|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$353.00
|
|
|
Service Code
|
HCPCS 45331
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$264.75 |
| Rate for Payer: Aetna Commercial |
$87.41
|
| Rate for Payer: Aetna Medicare |
$67.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.93
|
| Rate for Payer: BCBS Complete |
$44.73
|
| Rate for Payer: BCBS MAPPO |
$65.23
|
| Rate for Payer: BCN Commercial |
$108.06
|
| Rate for Payer: BCN Medicare Advantage |
$65.23
|
| Rate for Payer: Cash Price |
$282.40
|
| Rate for Payer: Cash Price |
$282.40
|
| Rate for Payer: Cofinity Commercial |
$87.41
|
| Rate for Payer: Cofinity Commercial |
$93.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.49
|
| Rate for Payer: Meridian Medicaid |
$44.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.75
|
| Rate for Payer: Nomi Health Commercial |
$78.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$264.75
|
| Rate for Payer: PACE SWMI |
$65.23
|
| Rate for Payer: PHP Commercial |
$91.32
|
| Rate for Payer: PHP Medicare Advantage |
$65.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$131.66
|
| Rate for Payer: Priority Health Medicare |
$65.23
|
| Rate for Payer: Priority Health SBD |
$131.66
|
| Rate for Payer: Priority Health Tiered Network |
$131.66
|
| Rate for Payer: Railroad Medicare Medicare |
$65.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.14
|
| Rate for Payer: UHC Core |
$125.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.23
|
| Rate for Payer: UHC Exchange |
$125.14
|
| Rate for Payer: UHC Medicaid |
$42.60
|
| Rate for Payer: UHCCP Medicaid |
$42.60
|
| Rate for Payer: UMR Bronson Commercial |
$162.38
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$353.00
|
|
|
Service Code
|
HCPCS 45331
|
| Hospital Charge Code |
45331
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$264.75 |
| Rate for Payer: Aetna Commercial |
$87.41
|
| Rate for Payer: Aetna Medicare |
$67.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.93
|
| Rate for Payer: BCBS Complete |
$44.73
|
| Rate for Payer: BCBS MAPPO |
$65.23
|
| Rate for Payer: BCN Commercial |
$108.06
|
| Rate for Payer: BCN Medicare Advantage |
$65.23
|
| Rate for Payer: Cash Price |
$282.40
|
| Rate for Payer: Cash Price |
$282.40
|
| Rate for Payer: Cofinity Commercial |
$87.41
|
| Rate for Payer: Cofinity Commercial |
$93.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.49
|
| Rate for Payer: Meridian Medicaid |
$44.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.75
|
| Rate for Payer: Nomi Health Commercial |
$78.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$264.75
|
| Rate for Payer: PACE SWMI |
$65.23
|
| Rate for Payer: PHP Commercial |
$91.32
|
| Rate for Payer: PHP Medicare Advantage |
$65.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$131.66
|
| Rate for Payer: Priority Health Medicare |
$65.23
|
| Rate for Payer: Priority Health SBD |
$131.66
|
| Rate for Payer: Priority Health Tiered Network |
$131.66
|
| Rate for Payer: Railroad Medicare Medicare |
$65.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.14
|
| Rate for Payer: UHC Core |
$125.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.23
|
| Rate for Payer: UHC Exchange |
$125.14
|
| Rate for Payer: UHC Medicaid |
$42.60
|
| Rate for Payer: UHCCP Medicaid |
$42.60
|
| Rate for Payer: UMR Bronson Commercial |
$162.38
|
|
|
PR SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S)
|
Professional
|
Both
|
$457.00
|
|
|
Service Code
|
HCPCS 45350
|
| Min. Negotiated Rate |
$58.58 |
| Max. Negotiated Rate |
$342.75 |
| Rate for Payer: Aetna Commercial |
$120.79
|
| Rate for Payer: Aetna Medicare |
$93.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.80
|
| Rate for Payer: BCBS Complete |
$61.51
|
| Rate for Payer: BCBS MAPPO |
$90.14
|
| Rate for Payer: BCN Commercial |
$149.39
|
| Rate for Payer: BCN Medicare Advantage |
$90.14
|
| Rate for Payer: Cash Price |
$365.60
|
| Rate for Payer: Cash Price |
$365.60
|
| Rate for Payer: Cofinity Commercial |
$120.79
|
| Rate for Payer: Cofinity Commercial |
$129.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.65
|
| Rate for Payer: Meridian Medicaid |
$61.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$99.15
|
| Rate for Payer: Nomi Health Commercial |
$108.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$342.75
|
| Rate for Payer: PACE SWMI |
$90.14
|
| Rate for Payer: PHP Commercial |
$126.20
|
| Rate for Payer: PHP Medicare Advantage |
$90.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$182.03
|
| Rate for Payer: Priority Health Medicare |
$90.14
|
| Rate for Payer: Priority Health SBD |
$182.03
|
| Rate for Payer: Priority Health Tiered Network |
$182.03
|
| Rate for Payer: Railroad Medicare Medicare |
$90.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.90
|
| Rate for Payer: UHC Core |
$177.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$90.14
|
| Rate for Payer: UHC Exchange |
$177.90
|
| Rate for Payer: UHC Medicaid |
$58.58
|
| Rate for Payer: UHCCP Medicaid |
$58.58
|
| Rate for Payer: UMR Bronson Commercial |
$210.22
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$536.00
|
|
|
Service Code
|
HCPCS 45332
|
| Min. Negotiated Rate |
$61.13 |
| Max. Negotiated Rate |
$402.00 |
| Rate for Payer: Aetna Commercial |
$126.11
|
| Rate for Payer: Aetna Medicare |
$97.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.52
|
| Rate for Payer: BCBS Complete |
$64.19
|
| Rate for Payer: BCBS MAPPO |
$94.11
|
| Rate for Payer: BCN Commercial |
$155.86
|
| Rate for Payer: BCN Medicare Advantage |
$94.11
|
| Rate for Payer: Cash Price |
$428.80
|
| Rate for Payer: Cash Price |
$428.80
|
| Rate for Payer: Cofinity Commercial |
$126.11
|
| Rate for Payer: Cofinity Commercial |
$135.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.82
|
| Rate for Payer: Meridian Medicaid |
$64.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$103.52
|
| Rate for Payer: Nomi Health Commercial |
$112.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$402.00
|
| Rate for Payer: PACE SWMI |
$94.11
|
| Rate for Payer: PHP Commercial |
$131.75
|
| Rate for Payer: PHP Medicare Advantage |
$94.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$189.91
|
| Rate for Payer: Priority Health Medicare |
$94.11
|
| Rate for Payer: Priority Health SBD |
$189.91
|
| Rate for Payer: Priority Health Tiered Network |
$189.91
|
| Rate for Payer: Railroad Medicare Medicare |
$94.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.33
|
| Rate for Payer: UHC Core |
$185.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$94.11
|
| Rate for Payer: UHC Exchange |
$185.33
|
| Rate for Payer: UHC Medicaid |
$61.13
|
| Rate for Payer: UHCCP Medicaid |
$61.13
|
| Rate for Payer: UMR Bronson Commercial |
$246.56
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS
|
Professional
|
Both
|
$774.00
|
|
|
Service Code
|
HCPCS 45333
|
| Min. Negotiated Rate |
$55.17 |
| Max. Negotiated Rate |
$580.50 |
| Rate for Payer: Aetna Commercial |
$113.85
|
| Rate for Payer: Aetna Medicare |
$88.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.34
|
| Rate for Payer: BCBS Complete |
$57.93
|
| Rate for Payer: BCBS MAPPO |
$84.96
|
| Rate for Payer: BCN Commercial |
$139.93
|
| Rate for Payer: BCN Medicare Advantage |
$84.96
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cofinity Commercial |
$113.85
|
| Rate for Payer: Cofinity Commercial |
$122.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.21
|
| Rate for Payer: Meridian Medicaid |
$57.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$93.46
|
| Rate for Payer: Nomi Health Commercial |
$101.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$580.50
|
| Rate for Payer: PACE SWMI |
$84.96
|
| Rate for Payer: PHP Commercial |
$118.94
|
| Rate for Payer: PHP Medicare Advantage |
$84.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$170.49
|
| Rate for Payer: Priority Health Medicare |
$84.96
|
| Rate for Payer: Priority Health SBD |
$170.49
|
| Rate for Payer: Priority Health Tiered Network |
$170.49
|
| Rate for Payer: Railroad Medicare Medicare |
$84.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.14
|
| Rate for Payer: UHC Core |
$165.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$84.96
|
| Rate for Payer: UHC Exchange |
$165.14
|
| Rate for Payer: UHC Medicaid |
$55.17
|
| Rate for Payer: UHCCP Medicaid |
$55.17
|
| Rate for Payer: UMR Bronson Commercial |
$356.04
|
|
|
PR SIGMOIDOSCOPY,TRANSENDOSCOPIC STENT
|
Professional
|
Both
|
$340.00
|
|
|
Service Code
|
HCPCS 45345
|
| Min. Negotiated Rate |
$136.00 |
| Max. Negotiated Rate |
$255.00 |
| Rate for Payer: Aetna Medicare |
$170.00
|
| Rate for Payer: BCBS Complete |
$136.00
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.00
|
| Rate for Payer: UMR Bronson Commercial |
$156.40
|
|
|
PR SIGMOIDOSCOPY W/STENT
|
Professional
|
Both
|
$340.00
|
|
|
Service Code
|
HCPCS G6023
|
| Min. Negotiated Rate |
$136.00 |
| Max. Negotiated Rate |
$255.00 |
| Rate for Payer: Aetna Medicare |
$170.00
|
| Rate for Payer: BCBS Complete |
$136.00
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.00
|
| Rate for Payer: UMR Bronson Commercial |
$156.40
|
|
|
PR SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS 93278
|
| Min. Negotiated Rate |
$18.86 |
| Max. Negotiated Rate |
$47.31 |
| Rate for Payer: Aetna Commercial |
$41.58
|
| Rate for Payer: Aetna Medicare |
$32.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.68
|
| Rate for Payer: BCBS MAPPO |
$31.03
|
| Rate for Payer: BCN Commercial |
$47.31
|
| Rate for Payer: BCN Medicare Advantage |
$31.03
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cofinity Commercial |
$44.68
|
| Rate for Payer: Cofinity Commercial |
$41.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.13
|
| Rate for Payer: Nomi Health Commercial |
$37.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.75
|
| Rate for Payer: PACE SWMI |
$31.03
|
| Rate for Payer: PHP Commercial |
$43.44
|
| Rate for Payer: PHP Medicare Advantage |
$31.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$44.97
|
| Rate for Payer: Priority Health Medicare |
$31.03
|
| Rate for Payer: Priority Health SBD |
$44.97
|
| Rate for Payer: Priority Health Tiered Network |
$44.97
|
| Rate for Payer: Railroad Medicare Medicare |
$31.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.53
|
| Rate for Payer: UHC Core |
$46.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.03
|
| Rate for Payer: UHC Exchange |
$46.53
|
| Rate for Payer: UMR Bronson Commercial |
$18.86
|
|
|
PR SIMPLE CYSTOMETROGRAM
|
Professional
|
Both
|
$553.00
|
|
|
Service Code
|
HCPCS 51725
|
| Min. Negotiated Rate |
$186.85 |
| Max. Negotiated Rate |
$414.75 |
| Rate for Payer: Aetna Commercial |
$250.38
|
| Rate for Payer: Aetna Medicare |
$194.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.06
|
| Rate for Payer: BCBS MAPPO |
$186.85
|
| Rate for Payer: BCN Commercial |
$309.24
|
| Rate for Payer: BCN Medicare Advantage |
$186.85
|
| Rate for Payer: Cash Price |
$442.40
|
| Rate for Payer: Cash Price |
$442.40
|
| Rate for Payer: Cofinity Commercial |
$269.06
|
| Rate for Payer: Cofinity Commercial |
$250.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$196.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$205.53
|
| Rate for Payer: Nomi Health Commercial |
$224.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$414.75
|
| Rate for Payer: PACE SWMI |
$186.85
|
| Rate for Payer: PHP Commercial |
$261.59
|
| Rate for Payer: PHP Medicare Advantage |
$186.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$186.85
|
| Rate for Payer: Priority Health SBD |
$336.87
|
| Rate for Payer: Priority Health Tiered Network |
$336.87
|
| Rate for Payer: Railroad Medicare Medicare |
$186.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.90
|
| Rate for Payer: UHC Core |
$355.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$186.85
|
| Rate for Payer: UHC Exchange |
$355.90
|
| Rate for Payer: UMR Bronson Commercial |
$254.38
|
|
|
PR SIMPLE IMPLANT REMOVAL, BILATERAL
|
Professional
|
Both
|
$1,803.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$721.20 |
| Max. Negotiated Rate |
$1,352.25 |
| Rate for Payer: Aetna Medicare |
$901.50
|
| Rate for Payer: BCBS Complete |
$721.20
|
| Rate for Payer: Cash Price |
$1,442.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,352.25
|
| Rate for Payer: UMR Bronson Commercial |
$829.38
|
|
|
PR SIMPLE INTRACRANIAL ARYSM CAROTID CIRCULATION
|
Professional
|
Both
|
$10,021.00
|
|
|
Service Code
|
HCPCS 61700
|
| Min. Negotiated Rate |
$2,047.57 |
| Max. Negotiated Rate |
$7,515.75 |
| Rate for Payer: Aetna Commercial |
$4,314.29
|
| Rate for Payer: Aetna Medicare |
$3,348.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,314.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,636.25
|
| Rate for Payer: BCBS Complete |
$2,149.95
|
| Rate for Payer: BCBS MAPPO |
$3,219.62
|
| Rate for Payer: BCN Commercial |
$7,136.34
|
| Rate for Payer: BCN Medicare Advantage |
$3,219.62
|
| Rate for Payer: Cash Price |
$8,016.80
|
| Rate for Payer: Cash Price |
$8,016.80
|
| Rate for Payer: Cofinity Commercial |
$4,314.29
|
| Rate for Payer: Cofinity Commercial |
$4,636.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,219.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,380.60
|
| Rate for Payer: Meridian Medicaid |
$2,149.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,541.58
|
| Rate for Payer: Nomi Health Commercial |
$3,863.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,515.75
|
| Rate for Payer: PACE SWMI |
$3,219.62
|
| Rate for Payer: PHP Commercial |
$4,507.47
|
| Rate for Payer: PHP Medicare Advantage |
$3,219.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,047.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,999.69
|
| Rate for Payer: Priority Health Medicare |
$3,219.62
|
| Rate for Payer: Priority Health SBD |
$5,999.69
|
| Rate for Payer: Priority Health Tiered Network |
$5,999.69
|
| Rate for Payer: Railroad Medicare Medicare |
$3,219.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,044.57
|
| Rate for Payer: UHC Core |
$6,044.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,219.62
|
| Rate for Payer: UHC Exchange |
$6,044.57
|
| Rate for Payer: UHC Medicaid |
$2,047.57
|
| Rate for Payer: UHCCP Medicaid |
$2,047.57
|
| Rate for Payer: UMR Bronson Commercial |
$4,609.66
|
|
|
PR SIMPLE INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ
|
Professional
|
Both
|
$8,929.00
|
|
|
Service Code
|
HCPCS 61702
|
| Min. Negotiated Rate |
$2,435.02 |
| Max. Negotiated Rate |
$8,407.03 |
| Rate for Payer: Aetna Commercial |
$5,138.43
|
| Rate for Payer: Aetna Medicare |
$3,988.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,138.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,521.90
|
| Rate for Payer: BCBS Complete |
$2,556.77
|
| Rate for Payer: BCBS MAPPO |
$3,834.65
|
| Rate for Payer: BCN Commercial |
$8,407.03
|
| Rate for Payer: BCN Medicare Advantage |
$3,834.65
|
| Rate for Payer: Cash Price |
$7,143.20
|
| Rate for Payer: Cash Price |
$7,143.20
|
| Rate for Payer: Cofinity Commercial |
$5,138.43
|
| Rate for Payer: Cofinity Commercial |
$5,521.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,834.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,026.38
|
| Rate for Payer: Meridian Medicaid |
$2,556.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,218.11
|
| Rate for Payer: Nomi Health Commercial |
$4,601.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,696.75
|
| Rate for Payer: PACE SWMI |
$3,834.65
|
| Rate for Payer: PHP Commercial |
$5,368.51
|
| Rate for Payer: PHP Medicare Advantage |
$3,834.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,435.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7,067.99
|
| Rate for Payer: Priority Health Medicare |
$3,834.65
|
| Rate for Payer: Priority Health SBD |
$7,067.99
|
| Rate for Payer: Priority Health Tiered Network |
$7,067.99
|
| Rate for Payer: Railroad Medicare Medicare |
$3,834.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,170.57
|
| Rate for Payer: UHC Core |
$7,170.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,834.65
|
| Rate for Payer: UHC Exchange |
$7,170.57
|
| Rate for Payer: UHC Medicaid |
$2,435.02
|
| Rate for Payer: UHCCP Medicaid |
$2,435.02
|
| Rate for Payer: UMR Bronson Commercial |
$4,107.34
|
|
|
PR SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0 CM
|
Professional
|
Both
|
$684.00
|
|
|
Service Code
|
HCPCS 12016
|
| Min. Negotiated Rate |
$77.96 |
| Max. Negotiated Rate |
$513.00 |
| Rate for Payer: Aetna Commercial |
$165.62
|
| Rate for Payer: Aetna Medicare |
$128.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.98
|
| Rate for Payer: BCBS Complete |
$81.86
|
| Rate for Payer: BCBS MAPPO |
$123.60
|
| Rate for Payer: BCN Commercial |
$189.73
|
| Rate for Payer: BCN Medicare Advantage |
$123.60
|
| Rate for Payer: Cash Price |
$547.20
|
| Rate for Payer: Cash Price |
$547.20
|
| Rate for Payer: Cofinity Commercial |
$165.62
|
| Rate for Payer: Cofinity Commercial |
$177.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.78
|
| Rate for Payer: Meridian Medicaid |
$81.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$135.96
|
| Rate for Payer: Nomi Health Commercial |
$148.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$513.00
|
| Rate for Payer: PACE SWMI |
$123.60
|
| Rate for Payer: PHP Commercial |
$173.04
|
| Rate for Payer: PHP Medicare Advantage |
$123.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$173.65
|
| Rate for Payer: Priority Health Medicare |
$123.60
|
| Rate for Payer: Priority Health SBD |
$173.65
|
| Rate for Payer: Priority Health Tiered Network |
$173.65
|
| Rate for Payer: Railroad Medicare Medicare |
$123.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.66
|
| Rate for Payer: UHC Core |
$233.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$123.60
|
| Rate for Payer: UHC Exchange |
$233.66
|
| Rate for Payer: UHC Medicaid |
$77.96
|
| Rate for Payer: UHCCP Medicaid |
$77.96
|
| Rate for Payer: UMR Bronson Commercial |
$314.64
|
|
|
PR SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM
|
Professional
|
Both
|
$335.00
|
|
|
Service Code
|
HCPCS 12017
|
| Min. Negotiated Rate |
$98.41 |
| Max. Negotiated Rate |
$277.70 |
| Rate for Payer: Aetna Commercial |
$208.40
|
| Rate for Payer: Aetna Medicare |
$161.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.95
|
| Rate for Payer: BCBS Complete |
$103.33
|
| Rate for Payer: BCBS MAPPO |
$155.52
|
| Rate for Payer: BCN Commercial |
$229.08
|
| Rate for Payer: BCN Medicare Advantage |
$155.52
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cofinity Commercial |
$208.40
|
| Rate for Payer: Cofinity Commercial |
$223.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.30
|
| Rate for Payer: Meridian Medicaid |
$103.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$171.07
|
| Rate for Payer: Nomi Health Commercial |
$186.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.25
|
| Rate for Payer: PACE SWMI |
$155.52
|
| Rate for Payer: PHP Commercial |
$217.73
|
| Rate for Payer: PHP Medicare Advantage |
$155.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$209.65
|
| Rate for Payer: Priority Health Medicare |
$155.52
|
| Rate for Payer: Priority Health SBD |
$209.65
|
| Rate for Payer: Priority Health Tiered Network |
$209.65
|
| Rate for Payer: Railroad Medicare Medicare |
$155.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.70
|
| Rate for Payer: UHC Core |
$277.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$155.52
|
| Rate for Payer: UHC Exchange |
$277.70
|
| Rate for Payer: UHC Medicaid |
$98.41
|
| Rate for Payer: UHCCP Medicaid |
$98.41
|
| Rate for Payer: UMR Bronson Commercial |
$154.10
|
|
|
PR SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<
|
Professional
|
Both
|
$315.00
|
|
|
Service Code
|
HCPCS 12011
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$236.25 |
| Rate for Payer: Aetna Commercial |
$72.88
|
| Rate for Payer: Aetna Medicare |
$56.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.32
|
| Rate for Payer: BCBS Complete |
$36.46
|
| Rate for Payer: BCBS MAPPO |
$54.39
|
| Rate for Payer: BCN Commercial |
$83.16
|
| Rate for Payer: BCN Medicare Advantage |
$54.39
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cofinity Commercial |
$72.88
|
| Rate for Payer: Cofinity Commercial |
$78.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.11
|
| Rate for Payer: Meridian Medicaid |
$36.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.83
|
| Rate for Payer: Nomi Health Commercial |
$65.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.25
|
| Rate for Payer: PACE SWMI |
$54.39
|
| Rate for Payer: PHP Commercial |
$76.15
|
| Rate for Payer: PHP Medicare Advantage |
$54.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$76.12
|
| Rate for Payer: Priority Health Medicare |
$54.39
|
| Rate for Payer: Priority Health SBD |
$76.12
|
| Rate for Payer: Priority Health Tiered Network |
$76.12
|
| Rate for Payer: Railroad Medicare Medicare |
$54.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.47
|
| Rate for Payer: UHC Core |
$100.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$54.39
|
| Rate for Payer: UHC Exchange |
$100.47
|
| Rate for Payer: UHC Medicaid |
$34.72
|
| Rate for Payer: UHCCP Medicaid |
$34.72
|
| Rate for Payer: UMR Bronson Commercial |
$144.90
|
|
|
PR SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM
|
Professional
|
Both
|
$369.00
|
|
|
Service Code
|
HCPCS 12013
|
| Min. Negotiated Rate |
$35.57 |
| Max. Negotiated Rate |
$276.75 |
| Rate for Payer: Aetna Commercial |
$75.48
|
| Rate for Payer: Aetna Medicare |
$58.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.12
|
| Rate for Payer: BCBS Complete |
$37.35
|
| Rate for Payer: BCBS MAPPO |
$56.33
|
| Rate for Payer: BCN Commercial |
$86.15
|
| Rate for Payer: BCN Medicare Advantage |
$56.33
|
| Rate for Payer: Cash Price |
$295.20
|
| Rate for Payer: Cash Price |
$295.20
|
| Rate for Payer: Cofinity Commercial |
$75.48
|
| Rate for Payer: Cofinity Commercial |
$81.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.15
|
| Rate for Payer: Meridian Medicaid |
$37.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.96
|
| Rate for Payer: Nomi Health Commercial |
$67.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.75
|
| Rate for Payer: PACE SWMI |
$56.33
|
| Rate for Payer: PHP Commercial |
$78.86
|
| Rate for Payer: PHP Medicare Advantage |
$56.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$78.85
|
| Rate for Payer: Priority Health Medicare |
$56.33
|
| Rate for Payer: Priority Health SBD |
$78.85
|
| Rate for Payer: Priority Health Tiered Network |
$78.85
|
| Rate for Payer: Railroad Medicare Medicare |
$56.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.61
|
| Rate for Payer: UHC Core |
$106.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$56.33
|
| Rate for Payer: UHC Exchange |
$106.61
|
| Rate for Payer: UHC Medicaid |
$35.57
|
| Rate for Payer: UHCCP Medicaid |
$35.57
|
| Rate for Payer: UMR Bronson Commercial |
$169.74
|
|
|
PR SIMPLE REPAIR F/E/E/N/L/M >30.0 CM
|
Professional
|
Both
|
$1,401.00
|
|
|
Service Code
|
HCPCS 12018
|
| Min. Negotiated Rate |
$110.97 |
| Max. Negotiated Rate |
$1,050.75 |
| Rate for Payer: Aetna Commercial |
$235.12
|
| Rate for Payer: Aetna Medicare |
$182.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.66
|
| Rate for Payer: BCBS Complete |
$116.52
|
| Rate for Payer: BCBS MAPPO |
$175.46
|
| Rate for Payer: BCN Commercial |
$259.44
|
| Rate for Payer: BCN Medicare Advantage |
$175.46
|
| Rate for Payer: Cash Price |
$1,120.80
|
| Rate for Payer: Cash Price |
$1,120.80
|
| Rate for Payer: Cofinity Commercial |
$235.12
|
| Rate for Payer: Cofinity Commercial |
$252.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.23
|
| Rate for Payer: Meridian Medicaid |
$116.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$193.01
|
| Rate for Payer: Nomi Health Commercial |
$210.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,050.75
|
| Rate for Payer: PACE SWMI |
$175.46
|
| Rate for Payer: PHP Commercial |
$245.64
|
| Rate for Payer: PHP Medicare Advantage |
$175.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$237.47
|
| Rate for Payer: Priority Health Medicare |
$175.46
|
| Rate for Payer: Priority Health SBD |
$237.47
|
| Rate for Payer: Priority Health Tiered Network |
$237.47
|
| Rate for Payer: Railroad Medicare Medicare |
$175.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.01
|
| Rate for Payer: UHC Core |
$315.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$175.46
|
| Rate for Payer: UHC Exchange |
$315.01
|
| Rate for Payer: UHC Medicaid |
$110.97
|
| Rate for Payer: UHCCP Medicaid |
$110.97
|
| Rate for Payer: UMR Bronson Commercial |
$644.46
|
|
|
PR SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM
|
Professional
|
Both
|
$506.00
|
|
|
Service Code
|
HCPCS 12014
|
| Min. Negotiated Rate |
$46.01 |
| Max. Negotiated Rate |
$379.50 |
| Rate for Payer: Aetna Commercial |
$97.70
|
| Rate for Payer: Aetna Medicare |
$75.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.70
|
| Rate for Payer: BCBS Complete |
$48.31
|
| Rate for Payer: BCBS MAPPO |
$72.91
|
| Rate for Payer: BCN Commercial |
$110.55
|
| Rate for Payer: BCN Medicare Advantage |
$72.91
|
| Rate for Payer: Cash Price |
$404.80
|
| Rate for Payer: Cash Price |
$404.80
|
| Rate for Payer: Cofinity Commercial |
$104.99
|
| Rate for Payer: Cofinity Commercial |
$97.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.56
|
| Rate for Payer: Meridian Medicaid |
$48.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$80.20
|
| Rate for Payer: Nomi Health Commercial |
$87.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$379.50
|
| Rate for Payer: PACE SWMI |
$72.91
|
| Rate for Payer: PHP Commercial |
$102.07
|
| Rate for Payer: PHP Medicare Advantage |
$72.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$101.18
|
| Rate for Payer: Priority Health Medicare |
$72.91
|
| Rate for Payer: Priority Health SBD |
$101.18
|
| Rate for Payer: Priority Health Tiered Network |
$101.18
|
| Rate for Payer: Railroad Medicare Medicare |
$72.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.36
|
| Rate for Payer: UHC Core |
$136.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$72.91
|
| Rate for Payer: UHC Exchange |
$136.36
|
| Rate for Payer: UHC Medicaid |
$46.01
|
| Rate for Payer: UHCCP Medicaid |
$46.01
|
| Rate for Payer: UMR Bronson Commercial |
$232.76
|
|
|
PR SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM
|
Professional
|
Both
|
$653.00
|
|
|
Service Code
|
HCPCS 12015
|
| Min. Negotiated Rate |
$57.51 |
| Max. Negotiated Rate |
$489.75 |
| Rate for Payer: Aetna Commercial |
$122.10
|
| Rate for Payer: Aetna Medicare |
$94.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.21
|
| Rate for Payer: BCBS Complete |
$60.39
|
| Rate for Payer: BCBS MAPPO |
$91.12
|
| Rate for Payer: BCN Commercial |
$139.93
|
| Rate for Payer: BCN Medicare Advantage |
$91.12
|
| Rate for Payer: Cash Price |
$522.40
|
| Rate for Payer: Cash Price |
$522.40
|
| Rate for Payer: Cofinity Commercial |
$122.10
|
| Rate for Payer: Cofinity Commercial |
$131.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.68
|
| Rate for Payer: Meridian Medicaid |
$60.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.23
|
| Rate for Payer: Nomi Health Commercial |
$109.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$489.75
|
| Rate for Payer: PACE SWMI |
$91.12
|
| Rate for Payer: PHP Commercial |
$127.57
|
| Rate for Payer: PHP Medicare Advantage |
$91.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$128.07
|
| Rate for Payer: Priority Health Medicare |
$91.12
|
| Rate for Payer: Priority Health SBD |
$128.07
|
| Rate for Payer: Priority Health Tiered Network |
$128.07
|
| Rate for Payer: Railroad Medicare Medicare |
$91.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.31
|
| Rate for Payer: UHC Core |
$172.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$91.12
|
| Rate for Payer: UHC Exchange |
$172.31
|
| Rate for Payer: UHC Medicaid |
$57.51
|
| Rate for Payer: UHCCP Medicaid |
$57.51
|
| Rate for Payer: UMR Bronson Commercial |
$300.38
|
|
|
PR SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<
|
Professional
|
Both
|
$262.00
|
|
|
Service Code
|
HCPCS 12001
|
| Min. Negotiated Rate |
$28.12 |
| Max. Negotiated Rate |
$196.50 |
| Rate for Payer: Aetna Commercial |
$58.87
|
| Rate for Payer: Aetna Medicare |
$45.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.26
|
| Rate for Payer: BCBS Complete |
$29.53
|
| Rate for Payer: BCBS MAPPO |
$43.93
|
| Rate for Payer: BCN Commercial |
$66.73
|
| Rate for Payer: BCN Medicare Advantage |
$43.93
|
| Rate for Payer: Cash Price |
$209.60
|
| Rate for Payer: Cash Price |
$209.60
|
| Rate for Payer: Cofinity Commercial |
$58.87
|
| Rate for Payer: Cofinity Commercial |
$63.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.13
|
| Rate for Payer: Meridian Medicaid |
$29.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.32
|
| Rate for Payer: Nomi Health Commercial |
$52.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.50
|
| Rate for Payer: PACE SWMI |
$43.93
|
| Rate for Payer: PHP Commercial |
$61.50
|
| Rate for Payer: PHP Medicare Advantage |
$43.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$61.07
|
| Rate for Payer: Priority Health Medicare |
$43.93
|
| Rate for Payer: Priority Health SBD |
$61.07
|
| Rate for Payer: Priority Health Tiered Network |
$61.07
|
| Rate for Payer: Railroad Medicare Medicare |
$43.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.97
|
| Rate for Payer: UHC Core |
$79.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43.93
|
| Rate for Payer: UHC Exchange |
$79.97
|
| Rate for Payer: UHC Medicaid |
$28.12
|
| Rate for Payer: UHCCP Medicaid |
$28.12
|
| Rate for Payer: UMR Bronson Commercial |
$120.52
|
|
|
PR SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM
|
Professional
|
Both
|
$568.00
|
|
|
Service Code
|
HCPCS 12007
|
| Min. Negotiated Rate |
$85.41 |
| Max. Negotiated Rate |
$426.00 |
| Rate for Payer: Aetna Commercial |
$180.87
|
| Rate for Payer: Aetna Medicare |
$140.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.37
|
| Rate for Payer: BCBS Complete |
$89.68
|
| Rate for Payer: BCBS MAPPO |
$134.98
|
| Rate for Payer: BCN Commercial |
$215.63
|
| Rate for Payer: BCN Medicare Advantage |
$134.98
|
| Rate for Payer: Cash Price |
$454.40
|
| Rate for Payer: Cash Price |
$454.40
|
| Rate for Payer: Cofinity Commercial |
$180.87
|
| Rate for Payer: Cofinity Commercial |
$194.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.73
|
| Rate for Payer: Meridian Medicaid |
$89.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$148.48
|
| Rate for Payer: Nomi Health Commercial |
$161.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$426.00
|
| Rate for Payer: PACE SWMI |
$134.98
|
| Rate for Payer: PHP Commercial |
$188.97
|
| Rate for Payer: PHP Medicare Advantage |
$134.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$197.35
|
| Rate for Payer: Priority Health Medicare |
$134.98
|
| Rate for Payer: Priority Health SBD |
$197.35
|
| Rate for Payer: Priority Health Tiered Network |
$197.35
|
| Rate for Payer: Railroad Medicare Medicare |
$134.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.38
|
| Rate for Payer: UHC Core |
$261.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$134.98
|
| Rate for Payer: UHC Exchange |
$261.38
|
| Rate for Payer: UHC Medicaid |
$85.41
|
| Rate for Payer: UHCCP Medicaid |
$85.41
|
| Rate for Payer: UMR Bronson Commercial |
$261.28
|
|
|
PR SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM
|
Professional
|
Both
|
$390.00
|
|
|
Service Code
|
HCPCS 12004
|
| Min. Negotiated Rate |
$46.01 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Aetna Commercial |
$96.91
|
| Rate for Payer: Aetna Medicare |
$75.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.91
|
| Rate for Payer: BCBS Complete |
$48.31
|
| Rate for Payer: BCBS MAPPO |
$72.32
|
| Rate for Payer: BCN Commercial |
$109.06
|
| Rate for Payer: BCN Medicare Advantage |
$72.32
|
| Rate for Payer: Cash Price |
$312.00
|
| Rate for Payer: Cash Price |
$312.00
|
| Rate for Payer: Cofinity Commercial |
$104.14
|
| Rate for Payer: Cofinity Commercial |
$96.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.94
|
| Rate for Payer: Meridian Medicaid |
$48.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$79.55
|
| Rate for Payer: Nomi Health Commercial |
$86.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.50
|
| Rate for Payer: PACE SWMI |
$72.32
|
| Rate for Payer: PHP Commercial |
$101.25
|
| Rate for Payer: PHP Medicare Advantage |
$72.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$99.82
|
| Rate for Payer: Priority Health Medicare |
$72.32
|
| Rate for Payer: Priority Health SBD |
$99.82
|
| Rate for Payer: Priority Health Tiered Network |
$99.82
|
| Rate for Payer: Railroad Medicare Medicare |
$72.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.64
|
| Rate for Payer: UHC Core |
$132.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$72.32
|
| Rate for Payer: UHC Exchange |
$132.64
|
| Rate for Payer: UHC Medicaid |
$46.01
|
| Rate for Payer: UHCCP Medicaid |
$46.01
|
| Rate for Payer: UMR Bronson Commercial |
$179.40
|
|
|
PR SIMPLE UROFLOMETRY
|
Professional
|
Both
|
$93.00
|
|
|
Service Code
|
HCPCS 51736
|
| Min. Negotiated Rate |
$14.13 |
| Max. Negotiated Rate |
$69.75 |
| Rate for Payer: Aetna Commercial |
$18.93
|
| Rate for Payer: Aetna Medicare |
$14.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.35
|
| Rate for Payer: BCBS MAPPO |
$14.13
|
| Rate for Payer: BCN Commercial |
$20.42
|
| Rate for Payer: BCN Medicare Advantage |
$14.13
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Cofinity Commercial |
$18.93
|
| Rate for Payer: Cofinity Commercial |
$20.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.54
|
| Rate for Payer: Nomi Health Commercial |
$16.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.75
|
| Rate for Payer: PACE SWMI |
$14.13
|
| Rate for Payer: PHP Commercial |
$19.78
|
| Rate for Payer: PHP Medicare Advantage |
$14.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$22.24
|
| Rate for Payer: Priority Health Medicare |
$14.13
|
| Rate for Payer: Priority Health SBD |
$22.24
|
| Rate for Payer: Priority Health Tiered Network |
$22.24
|
| Rate for Payer: Railroad Medicare Medicare |
$14.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.42
|
| Rate for Payer: UHC Core |
$23.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.13
|
| Rate for Payer: UHC Exchange |
$23.42
|
| Rate for Payer: UMR Bronson Commercial |
$42.78
|
|
|
PR SINUSOT FRNT NONOBLIT W/OSTPL FLAP CORONAL INC
|
Professional
|
Both
|
$2,207.00
|
|
|
Service Code
|
HCPCS 31087
|
| Min. Negotiated Rate |
$638.15 |
| Max. Negotiated Rate |
$1,884.35 |
| Rate for Payer: Aetna Commercial |
$1,299.61
|
| Rate for Payer: Aetna Medicare |
$1,008.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,299.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,396.60
|
| Rate for Payer: BCBS Complete |
$670.06
|
| Rate for Payer: BCBS MAPPO |
$969.86
|
| Rate for Payer: BCN Commercial |
$1,677.20
|
| Rate for Payer: BCN Medicare Advantage |
$969.86
|
| Rate for Payer: Cash Price |
$1,765.60
|
| Rate for Payer: Cash Price |
$1,765.60
|
| Rate for Payer: Cofinity Commercial |
$1,396.60
|
| Rate for Payer: Cofinity Commercial |
$1,299.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$969.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,018.35
|
| Rate for Payer: Meridian Medicaid |
$670.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,066.85
|
| Rate for Payer: Nomi Health Commercial |
$1,163.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,655.25
|
| Rate for Payer: PACE SWMI |
$969.86
|
| Rate for Payer: PHP Commercial |
$1,357.80
|
| Rate for Payer: PHP Medicare Advantage |
$969.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$638.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,579.42
|
| Rate for Payer: Priority Health Medicare |
$969.86
|
| Rate for Payer: Priority Health SBD |
$1,579.42
|
| Rate for Payer: Priority Health Tiered Network |
$1,579.42
|
| Rate for Payer: Railroad Medicare Medicare |
$969.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,884.35
|
| Rate for Payer: UHC Core |
$1,884.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$969.86
|
| Rate for Payer: UHC Exchange |
$1,884.35
|
| Rate for Payer: UHC Medicaid |
$638.15
|
| Rate for Payer: UHCCP Medicaid |
$638.15
|
| Rate for Payer: UMR Bronson Commercial |
$1,015.22
|
|
|
PR SINUSOT FRNT OBLIT W/O OSTPL FLAP CORONAL INC
|
Professional
|
Both
|
$2,148.00
|
|
|
Service Code
|
HCPCS 31081
|
| Min. Negotiated Rate |
$668.82 |
| Max. Negotiated Rate |
$1,945.89 |
| Rate for Payer: Aetna Commercial |
$1,356.52
|
| Rate for Payer: Aetna Medicare |
$1,052.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,356.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,457.76
|
| Rate for Payer: BCBS Complete |
$702.26
|
| Rate for Payer: BCBS MAPPO |
$1,012.33
|
| Rate for Payer: BCN Commercial |
$1,743.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,012.33
|
| Rate for Payer: Cash Price |
$1,718.40
|
| Rate for Payer: Cash Price |
$1,718.40
|
| Rate for Payer: Cofinity Commercial |
$1,356.52
|
| Rate for Payer: Cofinity Commercial |
$1,457.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,012.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,062.95
|
| Rate for Payer: Meridian Medicaid |
$702.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,113.56
|
| Rate for Payer: Nomi Health Commercial |
$1,214.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,611.00
|
| Rate for Payer: PACE SWMI |
$1,012.33
|
| Rate for Payer: PHP Commercial |
$1,417.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,012.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$668.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,642.26
|
| Rate for Payer: Priority Health Medicare |
$1,012.33
|
| Rate for Payer: Priority Health SBD |
$1,642.26
|
| Rate for Payer: Priority Health Tiered Network |
$1,642.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,012.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,945.89
|
| Rate for Payer: UHC Core |
$1,945.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,012.33
|
| Rate for Payer: UHC Exchange |
$1,945.89
|
| Rate for Payer: UHC Medicaid |
$668.82
|
| Rate for Payer: UHCCP Medicaid |
$668.82
|
| Rate for Payer: UMR Bronson Commercial |
$988.08
|
|
