|
PR PRTL THYROID LOBEC UNI W/CONTRATLAT STOT LOBEC
|
Professional
|
Both
|
$1,831.00
|
|
|
Service Code
|
HCPCS 60212
|
| Min. Negotiated Rate |
$732.40 |
| Max. Negotiated Rate |
$1,435.84 |
| Rate for Payer: Aetna Commercial |
$1,336.13
|
| Rate for Payer: Aetna Medicare |
$1,036.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,435.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,336.13
|
| Rate for Payer: BCBS Complete |
$732.40
|
| Rate for Payer: BCBS MAPPO |
$997.11
|
| Rate for Payer: BCN Medicare Advantage |
$997.11
|
| Rate for Payer: Cash Price |
$1,464.80
|
| Rate for Payer: Cash Price |
$1,464.80
|
| Rate for Payer: Cofinity Commercial |
$1,435.84
|
| Rate for Payer: Cofinity Commercial |
$1,336.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$997.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,046.97
|
| Rate for Payer: Nomi Health Commercial |
$1,196.53
|
| Rate for Payer: PACE SWMI |
$997.11
|
| Rate for Payer: PHP Commercial |
$1,395.95
|
| Rate for Payer: PHP Medicare Advantage |
$997.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.15
|
| Rate for Payer: Priority Health Medicare |
$997.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$997.11
|
| Rate for Payer: UHC Medicare Advantage |
$997.11
|
| Rate for Payer: UMR Bronson Commercial |
$842.26
|
|
|
PR PSA SCREENING
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS G0103
|
| Min. Negotiated Rate |
$19.31 |
| Max. Negotiated Rate |
$39.65 |
| Rate for Payer: Aetna Commercial |
$25.88
|
| Rate for Payer: Aetna Medicare |
$20.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.88
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: BCBS MAPPO |
$19.31
|
| Rate for Payer: BCN Medicare Advantage |
$19.31
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$27.81
|
| Rate for Payer: Cofinity Commercial |
$25.88
|
| 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: Nomi Health Commercial |
$23.17
|
| 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 |
$39.65
|
| Rate for Payer: Priority Health Medicare |
$19.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.31
|
| Rate for Payer: UHC Medicare Advantage |
$19.31
|
| Rate for Payer: UMR Bronson Commercial |
$28.06
|
|
|
PR PSYCHIATRIC DIAGNOSTIC EVALUATION
|
Professional
|
Both
|
$265.00
|
|
|
Service Code
|
HCPCS 90791
|
| Min. Negotiated Rate |
$106.00 |
| Max. Negotiated Rate |
$204.70 |
| Rate for Payer: Aetna Commercial |
$190.48
|
| Rate for Payer: Aetna Medicare |
$147.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.48
|
| Rate for Payer: BCBS Complete |
$106.00
|
| Rate for Payer: BCBS MAPPO |
$142.15
|
| Rate for Payer: BCN Medicare Advantage |
$142.15
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cofinity Commercial |
$204.70
|
| Rate for Payer: Cofinity Commercial |
$190.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.26
|
| Rate for Payer: Nomi Health Commercial |
$170.58
|
| Rate for Payer: PACE SWMI |
$142.15
|
| Rate for Payer: PHP Commercial |
$199.01
|
| Rate for Payer: PHP Medicare Advantage |
$142.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.25
|
| Rate for Payer: Priority Health Medicare |
$142.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.15
|
| Rate for Payer: UHC Medicare Advantage |
$142.15
|
| Rate for Payer: UMR Bronson Commercial |
$121.90
|
|
|
PR PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES
|
Professional
|
Both
|
$264.00
|
|
|
Service Code
|
HCPCS 90792
|
| Min. Negotiated Rate |
$105.60 |
| Max. Negotiated Rate |
$233.91 |
| Rate for Payer: Aetna Commercial |
$217.67
|
| Rate for Payer: Aetna Medicare |
$168.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.67
|
| Rate for Payer: BCBS Complete |
$105.60
|
| Rate for Payer: BCBS MAPPO |
$162.44
|
| Rate for Payer: BCN Medicare Advantage |
$162.44
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cofinity Commercial |
$233.91
|
| Rate for Payer: Cofinity Commercial |
$217.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.56
|
| Rate for Payer: Nomi Health Commercial |
$194.93
|
| Rate for Payer: PACE SWMI |
$162.44
|
| Rate for Payer: PHP Commercial |
$227.42
|
| Rate for Payer: PHP Medicare Advantage |
$162.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.60
|
| Rate for Payer: Priority Health Medicare |
$162.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.44
|
| Rate for Payer: UHC Medicare Advantage |
$162.44
|
| Rate for Payer: UMR Bronson Commercial |
$121.44
|
|
|
PR PSYCHOANALYSIS
|
Professional
|
Both
|
$201.00
|
|
|
Service Code
|
HCPCS 90845
|
| Min. Negotiated Rate |
$80.40 |
| Max. Negotiated Rate |
$130.65 |
| Rate for Payer: Aetna Commercial |
$116.16
|
| Rate for Payer: Aetna Medicare |
$90.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.16
|
| Rate for Payer: BCBS Complete |
$80.40
|
| Rate for Payer: BCBS MAPPO |
$86.69
|
| Rate for Payer: BCN Medicare Advantage |
$86.69
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cofinity Commercial |
$124.83
|
| Rate for Payer: Cofinity Commercial |
$116.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.02
|
| Rate for Payer: Nomi Health Commercial |
$104.03
|
| Rate for Payer: PACE SWMI |
$86.69
|
| Rate for Payer: PHP Commercial |
$121.37
|
| Rate for Payer: PHP Medicare Advantage |
$86.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health Medicare |
$86.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.69
|
| Rate for Payer: UHC Medicare Advantage |
$86.69
|
| Rate for Payer: UMR Bronson Commercial |
$92.46
|
|
|
PR PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR
|
Professional
|
Both
|
$182.00
|
|
|
Service Code
|
HCPCS 96131
|
| Min. Negotiated Rate |
$71.99 |
| Max. Negotiated Rate |
$118.30 |
| Rate for Payer: Aetna Commercial |
$96.47
|
| Rate for Payer: Aetna Medicare |
$74.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.67
|
| Rate for Payer: BCBS Complete |
$72.80
|
| Rate for Payer: BCBS MAPPO |
$71.99
|
| Rate for Payer: BCN Medicare Advantage |
$71.99
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cofinity Commercial |
$96.47
|
| Rate for Payer: Cofinity Commercial |
$103.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.59
|
| Rate for Payer: Nomi Health Commercial |
$86.39
|
| Rate for Payer: PACE SWMI |
$71.99
|
| Rate for Payer: PHP Commercial |
$100.79
|
| Rate for Payer: PHP Medicare Advantage |
$71.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.30
|
| Rate for Payer: Priority Health Medicare |
$71.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.99
|
| Rate for Payer: UHC Medicare Advantage |
$71.99
|
| Rate for Payer: UMR Bronson Commercial |
$83.72
|
|
|
PR PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR
|
Professional
|
Both
|
$239.00
|
|
|
Service Code
|
HCPCS 96130
|
| Min. Negotiated Rate |
$95.60 |
| Max. Negotiated Rate |
$155.35 |
| Rate for Payer: Aetna Commercial |
$140.87
|
| Rate for Payer: Aetna Medicare |
$109.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.87
|
| Rate for Payer: BCBS Complete |
$95.60
|
| Rate for Payer: BCBS MAPPO |
$105.13
|
| Rate for Payer: BCN Medicare Advantage |
$105.13
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cofinity Commercial |
$151.39
|
| Rate for Payer: Cofinity Commercial |
$140.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.39
|
| Rate for Payer: Nomi Health Commercial |
$126.16
|
| Rate for Payer: PACE SWMI |
$105.13
|
| Rate for Payer: PHP Commercial |
$147.18
|
| Rate for Payer: PHP Medicare Advantage |
$105.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.35
|
| Rate for Payer: Priority Health Medicare |
$105.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.13
|
| Rate for Payer: UHC Medicare Advantage |
$105.13
|
| Rate for Payer: UMR Bronson Commercial |
$109.94
|
|
|
PR PSYCHOLOGIC TESTING ADMIN BY COMPUTER
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 96103
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$35.75 |
| Rate for Payer: Aetna Medicare |
$27.50
|
| Rate for Payer: BCBS Complete |
$22.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.75
|
| Rate for Payer: UMR Bronson Commercial |
$25.30
|
|
|
PR PSYCHOLOGIC TESTING BY PSYCH/PHYS
|
Professional
|
Both
|
$149.00
|
|
|
Service Code
|
HCPCS 96101
|
| 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 PSYCHOTHERAPY COMPLEX INTERACTIVE
|
Professional
|
Both
|
$144.00
|
|
|
Service Code
|
HCPCS 90785
|
| Min. Negotiated Rate |
$12.23 |
| Max. Negotiated Rate |
$93.60 |
| Rate for Payer: Aetna Commercial |
$16.39
|
| Rate for Payer: Aetna Medicare |
$12.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.39
|
| Rate for Payer: BCBS Complete |
$57.60
|
| Rate for Payer: BCBS MAPPO |
$12.23
|
| Rate for Payer: BCN Medicare Advantage |
$12.23
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cofinity Commercial |
$17.61
|
| Rate for Payer: Cofinity Commercial |
$16.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.84
|
| Rate for Payer: Nomi Health Commercial |
$14.68
|
| Rate for Payer: PACE SWMI |
$12.23
|
| Rate for Payer: PHP Commercial |
$17.12
|
| Rate for Payer: PHP Medicare Advantage |
$12.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.60
|
| Rate for Payer: Priority Health Medicare |
$12.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.23
|
| Rate for Payer: UHC Medicare Advantage |
$12.23
|
| Rate for Payer: UMR Bronson Commercial |
$66.24
|
|
|
PR PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES
|
Professional
|
Both
|
$118.00
|
|
|
Service Code
|
HCPCS 90840
|
| Min. Negotiated Rate |
$47.20 |
| Max. Negotiated Rate |
$92.40 |
| Rate for Payer: Aetna Commercial |
$85.99
|
| Rate for Payer: Aetna Medicare |
$66.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.99
|
| Rate for Payer: BCBS Complete |
$47.20
|
| Rate for Payer: BCBS MAPPO |
$64.17
|
| Rate for Payer: BCN Medicare Advantage |
$64.17
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cofinity Commercial |
$92.40
|
| Rate for Payer: Cofinity Commercial |
$85.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.38
|
| Rate for Payer: Nomi Health Commercial |
$77.00
|
| Rate for Payer: PACE SWMI |
$64.17
|
| Rate for Payer: PHP Commercial |
$89.84
|
| Rate for Payer: PHP Medicare Advantage |
$64.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.70
|
| Rate for Payer: Priority Health Medicare |
$64.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.17
|
| Rate for Payer: UHC Medicare Advantage |
$64.17
|
| Rate for Payer: UMR Bronson Commercial |
$54.28
|
|
|
PR PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES
|
Professional
|
Both
|
$230.00
|
|
|
Service Code
|
HCPCS 90839
|
| Min. Negotiated Rate |
$92.00 |
| Max. Negotiated Rate |
$186.45 |
| Rate for Payer: Aetna Commercial |
$173.50
|
| Rate for Payer: Aetna Medicare |
$134.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.50
|
| Rate for Payer: BCBS Complete |
$92.00
|
| Rate for Payer: BCBS MAPPO |
$129.48
|
| Rate for Payer: BCN Medicare Advantage |
$129.48
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Cofinity Commercial |
$186.45
|
| Rate for Payer: Cofinity Commercial |
$173.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.95
|
| Rate for Payer: Nomi Health Commercial |
$155.38
|
| Rate for Payer: PACE SWMI |
$129.48
|
| Rate for Payer: PHP Commercial |
$181.27
|
| Rate for Payer: PHP Medicare Advantage |
$129.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.50
|
| Rate for Payer: Priority Health Medicare |
$129.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.48
|
| Rate for Payer: UHC Medicare Advantage |
$129.48
|
| Rate for Payer: UMR Bronson Commercial |
$105.80
|
|
|
PR PSYCHOTHERAPY W/PATIENT 30 MINUTES
|
Professional
|
Both
|
$111.00
|
|
|
Service Code
|
HCPCS 90832
|
| Min. Negotiated Rate |
$44.40 |
| Max. Negotiated Rate |
$98.58 |
| Rate for Payer: Aetna Commercial |
$91.74
|
| Rate for Payer: Aetna Medicare |
$71.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.74
|
| Rate for Payer: BCBS Complete |
$44.40
|
| Rate for Payer: BCBS MAPPO |
$68.46
|
| Rate for Payer: BCN Medicare Advantage |
$68.46
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cofinity Commercial |
$98.58
|
| Rate for Payer: Cofinity Commercial |
$91.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.88
|
| Rate for Payer: Nomi Health Commercial |
$82.15
|
| Rate for Payer: PACE SWMI |
$68.46
|
| Rate for Payer: PHP Commercial |
$95.84
|
| Rate for Payer: PHP Medicare Advantage |
$68.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.15
|
| Rate for Payer: Priority Health Medicare |
$68.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.46
|
| Rate for Payer: UHC Medicare Advantage |
$68.46
|
| Rate for Payer: UMR Bronson Commercial |
$51.06
|
|
|
PR PSYCHOTHERAPY W/PATIENT 45 MINUTES
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 90834
|
| Min. Negotiated Rate |
$68.00 |
| Max. Negotiated Rate |
$130.00 |
| Rate for Payer: Aetna Commercial |
$120.98
|
| Rate for Payer: Aetna Medicare |
$93.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.98
|
| Rate for Payer: BCBS Complete |
$68.00
|
| Rate for Payer: BCBS MAPPO |
$90.28
|
| Rate for Payer: BCN Medicare Advantage |
$90.28
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cofinity Commercial |
$130.00
|
| Rate for Payer: Cofinity Commercial |
$120.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.79
|
| Rate for Payer: Nomi Health Commercial |
$108.34
|
| Rate for Payer: PACE SWMI |
$90.28
|
| Rate for Payer: PHP Commercial |
$126.39
|
| Rate for Payer: PHP Medicare Advantage |
$90.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.50
|
| Rate for Payer: Priority Health Medicare |
$90.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.28
|
| Rate for Payer: UHC Medicare Advantage |
$90.28
|
| Rate for Payer: UMR Bronson Commercial |
$78.20
|
|
|
PR PSYCHOTHERAPY W/PATIENT 60 MINUTES
|
Professional
|
Both
|
$238.00
|
|
|
Service Code
|
HCPCS 90837
|
| Min. Negotiated Rate |
$95.20 |
| Max. Negotiated Rate |
$192.54 |
| Rate for Payer: Aetna Commercial |
$179.17
|
| Rate for Payer: Aetna Medicare |
$139.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.17
|
| Rate for Payer: BCBS Complete |
$95.20
|
| Rate for Payer: BCBS MAPPO |
$133.71
|
| Rate for Payer: BCN Medicare Advantage |
$133.71
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cofinity Commercial |
$192.54
|
| Rate for Payer: Cofinity Commercial |
$179.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.40
|
| Rate for Payer: Nomi Health Commercial |
$160.45
|
| Rate for Payer: PACE SWMI |
$133.71
|
| Rate for Payer: PHP Commercial |
$187.19
|
| Rate for Payer: PHP Medicare Advantage |
$133.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.70
|
| Rate for Payer: Priority Health Medicare |
$133.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.71
|
| Rate for Payer: UHC Medicare Advantage |
$133.71
|
| Rate for Payer: UMR Bronson Commercial |
$109.48
|
|
|
PR PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 30 MIN
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 90833
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$92.95 |
| Rate for Payer: Aetna Commercial |
$85.59
|
| Rate for Payer: Aetna Medicare |
$66.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.59
|
| Rate for Payer: BCBS Complete |
$57.20
|
| Rate for Payer: BCBS MAPPO |
$63.87
|
| Rate for Payer: BCN Medicare Advantage |
$63.87
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cofinity Commercial |
$91.97
|
| Rate for Payer: Cofinity Commercial |
$85.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.06
|
| Rate for Payer: Nomi Health Commercial |
$76.64
|
| Rate for Payer: PACE SWMI |
$63.87
|
| Rate for Payer: PHP Commercial |
$89.42
|
| Rate for Payer: PHP Medicare Advantage |
$63.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
| Rate for Payer: Priority Health Medicare |
$63.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.87
|
| Rate for Payer: UHC Medicare Advantage |
$63.87
|
| Rate for Payer: UMR Bronson Commercial |
$65.78
|
|
|
PR PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 45 MIN
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 90836
|
| Min. Negotiated Rate |
$68.80 |
| Max. Negotiated Rate |
$116.96 |
| Rate for Payer: Aetna Commercial |
$108.83
|
| Rate for Payer: Aetna Medicare |
$84.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.83
|
| Rate for Payer: BCBS Complete |
$68.80
|
| Rate for Payer: BCBS MAPPO |
$81.22
|
| Rate for Payer: BCN Medicare Advantage |
$81.22
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cofinity Commercial |
$116.96
|
| Rate for Payer: Cofinity Commercial |
$108.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.28
|
| Rate for Payer: Nomi Health Commercial |
$97.46
|
| Rate for Payer: PACE SWMI |
$81.22
|
| Rate for Payer: PHP Commercial |
$113.71
|
| Rate for Payer: PHP Medicare Advantage |
$81.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.80
|
| Rate for Payer: Priority Health Medicare |
$81.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.22
|
| Rate for Payer: UHC Medicare Advantage |
$81.22
|
| Rate for Payer: UMR Bronson Commercial |
$79.12
|
|
|
PR PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 60 MIN
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 90838
|
| Min. Negotiated Rate |
$94.80 |
| Max. Negotiated Rate |
$156.37 |
| Rate for Payer: Aetna Commercial |
$145.51
|
| Rate for Payer: Aetna Medicare |
$112.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.51
|
| Rate for Payer: BCBS Complete |
$94.80
|
| Rate for Payer: BCBS MAPPO |
$108.59
|
| Rate for Payer: BCN Medicare Advantage |
$108.59
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cofinity Commercial |
$156.37
|
| Rate for Payer: Cofinity Commercial |
$145.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.02
|
| Rate for Payer: Nomi Health Commercial |
$130.31
|
| Rate for Payer: PACE SWMI |
$108.59
|
| Rate for Payer: PHP Commercial |
$152.03
|
| Rate for Payer: PHP Medicare Advantage |
$108.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.05
|
| Rate for Payer: Priority Health Medicare |
$108.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.59
|
| Rate for Payer: UHC Medicare Advantage |
$108.59
|
| Rate for Payer: UMR Bronson Commercial |
$109.02
|
|
|
PR PSYCL/NRPSYCL TST ELEC PLATFORM AUTO RESULT
|
Professional
|
Both
|
$4.00
|
|
|
Service Code
|
HCPCS 96146
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$3.10 |
| Rate for Payer: Aetna Commercial |
$2.88
|
| Rate for Payer: Aetna Medicare |
$2.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.88
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: BCBS MAPPO |
$2.15
|
| Rate for Payer: BCN Medicare Advantage |
$2.15
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cofinity Commercial |
$3.10
|
| Rate for Payer: Cofinity Commercial |
$2.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.26
|
| Rate for Payer: Nomi Health Commercial |
$2.58
|
| Rate for Payer: PACE SWMI |
$2.15
|
| Rate for Payer: PHP Commercial |
$3.01
|
| Rate for Payer: PHP Medicare Advantage |
$2.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.60
|
| Rate for Payer: Priority Health Medicare |
$2.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.15
|
| Rate for Payer: UHC Medicare Advantage |
$2.15
|
| Rate for Payer: UMR Bronson Commercial |
$1.84
|
|
|
PR PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN
|
Professional
|
Both
|
$86.00
|
|
|
Service Code
|
HCPCS 96137
|
| Min. Negotiated Rate |
$17.03 |
| Max. Negotiated Rate |
$55.90 |
| Rate for Payer: Aetna Commercial |
$22.82
|
| Rate for Payer: Aetna Medicare |
$17.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.82
|
| Rate for Payer: BCBS Complete |
$34.40
|
| Rate for Payer: BCBS MAPPO |
$17.03
|
| Rate for Payer: BCN Medicare Advantage |
$17.03
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cofinity Commercial |
$24.52
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.88
|
| Rate for Payer: Nomi Health Commercial |
$20.44
|
| Rate for Payer: PACE SWMI |
$17.03
|
| Rate for Payer: PHP Commercial |
$23.84
|
| Rate for Payer: PHP Medicare Advantage |
$17.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.90
|
| Rate for Payer: Priority Health Medicare |
$17.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.03
|
| Rate for Payer: UHC Medicare Advantage |
$17.03
|
| Rate for Payer: UMR Bronson Commercial |
$39.56
|
|
|
PR PSYCL/NRPSYCL TST TECH 2+ TST 1ST 30 MIN
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 96138
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$47.45 |
| Rate for Payer: Aetna Commercial |
$41.18
|
| Rate for Payer: Aetna Medicare |
$31.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.18
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS MAPPO |
$30.73
|
| Rate for Payer: BCN Medicare Advantage |
$30.73
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cofinity Commercial |
$44.25
|
| Rate for Payer: Cofinity Commercial |
$41.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.27
|
| Rate for Payer: Nomi Health Commercial |
$36.88
|
| Rate for Payer: PACE SWMI |
$30.73
|
| Rate for Payer: PHP Commercial |
$43.02
|
| Rate for Payer: PHP Medicare Advantage |
$30.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.45
|
| Rate for Payer: Priority Health Medicare |
$30.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.73
|
| Rate for Payer: UHC Medicare Advantage |
$30.73
|
| Rate for Payer: UMR Bronson Commercial |
$33.58
|
|
|
PR PSYCL/NRPSYCL TST TECH 2+ TST EA ADDL 30 MIN
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 96139
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$47.45 |
| Rate for Payer: Aetna Commercial |
$41.18
|
| Rate for Payer: Aetna Medicare |
$31.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.18
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS MAPPO |
$30.73
|
| Rate for Payer: BCN Medicare Advantage |
$30.73
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cofinity Commercial |
$44.25
|
| Rate for Payer: Cofinity Commercial |
$41.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.27
|
| Rate for Payer: Nomi Health Commercial |
$36.88
|
| Rate for Payer: PACE SWMI |
$30.73
|
| Rate for Payer: PHP Commercial |
$43.02
|
| Rate for Payer: PHP Medicare Advantage |
$30.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.45
|
| Rate for Payer: Priority Health Medicare |
$30.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.73
|
| Rate for Payer: UHC Medicare Advantage |
$30.73
|
| Rate for Payer: UMR Bronson Commercial |
$33.58
|
|
|
PR PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
HCPCS 96136
|
| Min. Negotiated Rate |
$22.46 |
| Max. Negotiated Rate |
$61.10 |
| Rate for Payer: Aetna Commercial |
$30.10
|
| Rate for Payer: Aetna Medicare |
$23.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.10
|
| Rate for Payer: BCBS Complete |
$37.60
|
| Rate for Payer: BCBS MAPPO |
$22.46
|
| Rate for Payer: BCN Medicare Advantage |
$22.46
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cofinity Commercial |
$32.34
|
| Rate for Payer: Cofinity Commercial |
$30.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.58
|
| Rate for Payer: Nomi Health Commercial |
$26.95
|
| Rate for Payer: PACE SWMI |
$22.46
|
| Rate for Payer: PHP Commercial |
$31.44
|
| Rate for Payer: PHP Medicare Advantage |
$22.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.10
|
| Rate for Payer: Priority Health Medicare |
$22.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.46
|
| Rate for Payer: UHC Medicare Advantage |
$22.46
|
| Rate for Payer: UMR Bronson Commercial |
$43.24
|
|
|
PR PTERYGOMAXILLARY FOSSA SURGERY ANY APPROACH
|
Professional
|
Both
|
$2,219.00
|
|
|
Service Code
|
HCPCS 31040
|
| Min. Negotiated Rate |
$752.78 |
| Max. Negotiated Rate |
$1,442.35 |
| Rate for Payer: Aetna Commercial |
$1,008.73
|
| Rate for Payer: Aetna Medicare |
$782.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,084.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,008.73
|
| Rate for Payer: BCBS Complete |
$887.60
|
| Rate for Payer: BCBS MAPPO |
$752.78
|
| Rate for Payer: BCN Medicare Advantage |
$752.78
|
| Rate for Payer: Cash Price |
$1,775.20
|
| Rate for Payer: Cash Price |
$1,775.20
|
| Rate for Payer: Cofinity Commercial |
$1,084.00
|
| Rate for Payer: Cofinity Commercial |
$1,008.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$752.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$790.42
|
| Rate for Payer: Nomi Health Commercial |
$903.34
|
| Rate for Payer: PACE SWMI |
$752.78
|
| Rate for Payer: PHP Commercial |
$1,053.89
|
| Rate for Payer: PHP Medicare Advantage |
$752.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,442.35
|
| Rate for Payer: Priority Health Medicare |
$752.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$752.78
|
| Rate for Payer: UHC Medicare Advantage |
$752.78
|
| Rate for Payer: UMR Bronson Commercial |
$1,020.74
|
|
|
PR PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 96160
|
| Min. Negotiated Rate |
$2.65 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Commercial |
$3.55
|
| Rate for Payer: Aetna Medicare |
$2.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.55
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS MAPPO |
$2.65
|
| Rate for Payer: BCN Medicare Advantage |
$2.65
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$3.82
|
| Rate for Payer: Cofinity Commercial |
$3.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.78
|
| Rate for Payer: Nomi Health Commercial |
$3.18
|
| Rate for Payer: PACE SWMI |
$2.65
|
| Rate for Payer: PHP Commercial |
$3.71
|
| Rate for Payer: PHP Medicare Advantage |
$2.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health Medicare |
$2.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.65
|
| Rate for Payer: UHC Medicare Advantage |
$2.65
|
| Rate for Payer: UMR Bronson Commercial |
$23.46
|
|
