|
PR PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 30 MIN
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 90833
|
| Min. Negotiated Rate |
$36.72 |
| Max. Negotiated Rate |
$300.07 |
| Rate for Payer: Aetna Commercial |
$85.59
|
| Rate for Payer: Aetna Medicare |
$66.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.97
|
| Rate for Payer: BCBS Complete |
$44.51
|
| Rate for Payer: BCBS MAPPO |
$63.87
|
| Rate for Payer: BCBS Trust/PPO |
$300.07
|
| Rate for Payer: BCN Commercial |
$36.72
|
| 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 |
$85.59
|
| Rate for Payer: Cofinity Commercial |
$91.97
|
| 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: Meridian Medicaid |
$44.51
|
| 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 Choice Medicaid |
$42.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.27
|
| Rate for Payer: Priority Health Medicare |
$63.87
|
| Rate for Payer: Priority Health Narrow Network |
$56.27
|
| Rate for Payer: Priority Health SBD |
$56.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.87
|
| Rate for Payer: UHC Medicare Advantage |
$63.87
|
| Rate for Payer: UHCCP Medicaid |
$42.39
|
| 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 |
$46.57 |
| Max. Negotiated Rate |
$318.04 |
| Rate for Payer: Aetna Commercial |
$108.83
|
| Rate for Payer: Aetna Medicare |
$84.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.96
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCBS MAPPO |
$81.22
|
| Rate for Payer: BCBS Trust/PPO |
$318.04
|
| Rate for Payer: BCN Commercial |
$46.57
|
| 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 |
$108.83
|
| Rate for Payer: Cofinity Commercial |
$116.96
|
| 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: Meridian Medicaid |
$56.58
|
| 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 Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.08
|
| Rate for Payer: Priority Health Medicare |
$81.22
|
| Rate for Payer: Priority Health Narrow Network |
$92.08
|
| Rate for Payer: Priority Health SBD |
$92.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.22
|
| Rate for Payer: UHC Medicare Advantage |
$81.22
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
| 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 |
$61.62 |
| 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) |
$145.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.37
|
| Rate for Payer: BCBS Complete |
$75.59
|
| Rate for Payer: BCBS MAPPO |
$108.59
|
| Rate for Payer: BCBS Trust/PPO |
$128.38
|
| Rate for Payer: BCN Commercial |
$61.62
|
| 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 |
$145.51
|
| Rate for Payer: Cofinity Commercial |
$156.37
|
| 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: Meridian Medicaid |
$75.59
|
| 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 Choice Medicaid |
$71.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$147.89
|
| Rate for Payer: Priority Health Medicare |
$108.59
|
| Rate for Payer: Priority Health Narrow Network |
$147.89
|
| Rate for Payer: Priority Health SBD |
$147.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.59
|
| Rate for Payer: UHC Medicare Advantage |
$108.59
|
| Rate for Payer: UHCCP Medicaid |
$71.99
|
| 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 |
$303.77 |
| Rate for Payer: Aetna Commercial |
$2.88
|
| Rate for Payer: Aetna Medicare |
$2.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.10
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: BCBS MAPPO |
$2.15
|
| Rate for Payer: BCBS Trust/PPO |
$303.77
|
| Rate for Payer: BCN Commercial |
$3.42
|
| 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 HMO/PPO/Tiered Network |
$3.17
|
| Rate for Payer: Priority Health Medicare |
$2.15
|
| Rate for Payer: Priority Health Narrow Network |
$3.17
|
| Rate for Payer: Priority Health SBD |
$3.17
|
| 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 |
$11.29 |
| Max. Negotiated Rate |
$308.53 |
| 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 |
$11.85
|
| Rate for Payer: BCBS MAPPO |
$17.03
|
| Rate for Payer: BCBS Trust/PPO |
$308.53
|
| Rate for Payer: BCN Commercial |
$56.68
|
| 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: Meridian Medicaid |
$11.85
|
| 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 Choice Medicaid |
$11.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.97
|
| Rate for Payer: Priority Health Medicare |
$17.03
|
| Rate for Payer: Priority Health Narrow Network |
$23.97
|
| Rate for Payer: Priority Health SBD |
$23.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.03
|
| Rate for Payer: UHC Medicare Advantage |
$17.03
|
| Rate for Payer: UHCCP Medicaid |
$11.29
|
| 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 |
$313.81 |
| Rate for Payer: Aetna Commercial |
$41.18
|
| Rate for Payer: Aetna Medicare |
$31.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.25
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS MAPPO |
$30.73
|
| Rate for Payer: BCBS Trust/PPO |
$313.81
|
| Rate for Payer: BCN Commercial |
$49.36
|
| 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 |
$41.18
|
| Rate for Payer: Cofinity Commercial |
$44.25
|
| 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 HMO/PPO/Tiered Network |
$46.59
|
| Rate for Payer: Priority Health Medicare |
$30.73
|
| Rate for Payer: Priority Health Narrow Network |
$46.59
|
| Rate for Payer: Priority Health SBD |
$46.59
|
| 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 |
$342.87 |
| Rate for Payer: Aetna Commercial |
$41.18
|
| Rate for Payer: Aetna Medicare |
$31.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.25
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS MAPPO |
$30.73
|
| Rate for Payer: BCBS Trust/PPO |
$342.87
|
| Rate for Payer: BCN Commercial |
$50.82
|
| 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 HMO/PPO/Tiered Network |
$47.94
|
| Rate for Payer: Priority Health Medicare |
$30.73
|
| Rate for Payer: Priority Health Narrow Network |
$47.94
|
| Rate for Payer: Priority Health SBD |
$47.94
|
| 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 |
$14.91 |
| Max. Negotiated Rate |
$227.17 |
| Rate for Payer: Aetna Commercial |
$30.10
|
| Rate for Payer: Aetna Medicare |
$23.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.34
|
| Rate for Payer: BCBS Complete |
$15.66
|
| Rate for Payer: BCBS MAPPO |
$22.46
|
| Rate for Payer: BCBS Trust/PPO |
$227.17
|
| Rate for Payer: BCN Commercial |
$61.58
|
| 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 |
$30.10
|
| Rate for Payer: Cofinity Commercial |
$32.34
|
| 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: Meridian Medicaid |
$15.66
|
| 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 Choice Medicaid |
$14.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.21
|
| Rate for Payer: Priority Health Medicare |
$22.46
|
| Rate for Payer: Priority Health Narrow Network |
$31.21
|
| Rate for Payer: Priority Health SBD |
$31.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.46
|
| Rate for Payer: UHC Medicare Advantage |
$22.46
|
| Rate for Payer: UHCCP Medicaid |
$14.91
|
| 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 |
$514.61 |
| 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) |
$1,008.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,084.00
|
| Rate for Payer: BCBS Complete |
$540.34
|
| Rate for Payer: BCBS MAPPO |
$752.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,147.47
|
| Rate for Payer: BCN Commercial |
$1,190.91
|
| 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 |
$1,008.73
|
| Rate for Payer: Cofinity Commercial |
$1,084.00
|
| 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: Meridian Medicaid |
$540.34
|
| 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 Choice Medicaid |
$514.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,442.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,128.54
|
| Rate for Payer: Priority Health Medicare |
$752.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,128.54
|
| Rate for Payer: Priority Health SBD |
$1,128.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$752.78
|
| Rate for Payer: UHC Medicare Advantage |
$752.78
|
| Rate for Payer: UHCCP Medicaid |
$514.61
|
| 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 |
$124.15 |
| Rate for Payer: Aetna Commercial |
$3.55
|
| Rate for Payer: Aetna Medicare |
$2.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.82
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS MAPPO |
$2.65
|
| Rate for Payer: BCBS Trust/PPO |
$124.15
|
| Rate for Payer: BCN Commercial |
$3.91
|
| 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 HMO/PPO/Tiered Network |
$5.43
|
| Rate for Payer: Priority Health Medicare |
$2.65
|
| Rate for Payer: Priority Health Narrow Network |
$5.43
|
| Rate for Payer: Priority Health SBD |
$5.43
|
| 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
|
|
|
PR PULMONARY ARTERY EMBOLECTOMY W/CARD BYPASS
|
Professional
|
Both
|
$5,574.00
|
|
|
Service Code
|
HCPCS 33910
|
| Min. Negotiated Rate |
$727.47 |
| Max. Negotiated Rate |
$4,070.05 |
| Rate for Payer: Aetna Commercial |
$3,345.39
|
| Rate for Payer: Aetna Medicare |
$2,596.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,595.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,345.39
|
| Rate for Payer: BCBS Complete |
$1,718.52
|
| Rate for Payer: BCBS MAPPO |
$2,496.56
|
| Rate for Payer: BCBS Trust/PPO |
$727.47
|
| Rate for Payer: BCN Commercial |
$3,777.48
|
| Rate for Payer: BCN Medicare Advantage |
$2,496.56
|
| Rate for Payer: Cash Price |
$4,459.20
|
| Rate for Payer: Cash Price |
$4,459.20
|
| Rate for Payer: Cofinity Commercial |
$3,595.05
|
| Rate for Payer: Cofinity Commercial |
$3,345.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,496.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,621.39
|
| Rate for Payer: Meridian Medicaid |
$1,718.52
|
| Rate for Payer: Nomi Health Commercial |
$2,995.87
|
| Rate for Payer: PACE SWMI |
$2,496.56
|
| Rate for Payer: PHP Commercial |
$3,495.18
|
| Rate for Payer: PHP Medicare Advantage |
$2,496.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,636.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,623.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,070.05
|
| Rate for Payer: Priority Health Medicare |
$2,496.56
|
| Rate for Payer: Priority Health Narrow Network |
$4,070.05
|
| Rate for Payer: Priority Health SBD |
$4,070.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,496.56
|
| Rate for Payer: UHC Medicare Advantage |
$2,496.56
|
| Rate for Payer: UHCCP Medicaid |
$1,636.69
|
| Rate for Payer: UMR Bronson Commercial |
$2,564.04
|
|
|
PR PULMONARY COMPLIANCE STUDY
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 94750
|
| Min. Negotiated Rate |
$68.80 |
| Max. Negotiated Rate |
$111.80 |
| Rate for Payer: Aetna Medicare |
$86.00
|
| Rate for Payer: BCBS Complete |
$68.80
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.80
|
| Rate for Payer: UMR Bronson Commercial |
$79.12
|
|
|
PR PULMONARY STRESS TESTING
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS 94618
|
| Min. Negotiated Rate |
$13.85 |
| Max. Negotiated Rate |
$442.72 |
| Rate for Payer: Aetna Commercial |
$42.87
|
| Rate for Payer: Aetna Medicare |
$33.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.07
|
| Rate for Payer: BCBS Complete |
$14.54
|
| Rate for Payer: BCBS MAPPO |
$31.99
|
| Rate for Payer: BCBS Trust/PPO |
$442.72
|
| Rate for Payer: BCN Commercial |
$48.87
|
| Rate for Payer: BCN Medicare Advantage |
$31.99
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$46.07
|
| Rate for Payer: Cofinity Commercial |
$42.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.59
|
| Rate for Payer: Meridian Medicaid |
$14.54
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: PACE SWMI |
$31.99
|
| Rate for Payer: PHP Commercial |
$44.79
|
| Rate for Payer: PHP Medicare Advantage |
$31.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.13
|
| Rate for Payer: Priority Health Medicare |
$31.99
|
| Rate for Payer: Priority Health Narrow Network |
$46.13
|
| Rate for Payer: Priority Health SBD |
$29.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.99
|
| Rate for Payer: UHC Medicare Advantage |
$31.99
|
| Rate for Payer: UHCCP Medicaid |
$13.85
|
| Rate for Payer: UMR Bronson Commercial |
$21.62
|
|
|
PR PULMONARY STRESS TESTING,SIMPLE
|
Professional
|
Both
|
$358.00
|
|
|
Service Code
|
HCPCS 94620
|
| Min. Negotiated Rate |
$143.20 |
| Max. Negotiated Rate |
$232.70 |
| Rate for Payer: Aetna Medicare |
$179.00
|
| Rate for Payer: BCBS Complete |
$143.20
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.70
|
| Rate for Payer: UMR Bronson Commercial |
$164.68
|
|
|
PR PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION
|
Professional
|
Both
|
$182.00
|
|
|
Service Code
|
HCPCS 11105
|
| Min. Negotiated Rate |
$16.19 |
| Max. Negotiated Rate |
$118.30 |
| Rate for Payer: Aetna Commercial |
$32.43
|
| Rate for Payer: Aetna Medicare |
$25.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.85
|
| Rate for Payer: BCBS Complete |
$17.00
|
| Rate for Payer: BCBS MAPPO |
$24.20
|
| Rate for Payer: BCBS Trust/PPO |
$23.50
|
| Rate for Payer: BCN Commercial |
$69.89
|
| Rate for Payer: BCN Medicare Advantage |
$24.20
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cofinity Commercial |
$34.85
|
| Rate for Payer: Cofinity Commercial |
$32.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.41
|
| Rate for Payer: Meridian Medicaid |
$17.00
|
| Rate for Payer: Nomi Health Commercial |
$29.04
|
| Rate for Payer: PACE SWMI |
$24.20
|
| Rate for Payer: PHP Commercial |
$33.88
|
| Rate for Payer: PHP Medicare Advantage |
$24.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.32
|
| Rate for Payer: Priority Health Medicare |
$24.20
|
| Rate for Payer: Priority Health Narrow Network |
$34.32
|
| Rate for Payer: Priority Health SBD |
$34.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.20
|
| Rate for Payer: UHC Medicare Advantage |
$24.20
|
| Rate for Payer: UHCCP Medicaid |
$16.19
|
| Rate for Payer: UMR Bronson Commercial |
$83.72
|
|
|
PR PUNCH BIOPSY SKIN SINGLE LESION
|
Professional
|
Both
|
$244.00
|
|
|
Service Code
|
HCPCS 11104
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$158.60 |
| Rate for Payer: Aetna Commercial |
$59.62
|
| Rate for Payer: Aetna Medicare |
$46.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.07
|
| Rate for Payer: BCBS Complete |
$31.31
|
| Rate for Payer: BCBS MAPPO |
$44.49
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$148.43
|
| Rate for Payer: BCN Medicare Advantage |
$44.49
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cofinity Commercial |
$59.62
|
| Rate for Payer: Cofinity Commercial |
$64.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.71
|
| Rate for Payer: Meridian Medicaid |
$31.31
|
| Rate for Payer: Nomi Health Commercial |
$53.39
|
| Rate for Payer: PACE SWMI |
$44.49
|
| Rate for Payer: PHP Commercial |
$62.29
|
| Rate for Payer: PHP Medicare Advantage |
$44.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.76
|
| Rate for Payer: Priority Health Medicare |
$44.49
|
| Rate for Payer: Priority Health Narrow Network |
$62.76
|
| Rate for Payer: Priority Health SBD |
$62.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.49
|
| Rate for Payer: UHC Medicare Advantage |
$44.49
|
| Rate for Payer: UHCCP Medicaid |
$29.82
|
| Rate for Payer: UMR Bronson Commercial |
$112.24
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Professional
|
Both
|
$215.00
|
|
|
Service Code
|
HCPCS 10160
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$153.14 |
| Rate for Payer: Aetna Commercial |
$122.33
|
| Rate for Payer: Aetna Medicare |
$94.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.46
|
| Rate for Payer: BCBS Complete |
$65.53
|
| Rate for Payer: BCBS MAPPO |
$91.29
|
| Rate for Payer: BCBS Trust/PPO |
$11.15
|
| Rate for Payer: BCN Commercial |
$153.14
|
| Rate for Payer: BCN Medicare Advantage |
$91.29
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$122.33
|
| Rate for Payer: Cofinity Commercial |
$131.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.85
|
| Rate for Payer: Meridian Medicaid |
$65.53
|
| Rate for Payer: Nomi Health Commercial |
$109.55
|
| Rate for Payer: PACE SWMI |
$91.29
|
| Rate for Payer: PHP Commercial |
$127.81
|
| Rate for Payer: PHP Medicare Advantage |
$91.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.40
|
| Rate for Payer: Priority Health Medicare |
$91.29
|
| Rate for Payer: Priority Health Narrow Network |
$131.40
|
| Rate for Payer: Priority Health SBD |
$131.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.29
|
| Rate for Payer: UHC Medicare Advantage |
$91.29
|
| Rate for Payer: UHCCP Medicaid |
$62.41
|
| Rate for Payer: UMR Bronson Commercial |
$98.90
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Facility
|
IP
|
$215.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
10160
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$94.60 |
| Max. Negotiated Rate |
$193.50 |
| Rate for Payer: Aetna American Axle |
$139.75
|
| Rate for Payer: Aetna Commercial |
$182.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.75
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$150.50
|
| Rate for Payer: Cofinity Commercial |
$184.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$150.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.00
|
| Rate for Payer: Healthscope Commercial |
$193.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$150.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.75
|
| Rate for Payer: PHP Commercial |
$182.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health SBD |
$135.45
|
| Rate for Payer: UMR Bronson Commercial |
$94.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.25
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Professional
|
Both
|
$215.00
|
|
|
Service Code
|
HCPCS 10160
|
| Hospital Charge Code |
10160
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$153.14 |
| Rate for Payer: Aetna Commercial |
$122.33
|
| Rate for Payer: Aetna Medicare |
$94.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.46
|
| Rate for Payer: BCBS Complete |
$65.53
|
| Rate for Payer: BCBS MAPPO |
$91.29
|
| Rate for Payer: BCBS Trust/PPO |
$11.15
|
| Rate for Payer: BCN Commercial |
$153.14
|
| Rate for Payer: BCN Medicare Advantage |
$91.29
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$131.46
|
| Rate for Payer: Cofinity Commercial |
$122.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.85
|
| Rate for Payer: Meridian Medicaid |
$65.53
|
| Rate for Payer: Nomi Health Commercial |
$109.55
|
| Rate for Payer: PACE SWMI |
$91.29
|
| Rate for Payer: PHP Commercial |
$127.81
|
| Rate for Payer: PHP Medicare Advantage |
$91.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.40
|
| Rate for Payer: Priority Health Medicare |
$91.29
|
| Rate for Payer: Priority Health Narrow Network |
$131.40
|
| Rate for Payer: Priority Health SBD |
$131.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.29
|
| Rate for Payer: UHC Medicare Advantage |
$91.29
|
| Rate for Payer: UHCCP Medicaid |
$62.41
|
| Rate for Payer: UMR Bronson Commercial |
$98.90
|
|
|
PR PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST
|
Facility
|
OP
|
$215.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
10160
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$79.55 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna American Axle |
$139.75
|
| Rate for Payer: Aetna Commercial |
$182.75
|
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$291.18
|
| Rate for Payer: BCN Commercial |
$291.18
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$150.50
|
| Rate for Payer: Cofinity Commercial |
$184.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$150.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$193.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$150.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.25
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.75
|
| Rate for Payer: Nomi Health Commercial |
$822.04
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$182.75
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Priority Health SBD |
$135.45
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.00
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Exchange |
$91.82
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$209.82
|
| Rate for Payer: UMR Bronson Commercial |
$79.55
|
| Rate for Payer: VA VA |
$391.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.25
|
|
|
PR PUNCTURE ASPIRATION CYST BREAST EACH ADDL CYST
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 19001
|
| Min. Negotiated Rate |
$12.99 |
| Max. Negotiated Rate |
$456.13 |
| Rate for Payer: Aetna Commercial |
$26.16
|
| Rate for Payer: Aetna Medicare |
$20.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.11
|
| Rate for Payer: BCBS Complete |
$13.64
|
| Rate for Payer: BCBS MAPPO |
$19.52
|
| Rate for Payer: BCBS Trust/PPO |
$456.13
|
| Rate for Payer: BCN Commercial |
$38.12
|
| Rate for Payer: BCN Medicare Advantage |
$19.52
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$26.16
|
| Rate for Payer: Cofinity Commercial |
$28.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.50
|
| Rate for Payer: Meridian Medicaid |
$13.64
|
| Rate for Payer: Nomi Health Commercial |
$23.42
|
| Rate for Payer: PACE SWMI |
$19.52
|
| Rate for Payer: PHP Commercial |
$27.33
|
| Rate for Payer: PHP Medicare Advantage |
$19.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.00
|
| Rate for Payer: Priority Health Medicare |
$19.52
|
| Rate for Payer: Priority Health Narrow Network |
$28.00
|
| Rate for Payer: Priority Health SBD |
$28.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.52
|
| Rate for Payer: UHC Medicare Advantage |
$19.52
|
| Rate for Payer: UHCCP Medicaid |
$12.99
|
| Rate for Payer: UMR Bronson Commercial |
$34.50
|
|
|
PR PUNCTURE ASPIRATION CYST OF BREAST
|
Professional
|
Both
|
$191.00
|
|
|
Service Code
|
HCPCS 19000
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$6,614.63 |
| Rate for Payer: Aetna Commercial |
$54.75
|
| Rate for Payer: Aetna Medicare |
$42.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.84
|
| Rate for Payer: BCBS Complete |
$28.40
|
| Rate for Payer: BCBS MAPPO |
$40.86
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$149.54
|
| Rate for Payer: BCN Medicare Advantage |
$40.86
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cofinity Commercial |
$54.75
|
| Rate for Payer: Cofinity Commercial |
$58.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.90
|
| Rate for Payer: Meridian Medicaid |
$28.40
|
| Rate for Payer: Nomi Health Commercial |
$49.03
|
| Rate for Payer: PACE SWMI |
$40.86
|
| Rate for Payer: PHP Commercial |
$57.20
|
| Rate for Payer: PHP Medicare Advantage |
$40.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$124.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.44
|
| Rate for Payer: Priority Health Medicare |
$40.86
|
| Rate for Payer: Priority Health Narrow Network |
$56.44
|
| Rate for Payer: Priority Health SBD |
$56.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.86
|
| Rate for Payer: UHC Medicare Advantage |
$40.86
|
| Rate for Payer: UHCCP Medicaid |
$27.05
|
| Rate for Payer: UMR Bronson Commercial |
$87.86
|
|
|
PR PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX
|
Professional
|
Both
|
$401.00
|
|
|
Service Code
|
HCPCS 61070
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$355.02 |
| Rate for Payer: Aetna Commercial |
$71.98
|
| Rate for Payer: Aetna Medicare |
$55.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.36
|
| Rate for Payer: BCBS Complete |
$37.80
|
| Rate for Payer: BCBS MAPPO |
$53.72
|
| Rate for Payer: BCBS Trust/PPO |
$355.02
|
| Rate for Payer: BCN Commercial |
$113.90
|
| Rate for Payer: BCN Medicare Advantage |
$53.72
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cofinity Commercial |
$77.36
|
| Rate for Payer: Cofinity Commercial |
$71.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.41
|
| Rate for Payer: Meridian Medicaid |
$37.80
|
| Rate for Payer: Nomi Health Commercial |
$64.46
|
| Rate for Payer: PACE SWMI |
$53.72
|
| Rate for Payer: PHP Commercial |
$75.21
|
| Rate for Payer: PHP Medicare Advantage |
$53.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.54
|
| Rate for Payer: Priority Health Medicare |
$53.72
|
| Rate for Payer: Priority Health Narrow Network |
$95.54
|
| Rate for Payer: Priority Health SBD |
$95.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.72
|
| Rate for Payer: UHC Medicare Advantage |
$53.72
|
| Rate for Payer: UHCCP Medicaid |
$36.00
|
| Rate for Payer: UMR Bronson Commercial |
$184.46
|
|
|
PR PURE TONE AUDIOMETRY AIR & BONE
|
Professional
|
Both
|
$65.00
|
|
|
Service Code
|
HCPCS 92553
|
| Min. Negotiated Rate |
$26.00 |
| Max. Negotiated Rate |
$1,526.79 |
| Rate for Payer: Aetna Commercial |
$57.37
|
| Rate for Payer: Aetna Medicare |
$44.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.65
|
| Rate for Payer: BCBS Complete |
$26.00
|
| Rate for Payer: BCBS MAPPO |
$42.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,526.79
|
| Rate for Payer: BCN Commercial |
$63.53
|
| Rate for Payer: BCN Medicare Advantage |
$42.81
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$61.65
|
| Rate for Payer: Cofinity Commercial |
$57.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.95
|
| Rate for Payer: Nomi Health Commercial |
$51.37
|
| Rate for Payer: PACE SWMI |
$42.81
|
| Rate for Payer: PHP Commercial |
$59.93
|
| Rate for Payer: PHP Medicare Advantage |
$42.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.42
|
| Rate for Payer: Priority Health Medicare |
$42.81
|
| Rate for Payer: Priority Health Narrow Network |
$62.42
|
| Rate for Payer: Priority Health SBD |
$62.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.81
|
| Rate for Payer: UHC Medicare Advantage |
$42.81
|
| Rate for Payer: UMR Bronson Commercial |
$29.90
|
|
|
PR PURE TONE AUDIOMETRY AIR ONLY
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 92552
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$1,476.07 |
| Rate for Payer: Aetna Commercial |
$47.50
|
| Rate for Payer: Aetna Medicare |
$36.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.05
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: BCBS MAPPO |
$35.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,476.07
|
| Rate for Payer: BCN Commercial |
$51.80
|
| Rate for Payer: BCN Medicare Advantage |
$35.45
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$51.05
|
| Rate for Payer: Cofinity Commercial |
$47.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.22
|
| Rate for Payer: Nomi Health Commercial |
$42.54
|
| Rate for Payer: PACE SWMI |
$35.45
|
| Rate for Payer: PHP Commercial |
$49.63
|
| Rate for Payer: PHP Medicare Advantage |
$35.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.57
|
| Rate for Payer: Priority Health Medicare |
$35.45
|
| Rate for Payer: Priority Health Narrow Network |
$51.57
|
| Rate for Payer: Priority Health SBD |
$51.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.45
|
| Rate for Payer: UHC Medicare Advantage |
$35.45
|
| Rate for Payer: UMR Bronson Commercial |
$24.84
|
|
