31
|
| Rate for Payer: PACE SWMI |
$1,096.09
|
| Rate for Payer: PHP Commercial |
$1,534.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,096.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$725.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,570.68
|
| Rate for Payer: Priority Health Medicare |
$1,096.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,570.68
|
| Rate for Payer: Priority Health SBD |
$1,570.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,096.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,096.09
|
| Rate for Payer: UHCCP Medicaid |
$725.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,255.34
|
|
|
PR PNEUMOTHORAX THER INTRAPLEURAL INJECTION AIR
|
Professional
|
Both
|
$309.00
|
|
|
Service Code
|
HCPCS 32960
|
| Min. Negotiated Rate |
$57.30 |
| Max. Negotiated Rate |
$1,588.07 |
| Rate for Payer: Aetna Commercial |
$115.13
|
| Rate for Payer: Aetna Medicare |
$89.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.72
|
| Rate for Payer: BCBS Complete |
$60.16
|
| Rate for Payer: BCBS MAPPO |
$85.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,588.07
|
| Rate for Payer: BCN Commercial |
$184.23
|
| Rate for Payer: BCN Medicare Advantage |
$85.92
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cofinity Commercial |
$115.13
|
| Rate for Payer: Cofinity Commercial |
$123.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.22
|
| Rate for Payer: Meridian Medicaid |
$60.16
|
| Rate for Payer: Nomi Health Commercial |
$103.10
|
| Rate for Payer: PACE SWMI |
$85.92
|
| Rate for Payer: PHP Commercial |
$120.29
|
| Rate for Payer: PHP Medicare Advantage |
$85.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$123.75
|
| Rate for Payer: Priority Health Medicare |
$85.92
|
| Rate for Payer: Priority Health Narrow Network |
$123.75
|
| Rate for Payer: Priority Health SBD |
$123.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.92
|
| Rate for Payer: UHC Medicare Advantage |
$85.92
|
| Rate for Payer: UHCCP Medicaid |
$57.30
|
| Rate for Payer: UMR Bronson Commercial |
$142.14
|
|
|
PR PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 55000
|
| Min. Negotiated Rate |
$54.10 |
| Max. Negotiated Rate |
$2,324.52 |
| Rate for Payer: Aetna Commercial |
$107.75
|
| Rate for Payer: Aetna Medicare |
$83.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.79
|
| Rate for Payer: BCBS Complete |
$56.80
|
| Rate for Payer: BCBS MAPPO |
$80.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,324.52
|
| Rate for Payer: BCN Commercial |
$175.44
|
| Rate for Payer: BCN Medicare Advantage |
$80.41
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$115.79
|
| Rate for Payer: Cofinity Commercial |
$107.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.43
|
| Rate for Payer: Meridian Medicaid |
$56.80
|
| Rate for Payer: Nomi Health Commercial |
$96.49
|
| Rate for Payer: PACE SWMI |
$80.41
|
| Rate for Payer: PHP Commercial |
$112.57
|
| Rate for Payer: PHP Medicare Advantage |
$80.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.75
|
| Rate for Payer: Priority Health Medicare |
$80.41
|
| Rate for Payer: Priority Health Narrow Network |
$134.75
|
| Rate for Payer: Priority Health SBD |
$134.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.41
|
| Rate for Payer: UHC Medicare Advantage |
$80.41
|
| Rate for Payer: UHCCP Medicaid |
$54.10
|
| Rate for Payer: UMR Bronson Commercial |
$101.66
|
|
|
PR POLIOVIRUS VACCINE INACTIVATED SUBQ/IM
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 90713
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$43.27 |
| Rate for Payer: Aetna Commercial |
$43.27
|
| Rate for Payer: Aetna Medicare |
$23.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.27
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: BCBS Trust/PPO |
$40.14
|
| Rate for Payer: BCN Commercial |
$40.14
|
| Rate for Payer: Cash Price |
$36.80
|
| 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 POLLICIZATION DIGIT
|
Professional
|
Both
|
$2,768.00
|
|
|
Service Code
|
HCPCS 26550
|
| Min. Negotiated Rate |
$136.83 |
| Max. Negotiated Rate |
$2,534.63 |
| Rate for Payer: Aetna Commercial |
$2,100.16
|
| Rate for Payer: Aetna Medicare |
$1,629.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,100.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,256.88
|
| Rate for Payer: BCBS Complete |
$1,113.78
|
| Rate for Payer: BCBS MAPPO |
$1,567.28
|
| Rate for Payer: BCBS Trust/PPO |
$136.83
|
| Rate for Payer: BCN Commercial |
$2,434.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,567.28
|
| Rate for Payer: Cash Price |
$2,214.40
|
| Rate for Payer: Cash Price |
$2,214.40
|
| Rate for Payer: Cofinity Commercial |
$2,100.16
|
| Rate for Payer: Cofinity Commercial |
$2,256.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,567.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,645.64
|
| Rate for Payer: Meridian Medicaid |
$1,113.78
|
| Rate for Payer: Nomi Health Commercial |
$1,880.74
|
| Rate for Payer: PACE SWMI |
$1,567.28
|
| Rate for Payer: PHP Commercial |
$2,194.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,567.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,060.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,799.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,534.63
|
| Rate for Payer: Priority Health Medicare |
$1,567.28
|
| Rate for Payer: Priority Health Narrow Network |
$2,534.63
|
| Rate for Payer: Priority Health SBD |
$2,534.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,567.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,567.28
|
| Rate for Payer: UHCCP Medicaid |
$1,060.74
|
| Rate for Payer: UMR Bronson Commercial |
$1,273.28
|
|
|
PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND
|
Professional
|
Both
|
$474.00
|
|
|
Service Code
|
HCPCS 95810
|
| Min. Negotiated Rate |
$73.91 |
| Max. Negotiated Rate |
$846.73 |
| Rate for Payer: Aetna Commercial |
$755.12
|
| Rate for Payer: Aetna Commercial |
$755.12
|
| Rate for Payer: Aetna Medicare |
$586.06
|
| Rate for Payer: Aetna Medicare |
$586.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$755.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$755.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$811.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$811.47
|
| Rate for Payer: BCBS Complete |
$77.61
|
| Rate for Payer: BCBS Complete |
$77.61
|
| Rate for Payer: BCBS MAPPO |
$563.52
|
| Rate for Payer: BCBS MAPPO |
$563.52
|
| Rate for Payer: BCBS Trust/PPO |
$634.49
|
| Rate for Payer: BCBS Trust/PPO |
$634.49
|
| Rate for Payer: BCN Commercial |
$712.68
|
| Rate for Payer: BCN Commercial |
$712.68
|
| Rate for Payer: BCN Medicare Advantage |
$563.52
|
| Rate for Payer: BCN Medicare Advantage |
$563.52
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cash Price |
$797.60
|
| Rate for Payer: Cash Price |
$797.60
|
| Rate for Payer: Cofinity Commercial |
$755.12
|
| Rate for Payer: Cofinity Commercial |
$811.47
|
| Rate for Payer: Cofinity Commercial |
$811.47
|
| Rate for Payer: Cofinity Commercial |
$755.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$563.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$563.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.70
|
| Rate for Payer: Meridian Medicaid |
$77.61
|
| Rate for Payer: Meridian Medicaid |
$77.61
|
| Rate for Payer: Nomi Health Commercial |
$676.22
|
| Rate for Payer: Nomi Health Commercial |
$676.22
|
| Rate for Payer: PACE SWMI |
$563.52
|
| Rate for Payer: PACE SWMI |
$563.52
|
| Rate for Payer: PHP Commercial |
$788.93
|
| Rate for Payer: PHP Commercial |
$788.93
|
| Rate for Payer: PHP Medicare Advantage |
$563.52
|
| Rate for Payer: PHP Medicare Advantage |
$563.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$648.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$846.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$846.73
|
| Rate for Payer: Priority Health Medicare |
$563.52
|
| Rate for Payer: Priority Health Medicare |
$563.52
|
| Rate for Payer: Priority Health Narrow Network |
$846.73
|
| Rate for Payer: Priority Health Narrow Network |
$846.73
|
| Rate for Payer: Priority Health SBD |
$156.96
|
| Rate for Payer: Priority Health SBD |
$156.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$563.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$563.52
|
| Rate for Payer: UHC Medicare Advantage |
$563.52
|
| Rate for Payer: UHC Medicare Advantage |
$563.52
|
| Rate for Payer: UHCCP Medicaid |
$73.91
|
| Rate for Payer: UHCCP Medicaid |
$73.91
|
| Rate for Payer: UMR Bronson Commercial |
$458.62
|
| Rate for Payer: UMR Bronson Commercial |
$218.04
|
|
|
PR POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND
|
Professional
|
Both
|
$258.00
|
|
|
Service Code
|
HCPCS 95782
|
| Min. Negotiated Rate |
$76.89 |
| Max. Negotiated Rate |
$1,387.84 |
| Rate for Payer: Aetna Commercial |
$1,165.04
|
| Rate for Payer: Aetna Commercial |
$1,165.04
|
| Rate for Payer: Aetna Medicare |
$904.21
|
| Rate for Payer: Aetna Medicare |
$904.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,165.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,251.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,251.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,165.04
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$869.43
|
| Rate for Payer: BCBS MAPPO |
$869.43
|
| Rate for Payer: BCBS Trust/PPO |
$567.92
|
| Rate for Payer: BCBS Trust/PPO |
$567.92
|
| Rate for Payer: BCN Commercial |
$1,387.84
|
| Rate for Payer: BCN Commercial |
$1,387.84
|
| Rate for Payer: BCN Medicare Advantage |
$869.43
|
| Rate for Payer: BCN Medicare Advantage |
$869.43
|
| Rate for Payer: Cash Price |
$1,388.80
|
| Rate for Payer: Cash Price |
$1,388.80
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cofinity Commercial |
$1,165.04
|
| Rate for Payer: Cofinity Commercial |
$1,251.98
|
| Rate for Payer: Cofinity Commercial |
$1,251.98
|
| Rate for Payer: Cofinity Commercial |
$1,165.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$869.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$869.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$912.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$912.90
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: Nomi Health Commercial |
$1,043.32
|
| Rate for Payer: Nomi Health Commercial |
$1,043.32
|
| Rate for Payer: PACE SWMI |
$869.43
|
| Rate for Payer: PACE SWMI |
$869.43
|
| Rate for Payer: PHP Commercial |
$1,217.20
|
| Rate for Payer: PHP Commercial |
$1,217.20
|
| Rate for Payer: PHP Medicare Advantage |
$869.43
|
| Rate for Payer: PHP Medicare Advantage |
$869.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,128.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,328.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,328.90
|
| Rate for Payer: Priority Health Medicare |
$869.43
|
| Rate for Payer: Priority Health Medicare |
$869.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,328.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,328.90
|
| Rate for Payer: Priority Health SBD |
$164.18
|
| Rate for Payer: Priority Health SBD |
$164.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$869.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$869.43
|
| Rate for Payer: UHC Medicare Advantage |
$869.43
|
| Rate for Payer: UHC Medicare Advantage |
$869.43
|
| Rate for Payer: UHCCP Medicaid |
$76.89
|
| Rate for Payer: UHCCP Medicaid |
$76.89
|
| Rate for Payer: UMR Bronson Commercial |
$798.56
|
| Rate for Payer: UMR Bronson Commercial |
$118.68
|
|
|
PR POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND
|
Professional
|
Both
|
$502.00
|
|
|
Service Code
|
HCPCS 95811
|
| Min. Negotiated Rate |
$77.11 |
| Max. Negotiated Rate |
$1,013.28 |
| Rate for Payer: Aetna Commercial |
$790.87
|
| Rate for Payer: Aetna Commercial |
$790.87
|
| Rate for Payer: Aetna Medicare |
$613.81
|
| Rate for Payer: Aetna Medicare |
$613.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$790.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$849.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$849.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$790.87
|
| Rate for Payer: BCBS Complete |
$80.97
|
| Rate for Payer: BCBS Complete |
$80.97
|
| Rate for Payer: BCBS MAPPO |
$590.20
|
| Rate for Payer: BCBS MAPPO |
$590.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,013.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,013.28
|
| Rate for Payer: BCN Commercial |
$745.67
|
| Rate for Payer: BCN Commercial |
$745.67
|
| Rate for Payer: BCN Medicare Advantage |
$590.20
|
| Rate for Payer: BCN Medicare Advantage |
$590.20
|
| Rate for Payer: Cash Price |
$996.80
|
| Rate for Payer: Cash Price |
$996.80
|
| Rate for Payer: Cash Price |
$401.60
|
| Rate for Payer: Cash Price |
$401.60
|
| Rate for Payer: Cofinity Commercial |
$790.87
|
| Rate for Payer: Cofinity Commercial |
$849.89
|
| Rate for Payer: Cofinity Commercial |
$849.89
|
| Rate for Payer: Cofinity Commercial |
$790.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$590.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$590.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.71
|
| Rate for Payer: Meridian Medicaid |
$80.97
|
| Rate for Payer: Meridian Medicaid |
$80.97
|
| Rate for Payer: Nomi Health Commercial |
$708.24
|
| Rate for Payer: Nomi Health Commercial |
$708.24
|
| Rate for Payer: PACE SWMI |
$590.20
|
| Rate for Payer: PACE SWMI |
$590.20
|
| Rate for Payer: PHP Commercial |
$826.28
|
| Rate for Payer: PHP Commercial |
$826.28
|
| Rate for Payer: PHP Medicare Advantage |
$590.20
|
| Rate for Payer: PHP Medicare Advantage |
$590.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$809.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$885.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$885.18
|
| Rate for Payer: Priority Health Medicare |
$590.20
|
| Rate for Payer: Priority Health Medicare |
$590.20
|
| Rate for Payer: Priority Health Narrow Network |
$885.18
|
| Rate for Payer: Priority Health Narrow Network |
$885.18
|
| Rate for Payer: Priority Health SBD |
$163.29
|
| Rate for Payer: Priority Health SBD |
$163.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$590.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$590.20
|
| Rate for Payer: UHC Medicare Advantage |
$590.20
|
| Rate for Payer: UHC Medicare Advantage |
$590.20
|
| Rate for Payer: UHCCP Medicaid |
$77.11
|
| Rate for Payer: UHCCP Medicaid |
$77.11
|
| Rate for Payer: UMR Bronson Commercial |
$573.16
|
| Rate for Payer: UMR Bronson Commercial |
$230.92
|
|
