|
PR SBSQ INTENSIVE CARE INFANT PBW 2,501-5,000 GRAMS
|
Professional
|
Both
|
$394.00
|
|
|
Service Code
|
HCPCS 99480
|
| Min. Negotiated Rate |
$100.46 |
| Max. Negotiated Rate |
$295.50 |
| Rate for Payer: Aetna Commercial |
$134.62
|
| Rate for Payer: Aetna Medicare |
$104.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.66
|
| Rate for Payer: BCBS Complete |
$105.48
|
| Rate for Payer: BCBS MAPPO |
$100.46
|
| Rate for Payer: BCN Commercial |
$170.81
|
| Rate for Payer: BCN Medicare Advantage |
$100.46
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$134.62
|
| Rate for Payer: Cofinity Commercial |
$144.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.48
|
| Rate for Payer: Meridian Medicaid |
$105.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$110.51
|
| Rate for Payer: Nomi Health Commercial |
$120.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$295.50
|
| Rate for Payer: PACE SWMI |
$100.46
|
| Rate for Payer: PHP Commercial |
$140.64
|
| Rate for Payer: PHP Medicare Advantage |
$100.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$153.65
|
| Rate for Payer: Priority Health Medicare |
$100.46
|
| Rate for Payer: Priority Health SBD |
$153.65
|
| Rate for Payer: Priority Health Tiered Network |
$153.65
|
| Rate for Payer: Railroad Medicare Medicare |
$100.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.59
|
| Rate for Payer: UHC Core |
$169.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$100.46
|
| Rate for Payer: UHC Exchange |
$169.59
|
| Rate for Payer: UHC Medicaid |
$100.46
|
| Rate for Payer: UHCCP Medicaid |
$100.46
|
| Rate for Payer: UMR Bronson Commercial |
$181.24
|
|
|
PR SBSQ INTENSIVE CARE LBW INFANT 1,500-2,500 GRAMS
|
Professional
|
Both
|
$394.00
|
|
|
Service Code
|
HCPCS 99479
|
| Min. Negotiated Rate |
$104.41 |
| Max. Negotiated Rate |
$295.50 |
| Rate for Payer: Aetna Commercial |
$139.91
|
| Rate for Payer: Aetna Medicare |
$108.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.35
|
| Rate for Payer: BCBS Complete |
$109.63
|
| Rate for Payer: BCBS MAPPO |
$104.41
|
| Rate for Payer: BCN Commercial |
$177.29
|
| Rate for Payer: BCN Medicare Advantage |
$104.41
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$139.91
|
| Rate for Payer: Cofinity Commercial |
$150.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.63
|
| Rate for Payer: Meridian Medicaid |
$109.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.85
|
| Rate for Payer: Nomi Health Commercial |
$125.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$295.50
|
| Rate for Payer: PACE SWMI |
$104.41
|
| Rate for Payer: PHP Commercial |
$146.17
|
| Rate for Payer: PHP Medicare Advantage |
$104.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$159.46
|
| Rate for Payer: Priority Health Medicare |
$104.41
|
| Rate for Payer: Priority Health SBD |
$159.46
|
| Rate for Payer: Priority Health Tiered Network |
$159.46
|
| Rate for Payer: Railroad Medicare Medicare |
$104.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.63
|
| Rate for Payer: UHC Core |
$176.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.41
|
| Rate for Payer: UHC Exchange |
$176.63
|
| Rate for Payer: UHC Medicaid |
$104.41
|
| Rate for Payer: UHCCP Medicaid |
$104.41
|
| Rate for Payer: UMR Bronson Commercial |
$181.24
|
|
|
PR SBSQ INTENSIVE CARE VLBW INFANT<1,500 GRAMS
|
Professional
|
Both
|
$289.00
|
|
|
Service Code
|
HCPCS 99478
|
| Min. Negotiated Rate |
$115.04 |
| Max. Negotiated Rate |
$216.75 |
| Rate for Payer: Aetna Commercial |
$154.15
|
| Rate for Payer: Aetna Medicare |
$119.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.66
|
| Rate for Payer: BCBS Complete |
$120.79
|
| Rate for Payer: BCBS MAPPO |
$115.04
|
| Rate for Payer: BCN Commercial |
$195.21
|
| Rate for Payer: BCN Medicare Advantage |
$115.04
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cofinity Commercial |
$154.15
|
| Rate for Payer: Cofinity Commercial |
$165.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.79
|
| Rate for Payer: Meridian Medicaid |
$120.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$126.54
|
| Rate for Payer: Nomi Health Commercial |
$138.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$216.75
|
| Rate for Payer: PACE SWMI |
$115.04
|
| Rate for Payer: PHP Commercial |
$161.06
|
| Rate for Payer: PHP Medicare Advantage |
$115.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$175.59
|
| Rate for Payer: Priority Health Medicare |
$115.04
|
| Rate for Payer: Priority Health SBD |
$175.59
|
| Rate for Payer: Priority Health Tiered Network |
$175.59
|
| Rate for Payer: Railroad Medicare Medicare |
$115.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$194.70
|
| Rate for Payer: UHC Core |
$194.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$115.04
|
| Rate for Payer: UHC Exchange |
$194.70
|
| Rate for Payer: UHC Medicaid |
$115.04
|
| Rate for Payer: UHCCP Medicaid |
$115.04
|
| Rate for Payer: UMR Bronson Commercial |
$132.94
|
|
|
PR SBSQ NURSING FACILITY CARE HIGH MDM 45 MINUTES
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 99310
|
| Min. Negotiated Rate |
$96.60 |
| Max. Negotiated Rate |
$228.57 |
| Rate for Payer: Aetna Commercial |
$184.56
|
| Rate for Payer: Aetna Medicare |
$143.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.33
|
| Rate for Payer: BCBS Complete |
$129.62
|
| Rate for Payer: BCBS MAPPO |
$137.73
|
| Rate for Payer: BCN Commercial |
$228.57
|
| Rate for Payer: BCN Medicare Advantage |
$137.73
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$184.56
|
| Rate for Payer: Cofinity Commercial |
$198.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.62
|
| Rate for Payer: Meridian Medicaid |
$129.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$151.50
|
| Rate for Payer: Nomi Health Commercial |
$165.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
| Rate for Payer: PACE SWMI |
$137.73
|
| Rate for Payer: PHP Commercial |
$192.82
|
| Rate for Payer: PHP Medicare Advantage |
$137.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$205.60
|
| Rate for Payer: Priority Health Medicare |
$137.73
|
| Rate for Payer: Priority Health SBD |
$205.60
|
| Rate for Payer: Priority Health Tiered Network |
$205.60
|
| Rate for Payer: Railroad Medicare Medicare |
$137.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.52
|
| Rate for Payer: UHC Core |
$188.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$137.73
|
| Rate for Payer: UHC Exchange |
$188.52
|
| Rate for Payer: UHC Medicaid |
$123.45
|
| Rate for Payer: UHCCP Medicaid |
$123.45
|
| Rate for Payer: UMR Bronson Commercial |
$96.60
|
|
|
PR SBSQ NURSING FACILITY CARE LOW MDM 20 MINUTES
|
Professional
|
Both
|
$106.00
|
|
|
Service Code
|
HCPCS 99308
|
| Min. Negotiated Rate |
$48.76 |
| Max. Negotiated Rate |
$110.55 |
| Rate for Payer: Aetna Commercial |
$88.79
|
| Rate for Payer: Aetna Medicare |
$68.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.41
|
| Rate for Payer: BCBS Complete |
$62.64
|
| Rate for Payer: BCBS MAPPO |
$66.26
|
| Rate for Payer: BCN Commercial |
$110.55
|
| Rate for Payer: BCN Medicare Advantage |
$66.26
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$88.79
|
| Rate for Payer: Cofinity Commercial |
$95.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.57
|
| Rate for Payer: Meridian Medicaid |
$62.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.89
|
| Rate for Payer: Nomi Health Commercial |
$79.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.50
|
| Rate for Payer: PACE SWMI |
$66.26
|
| Rate for Payer: PHP Commercial |
$92.76
|
| Rate for Payer: PHP Medicare Advantage |
$66.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$105.05
|
| Rate for Payer: Priority Health Medicare |
$66.26
|
| Rate for Payer: Priority Health SBD |
$105.05
|
| Rate for Payer: Priority Health Tiered Network |
$105.05
|
| Rate for Payer: Railroad Medicare Medicare |
$66.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.83
|
| Rate for Payer: UHC Core |
$96.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$66.26
|
| Rate for Payer: UHC Exchange |
$96.83
|
| Rate for Payer: UHC Medicaid |
$59.66
|
| Rate for Payer: UHCCP Medicaid |
$59.66
|
| Rate for Payer: UMR Bronson Commercial |
$48.76
|
|
|
PR SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES
|
Professional
|
Both
|
$141.00
|
|
|
Service Code
|
HCPCS 99309
|
| Min. Negotiated Rate |
$64.86 |
| Max. Negotiated Rate |
$160.35 |
| Rate for Payer: Aetna Commercial |
$129.38
|
| Rate for Payer: Aetna Medicare |
$100.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.03
|
| Rate for Payer: BCBS Complete |
$91.05
|
| Rate for Payer: BCBS MAPPO |
$96.55
|
| Rate for Payer: BCN Commercial |
$160.35
|
| Rate for Payer: BCN Medicare Advantage |
$96.55
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cofinity Commercial |
$129.38
|
| Rate for Payer: Cofinity Commercial |
$139.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.38
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$106.20
|
| Rate for Payer: Nomi Health Commercial |
$115.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.75
|
| Rate for Payer: PACE SWMI |
$96.55
|
| Rate for Payer: PHP Commercial |
$135.17
|
| Rate for Payer: PHP Medicare Advantage |
$96.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$138.47
|
| Rate for Payer: Priority Health Medicare |
$96.55
|
| Rate for Payer: Priority Health SBD |
$138.47
|
| Rate for Payer: Priority Health Tiered Network |
$138.47
|
| Rate for Payer: Railroad Medicare Medicare |
$96.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.64
|
| Rate for Payer: UHC Core |
$127.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$96.55
|
| Rate for Payer: UHC Exchange |
$127.64
|
| Rate for Payer: UHC Medicaid |
$86.71
|
| Rate for Payer: UHCCP Medicaid |
$86.71
|
| Rate for Payer: UMR Bronson Commercial |
$64.86
|
|
|
PR SBSQ NURSING FACILITY CARE SF MDM 10 MINUTES
|
Professional
|
Both
|
$69.00
|
|
|
Service Code
|
HCPCS 99307
|
| Min. Negotiated Rate |
$31.74 |
| Max. Negotiated Rate |
$61.67 |
| Rate for Payer: Aetna Commercial |
$48.56
|
| Rate for Payer: Aetna Medicare |
$37.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.19
|
| Rate for Payer: BCBS Complete |
$34.25
|
| Rate for Payer: BCBS MAPPO |
$36.24
|
| Rate for Payer: BCN Commercial |
$59.26
|
| Rate for Payer: BCN Medicare Advantage |
$36.24
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$48.56
|
| Rate for Payer: Cofinity Commercial |
$52.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.05
|
| Rate for Payer: Meridian Medicaid |
$34.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.86
|
| Rate for Payer: Nomi Health Commercial |
$43.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.75
|
| Rate for Payer: PACE SWMI |
$36.24
|
| Rate for Payer: PHP Commercial |
$50.74
|
| Rate for Payer: PHP Medicare Advantage |
$36.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$53.30
|
| Rate for Payer: Priority Health Medicare |
$36.24
|
| Rate for Payer: Priority Health SBD |
$53.30
|
| Rate for Payer: Priority Health Tiered Network |
$53.30
|
| Rate for Payer: Railroad Medicare Medicare |
$36.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.67
|
| Rate for Payer: UHC Core |
$61.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.24
|
| Rate for Payer: UHC Exchange |
$61.67
|
| Rate for Payer: UHC Medicaid |
$32.62
|
| Rate for Payer: UHCCP Medicaid |
$32.62
|
| Rate for Payer: UMR Bronson Commercial |
$31.74
|
|
|
PR SBSQ OBSERVATION CARE/DAY 15 MINUTES
|
Professional
|
Both
|
$88.00
|
|
|
Service Code
|
HCPCS 99224
|
| Min. Negotiated Rate |
$35.20 |
| Max. Negotiated Rate |
$66.00 |
| Rate for Payer: Aetna Medicare |
$44.00
|
| Rate for Payer: BCBS Complete |
$35.20
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.00
|
| Rate for Payer: UMR Bronson Commercial |
$40.48
|
|
|
PR SBSQ OBSERVATION CARE/DAY 25 MINUTES
|
Professional
|
Both
|
$155.00
|
|
|
Service Code
|
HCPCS 99225
|
| Min. Negotiated Rate |
$62.00 |
| Max. Negotiated Rate |
$116.25 |
| Rate for Payer: Aetna Medicare |
$77.50
|
| Rate for Payer: BCBS Complete |
$62.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$116.25
|
| Rate for Payer: UMR Bronson Commercial |
$71.30
|
|
|
PR SBSQ OBSERVATION CARE/DAY 35 MINUTES
|
Professional
|
Both
|
$231.00
|
|
|
Service Code
|
HCPCS 99226
|
| Min. Negotiated Rate |
$92.40 |
| Max. Negotiated Rate |
$173.25 |
| Rate for Payer: Aetna Medicare |
$115.50
|
| Rate for Payer: BCBS Complete |
$92.40
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$173.25
|
| Rate for Payer: UMR Bronson Commercial |
$106.26
|
|
|
PR SBSQ PSYCHIATRIC COLLAB CARE MGMT 1ST 60 MINS
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
HCPCS 99493
|
| Min. Negotiated Rate |
$57.08 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$118.84
|
| Rate for Payer: Aetna Medicare |
$92.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.71
|
| Rate for Payer: BCBS Complete |
$59.93
|
| Rate for Payer: BCBS MAPPO |
$88.69
|
| Rate for Payer: BCN Commercial |
$98.64
|
| Rate for Payer: BCN Medicare Advantage |
$88.69
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Commercial |
$118.84
|
| Rate for Payer: Cofinity Commercial |
$127.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.12
|
| Rate for Payer: Meridian Medicaid |
$59.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$97.56
|
| Rate for Payer: Nomi Health Commercial |
$106.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.00
|
| Rate for Payer: PACE SWMI |
$88.69
|
| Rate for Payer: PHP Commercial |
$124.17
|
| Rate for Payer: PHP Medicare Advantage |
$88.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$154.29
|
| Rate for Payer: Priority Health Medicare |
$88.69
|
| Rate for Payer: Priority Health SBD |
$154.29
|
| Rate for Payer: Priority Health Tiered Network |
$154.29
|
| Rate for Payer: Railroad Medicare Medicare |
$88.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.56
|
| Rate for Payer: UHC Core |
$112.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$88.69
|
| Rate for Payer: UHC Exchange |
$112.56
|
| Rate for Payer: UHC Medicaid |
$57.08
|
| Rate for Payer: UHCCP Medicaid |
$57.08
|
| Rate for Payer: UMR Bronson Commercial |
$119.60
|
|
|
PR SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID
|
Professional
|
Both
|
$2,335.00
|
|
|
Service Code
|
HCPCS 49185
|
| Min. Negotiated Rate |
$67.10 |
| Max. Negotiated Rate |
$1,751.25 |
| Rate for Payer: Aetna Commercial |
$140.54
|
| Rate for Payer: Aetna Medicare |
$109.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.03
|
| Rate for Payer: BCBS Complete |
$70.45
|
| Rate for Payer: BCBS MAPPO |
$104.88
|
| Rate for Payer: BCN Commercial |
$176.28
|
| Rate for Payer: BCN Medicare Advantage |
$104.88
|
| Rate for Payer: Cash Price |
$1,868.00
|
| Rate for Payer: Cash Price |
$1,868.00
|
| Rate for Payer: Cofinity Commercial |
$140.54
|
| Rate for Payer: Cofinity Commercial |
$151.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.12
|
| Rate for Payer: Meridian Medicaid |
$70.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$115.37
|
| Rate for Payer: Nomi Health Commercial |
$125.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,751.25
|
| Rate for Payer: PACE SWMI |
$104.88
|
| Rate for Payer: PHP Commercial |
$146.83
|
| Rate for Payer: PHP Medicare Advantage |
$104.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$214.80
|
| Rate for Payer: Priority Health Medicare |
$104.88
|
| Rate for Payer: Priority Health SBD |
$214.80
|
| Rate for Payer: Priority Health Tiered Network |
$214.80
|
| Rate for Payer: Railroad Medicare Medicare |
$104.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.08
|
| Rate for Payer: UHC Core |
$213.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.88
|
| Rate for Payer: UHC Exchange |
$213.08
|
| Rate for Payer: UHC Medicaid |
$67.10
|
| Rate for Payer: UHCCP Medicaid |
$67.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,074.10
|
|
|
PR SCREENING PAP SMEAR BY PHYS
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS P3001
|
| Min. Negotiated Rate |
$14.96 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Aetna Commercial |
$30.50
|
| Rate for Payer: Aetna Medicare |
$23.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.77
|
| Rate for Payer: BCBS Complete |
$26.40
|
| Rate for Payer: BCBS MAPPO |
$22.76
|
| Rate for Payer: BCN Commercial |
$37.35
|
| Rate for Payer: BCN Medicare Advantage |
$22.76
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cofinity Commercial |
$32.77
|
| Rate for Payer: Cofinity Commercial |
$30.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.04
|
| Rate for Payer: Nomi Health Commercial |
$27.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.50
|
| Rate for Payer: PACE SWMI |
$22.76
|
| Rate for Payer: PHP Commercial |
$31.86
|
| Rate for Payer: PHP Medicare Advantage |
$22.76
|
| Rate for Payer: Priority Health Medicare |
$22.76
|
| Rate for Payer: Railroad Medicare Medicare |
$22.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.96
|
| Rate for Payer: UHC Core |
$14.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.76
|
| Rate for Payer: UHC Exchange |
$14.96
|
| Rate for Payer: UMR Bronson Commercial |
$30.36
|
|
|
PR SCREENING PROCTOSCOPY
|
Professional
|
Both
|
$159.00
|
|
|
Service Code
|
HCPCS S0601
|
| Min. Negotiated Rate |
$24.45 |
| Max. Negotiated Rate |
$119.25 |
| Rate for Payer: Aetna Commercial |
$24.45
|
| Rate for Payer: Aetna Medicare |
$79.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.45
|
| Rate for Payer: BCBS Complete |
$63.60
|
| Rate for Payer: BCN Commercial |
$67.74
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.25
|
| Rate for Payer: UMR Bronson Commercial |
$73.14
|
|
|
PR SCREENING TEST PURE TONE AIR ONLY
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS 92551
|
| Min. Negotiated Rate |
$12.13 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Aetna Commercial |
$12.13
|
| Rate for Payer: Aetna Medicare |
$15.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.13
|
| Rate for Payer: BCN Commercial |
$18.92
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.45
|
| Rate for Payer: Priority Health SBD |
$17.45
|
| Rate for Payer: Priority Health Tiered Network |
$17.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.60
|
| Rate for Payer: UHC Core |
$17.60
|
| Rate for Payer: UHC Exchange |
$17.60
|
| Rate for Payer: UMR Bronson Commercial |
$13.80
|
|
|
PR SCREENING TEST VISUAL ACUITY QUANTITATIVE BILAT
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS 99173
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Aetna Commercial |
$3.23
|
| Rate for Payer: Aetna Medicare |
$12.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.23
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCN Commercial |
$4.98
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.59
|
| Rate for Payer: Priority Health SBD |
$4.59
|
| Rate for Payer: Priority Health Tiered Network |
$4.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.79
|
| Rate for Payer: UHC Core |
$3.79
|
| Rate for Payer: UHC Exchange |
$3.79
|
| Rate for Payer: UMR Bronson Commercial |
$11.04
|
|
|
PR SCR MAMMO BI INCL CAD
|
Professional
|
Both
|
$213.00
|
|
|
Service Code
|
HCPCS G0202
|
| Min. Negotiated Rate |
$85.20 |
| Max. Negotiated Rate |
$159.75 |
| Rate for Payer: Aetna Medicare |
$106.50
|
| Rate for Payer: BCBS Complete |
$85.20
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.75
|
| Rate for Payer: UMR Bronson Commercial |
$97.98
|
|
|
PR SCROTAL EXPLORATION
|
Professional
|
Both
|
$723.00
|
|
|
Service Code
|
HCPCS 55110
|
| Min. Negotiated Rate |
$231.53 |
| Max. Negotiated Rate |
$680.86 |
| Rate for Payer: Aetna Commercial |
$476.52
|
| Rate for Payer: Aetna Medicare |
$369.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$476.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.08
|
| Rate for Payer: BCBS Complete |
$243.11
|
| Rate for Payer: BCBS MAPPO |
$355.61
|
| Rate for Payer: BCN Commercial |
$588.12
|
| Rate for Payer: BCN Medicare Advantage |
$355.61
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cofinity Commercial |
$476.52
|
| Rate for Payer: Cofinity Commercial |
$512.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$355.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.39
|
| Rate for Payer: Meridian Medicaid |
$243.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$391.17
|
| Rate for Payer: Nomi Health Commercial |
$426.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$542.25
|
| Rate for Payer: PACE SWMI |
$355.61
|
| Rate for Payer: PHP Commercial |
$497.85
|
| Rate for Payer: PHP Medicare Advantage |
$355.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$231.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$640.65
|
| Rate for Payer: Priority Health Medicare |
$355.61
|
| Rate for Payer: Priority Health SBD |
$640.65
|
| Rate for Payer: Priority Health Tiered Network |
$640.65
|
| Rate for Payer: Railroad Medicare Medicare |
$355.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$680.86
|
| Rate for Payer: UHC Core |
$680.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$355.61
|
| Rate for Payer: UHC Exchange |
$680.86
|
| Rate for Payer: UHC Medicaid |
$231.53
|
| Rate for Payer: UHCCP Medicaid |
$231.53
|
| Rate for Payer: UMR Bronson Commercial |
$332.58
|
|
|
PR SCROTOPLASTY COMPLICATED
|
Professional
|
Both
|
$1,456.00
|
|
|
Service Code
|
HCPCS 55180
|
| Min. Negotiated Rate |
$397.88 |
| Max. Negotiated Rate |
$1,219.64 |
| Rate for Payer: Aetna Commercial |
$822.57
|
| Rate for Payer: Aetna Medicare |
$638.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$822.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$883.96
|
| Rate for Payer: BCBS Complete |
$417.77
|
| Rate for Payer: BCBS MAPPO |
$613.86
|
| Rate for Payer: BCN Commercial |
$1,034.31
|
| Rate for Payer: BCN Medicare Advantage |
$613.86
|
| Rate for Payer: Cash Price |
$1,164.80
|
| Rate for Payer: Cash Price |
$1,164.80
|
| Rate for Payer: Cofinity Commercial |
$822.57
|
| Rate for Payer: Cofinity Commercial |
$883.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$613.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$644.55
|
| Rate for Payer: Meridian Medicaid |
$417.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$675.25
|
| Rate for Payer: Nomi Health Commercial |
$736.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,092.00
|
| Rate for Payer: PACE SWMI |
$613.86
|
| Rate for Payer: PHP Commercial |
$859.40
|
| Rate for Payer: PHP Medicare Advantage |
$613.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$397.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,126.70
|
| Rate for Payer: Priority Health Medicare |
$613.86
|
| Rate for Payer: Priority Health SBD |
$1,126.70
|
| Rate for Payer: Priority Health Tiered Network |
$1,126.70
|
| Rate for Payer: Railroad Medicare Medicare |
$613.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,219.64
|
| Rate for Payer: UHC Core |
$1,219.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$613.86
|
| Rate for Payer: UHC Exchange |
$1,219.64
|
| Rate for Payer: UHC Medicaid |
$397.88
|
| Rate for Payer: UHCCP Medicaid |
$397.88
|
| Rate for Payer: UMR Bronson Commercial |
$669.76
|
|
|
PR SCROTOPLASTY SIMPLE
|
Professional
|
Both
|
$705.00
|
|
|
Service Code
|
HCPCS 55175
|
| Min. Negotiated Rate |
$216.62 |
| Max. Negotiated Rate |
$635.88 |
| Rate for Payer: Aetna Commercial |
$445.11
|
| Rate for Payer: Aetna Medicare |
$345.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$445.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.32
|
| Rate for Payer: BCBS Complete |
$227.45
|
| Rate for Payer: BCBS MAPPO |
$332.17
|
| Rate for Payer: BCN Commercial |
$552.26
|
| Rate for Payer: BCN Medicare Advantage |
$332.17
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cofinity Commercial |
$445.11
|
| Rate for Payer: Cofinity Commercial |
$478.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$348.78
|
| Rate for Payer: Meridian Medicaid |
$227.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$365.39
|
| Rate for Payer: Nomi Health Commercial |
$398.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$528.75
|
| Rate for Payer: PACE SWMI |
$332.17
|
| Rate for Payer: PHP Commercial |
$465.04
|
| Rate for Payer: PHP Medicare Advantage |
$332.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$601.59
|
| Rate for Payer: Priority Health Medicare |
$332.17
|
| Rate for Payer: Priority Health SBD |
$601.59
|
| Rate for Payer: Priority Health Tiered Network |
$601.59
|
| Rate for Payer: Railroad Medicare Medicare |
$332.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$635.88
|
| Rate for Payer: UHC Core |
$635.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$332.17
|
| Rate for Payer: UHC Exchange |
$635.88
|
| Rate for Payer: UHC Medicaid |
$216.62
|
| Rate for Payer: UHCCP Medicaid |
$216.62
|
| Rate for Payer: UMR Bronson Commercial |
$324.30
|
|
|
PR SEC ABDOMINAL WALL SUTURE EVISCERATION/DEHSN
|
Professional
|
Both
|
$2,416.00
|
|
|
Service Code
|
HCPCS 49900
|
| Min. Negotiated Rate |
$510.35 |
| Max. Negotiated Rate |
$1,812.00 |
| Rate for Payer: Aetna Commercial |
$1,055.59
|
| Rate for Payer: Aetna Medicare |
$819.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,134.36
|
| Rate for Payer: BCBS Complete |
$535.87
|
| Rate for Payer: BCBS MAPPO |
$787.75
|
| Rate for Payer: BCN Commercial |
$1,247.94
|
| Rate for Payer: BCN Medicare Advantage |
$787.75
|
| Rate for Payer: Cash Price |
$1,932.80
|
| Rate for Payer: Cash Price |
$1,932.80
|
| Rate for Payer: Cofinity Commercial |
$1,055.59
|
| Rate for Payer: Cofinity Commercial |
$1,134.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$827.14
|
| Rate for Payer: Meridian Medicaid |
$535.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$866.52
|
| Rate for Payer: Nomi Health Commercial |
$945.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,812.00
|
| Rate for Payer: PACE SWMI |
$787.75
|
| Rate for Payer: PHP Commercial |
$1,102.85
|
| Rate for Payer: PHP Medicare Advantage |
$787.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$510.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,520.53
|
| Rate for Payer: Priority Health Medicare |
$787.75
|
| Rate for Payer: Priority Health SBD |
$1,520.53
|
| Rate for Payer: Priority Health Tiered Network |
$1,520.53
|
| Rate for Payer: Railroad Medicare Medicare |
$787.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,445.75
|
| Rate for Payer: UHC Core |
$1,445.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$787.75
|
| Rate for Payer: UHC Exchange |
$1,445.75
|
| Rate for Payer: UHC Medicaid |
$510.35
|
| Rate for Payer: UHCCP Medicaid |
$510.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,111.36
|
|
|
PR SECONDARY CLOSURE SURG WOUND/DEHSN XTNSV/COMP
|
Professional
|
Both
|
$1,846.00
|
|
|
Service Code
|
HCPCS 13160
|
| Min. Negotiated Rate |
$472.43 |
| Max. Negotiated Rate |
$1,396.09 |
| Rate for Payer: Aetna Commercial |
$972.37
|
| Rate for Payer: Aetna Medicare |
$754.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,044.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$972.37
|
| Rate for Payer: BCBS Complete |
$496.05
|
| Rate for Payer: BCBS MAPPO |
$725.65
|
| Rate for Payer: BCN Commercial |
$1,201.13
|
| Rate for Payer: BCN Medicare Advantage |
$725.65
|
| Rate for Payer: Cash Price |
$1,476.80
|
| Rate for Payer: Cash Price |
$1,476.80
|
| Rate for Payer: Cofinity Commercial |
$1,044.94
|
| Rate for Payer: Cofinity Commercial |
$972.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$725.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$761.93
|
| Rate for Payer: Meridian Medicaid |
$496.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$798.22
|
| Rate for Payer: Nomi Health Commercial |
$870.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,384.50
|
| Rate for Payer: PACE SWMI |
$725.65
|
| Rate for Payer: PHP Commercial |
$1,015.91
|
| Rate for Payer: PHP Medicare Advantage |
$725.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,099.35
|
| Rate for Payer: Priority Health Medicare |
$725.65
|
| Rate for Payer: Priority Health SBD |
$1,099.35
|
| Rate for Payer: Priority Health Tiered Network |
$1,099.35
|
| Rate for Payer: Railroad Medicare Medicare |
$725.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,396.09
|
| Rate for Payer: UHC Core |
$1,396.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$725.65
|
| Rate for Payer: UHC Exchange |
$1,396.09
|
| Rate for Payer: UHC Medicaid |
$472.43
|
| Rate for Payer: UHCCP Medicaid |
$472.43
|
| Rate for Payer: UMR Bronson Commercial |
$849.16
|
|
|
PR SECONDARY REVISION ORBITOCRANIOFACIAL RCNSTJ
|
Professional
|
Both
|
$4,707.00
|
|
|
Service Code
|
HCPCS 21275
|
| Min. Negotiated Rate |
$487.34 |
| Max. Negotiated Rate |
$3,530.25 |
| Rate for Payer: Aetna Commercial |
$1,000.20
|
| Rate for Payer: Aetna Medicare |
$776.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,000.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,074.84
|
| Rate for Payer: BCBS Complete |
$511.71
|
| Rate for Payer: BCBS MAPPO |
$746.42
|
| Rate for Payer: BCN Commercial |
$1,272.84
|
| Rate for Payer: BCN Medicare Advantage |
$746.42
|
| Rate for Payer: Cash Price |
$3,765.60
|
| Rate for Payer: Cash Price |
$3,765.60
|
| Rate for Payer: Cofinity Commercial |
$1,000.20
|
| Rate for Payer: Cofinity Commercial |
$1,074.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$746.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$783.74
|
| Rate for Payer: Meridian Medicaid |
$511.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$821.06
|
| Rate for Payer: Nomi Health Commercial |
$895.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,530.25
|
| Rate for Payer: PACE SWMI |
$746.42
|
| Rate for Payer: PHP Commercial |
$1,044.99
|
| Rate for Payer: PHP Medicare Advantage |
$746.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,360.64
|
| Rate for Payer: Priority Health Medicare |
$746.42
|
| Rate for Payer: Priority Health SBD |
$1,360.64
|
| Rate for Payer: Priority Health Tiered Network |
$1,360.64
|
| Rate for Payer: Railroad Medicare Medicare |
$746.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,475.62
|
| Rate for Payer: UHC Core |
$1,475.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$746.42
|
| Rate for Payer: UHC Exchange |
$1,475.62
|
| Rate for Payer: UHC Medicaid |
$487.34
|
| Rate for Payer: UHCCP Medicaid |
$487.34
|
| Rate for Payer: UMR Bronson Commercial |
$2,165.22
|
|
|
PR SECONDARY RPR DURA CSF LEAK FREE TISSUE GRAFT
|
Professional
|
Both
|
$6,479.00
|
|
|
Service Code
|
HCPCS 61618
|
| Min. Negotiated Rate |
$777.02 |
| Max. Negotiated Rate |
$4,859.25 |
| Rate for Payer: Aetna Commercial |
$1,620.42
|
| Rate for Payer: Aetna Medicare |
$1,257.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,620.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,741.35
|
| Rate for Payer: BCBS Complete |
$815.87
|
| Rate for Payer: BCBS MAPPO |
$1,209.27
|
| Rate for Payer: BCN Commercial |
$2,714.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,209.27
|
| Rate for Payer: Cash Price |
$5,183.20
|
| Rate for Payer: Cash Price |
$5,183.20
|
| Rate for Payer: Cofinity Commercial |
$1,620.42
|
| Rate for Payer: Cofinity Commercial |
$1,741.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,209.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,269.73
|
| Rate for Payer: Meridian Medicaid |
$815.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,330.20
|
| Rate for Payer: Nomi Health Commercial |
$1,451.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,859.25
|
| Rate for Payer: PACE SWMI |
$1,209.27
|
| Rate for Payer: PHP Commercial |
$1,692.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,209.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$777.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.77
|
| Rate for Payer: Priority Health Medicare |
$1,209.27
|
| Rate for Payer: Priority Health SBD |
$2,281.77
|
| Rate for Payer: Priority Health Tiered Network |
$2,281.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,209.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,246.64
|
| Rate for Payer: UHC Core |
$2,246.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,209.27
|
| Rate for Payer: UHC Exchange |
$2,246.64
|
| Rate for Payer: UHC Medicaid |
$777.02
|
| Rate for Payer: UHCCP Medicaid |
$777.02
|
| Rate for Payer: UMR Bronson Commercial |
$2,980.34
|
|
|
PR SEC PRQ TRLUML THRMBC N-CORONARY N-INTRACRANIAL
|
Professional
|
Both
|
$2,644.00
|
|
|
Service Code
|
HCPCS 37186
|
| Min. Negotiated Rate |
$138.88 |
| Max. Negotiated Rate |
$1,983.00 |
| Rate for Payer: Aetna Commercial |
$295.36
|
| Rate for Payer: Aetna Medicare |
$229.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$295.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$317.40
|
| Rate for Payer: BCBS Complete |
$145.82
|
| Rate for Payer: BCBS MAPPO |
$220.42
|
| Rate for Payer: BCN Commercial |
$356.55
|
| Rate for Payer: BCN Medicare Advantage |
$220.42
|
| Rate for Payer: Cash Price |
$2,115.20
|
| Rate for Payer: Cash Price |
$2,115.20
|
| Rate for Payer: Cofinity Commercial |
$295.36
|
| Rate for Payer: Cofinity Commercial |
$317.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$220.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$231.44
|
| Rate for Payer: Meridian Medicaid |
$145.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$242.46
|
| Rate for Payer: Nomi Health Commercial |
$264.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,983.00
|
| Rate for Payer: PACE SWMI |
$220.42
|
| Rate for Payer: PHP Commercial |
$308.59
|
| Rate for Payer: PHP Medicare Advantage |
$220.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$383.43
|
| Rate for Payer: Priority Health Medicare |
$220.42
|
| Rate for Payer: Priority Health SBD |
$383.43
|
| Rate for Payer: Priority Health Tiered Network |
$383.43
|
| Rate for Payer: Railroad Medicare Medicare |
$220.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$438.55
|
| Rate for Payer: UHC Core |
$438.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$220.42
|
| Rate for Payer: UHC Exchange |
$438.55
|
| Rate for Payer: UHC Medicaid |
$138.88
|
| Rate for Payer: UHCCP Medicaid |
$138.88
|
| Rate for Payer: UMR Bronson Commercial |
$1,216.24
|
|
