|
PR SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART
|
Professional
|
Both
|
$985.00
|
|
|
Service Code
|
HCPCS 36015
|
| Min. Negotiated Rate |
$95.00 |
| Max. Negotiated Rate |
$738.75 |
| Rate for Payer: Aetna Commercial |
$200.30
|
| Rate for Payer: Aetna Medicare |
$155.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.25
|
| Rate for Payer: BCBS Complete |
$99.75
|
| Rate for Payer: BCBS MAPPO |
$149.48
|
| Rate for Payer: BCN Commercial |
$252.48
|
| Rate for Payer: BCN Medicare Advantage |
$149.48
|
| Rate for Payer: Cash Price |
$788.00
|
| Rate for Payer: Cash Price |
$788.00
|
| Rate for Payer: Cofinity Commercial |
$200.30
|
| Rate for Payer: Cofinity Commercial |
$215.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.95
|
| Rate for Payer: Meridian Medicaid |
$99.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$164.43
|
| Rate for Payer: Nomi Health Commercial |
$179.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$738.75
|
| Rate for Payer: PACE SWMI |
$149.48
|
| Rate for Payer: PHP Commercial |
$209.27
|
| Rate for Payer: PHP Medicare Advantage |
$149.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$271.51
|
| Rate for Payer: Priority Health Medicare |
$149.48
|
| Rate for Payer: Priority Health SBD |
$271.51
|
| Rate for Payer: Priority Health Tiered Network |
$271.51
|
| Rate for Payer: Railroad Medicare Medicare |
$149.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.14
|
| Rate for Payer: UHC Core |
$308.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$149.48
|
| Rate for Payer: UHC Exchange |
$308.14
|
| Rate for Payer: UHC Medicaid |
$95.00
|
| Rate for Payer: UHCCP Medicaid |
$95.00
|
| Rate for Payer: UMR Bronson Commercial |
$453.10
|
|
|
PR SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH
|
Professional
|
Both
|
$769.00
|
|
|
Service Code
|
HCPCS 36011
|
| Min. Negotiated Rate |
$87.12 |
| Max. Negotiated Rate |
$576.75 |
| Rate for Payer: Aetna Commercial |
$184.26
|
| Rate for Payer: Aetna Medicare |
$143.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.01
|
| Rate for Payer: BCBS Complete |
$91.48
|
| Rate for Payer: BCBS MAPPO |
$137.51
|
| Rate for Payer: BCN Commercial |
$228.07
|
| Rate for Payer: BCN Medicare Advantage |
$137.51
|
| Rate for Payer: Cash Price |
$615.20
|
| Rate for Payer: Cash Price |
$615.20
|
| Rate for Payer: Cofinity Commercial |
$184.26
|
| Rate for Payer: Cofinity Commercial |
$198.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.39
|
| Rate for Payer: Meridian Medicaid |
$91.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$151.26
|
| Rate for Payer: Nomi Health Commercial |
$165.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$576.75
|
| Rate for Payer: PACE SWMI |
$137.51
|
| Rate for Payer: PHP Commercial |
$192.51
|
| Rate for Payer: PHP Medicare Advantage |
$137.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$245.27
|
| Rate for Payer: Priority Health Medicare |
$137.51
|
| Rate for Payer: Priority Health SBD |
$245.27
|
| Rate for Payer: Priority Health Tiered Network |
$245.27
|
| Rate for Payer: Railroad Medicare Medicare |
$137.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$281.88
|
| Rate for Payer: UHC Core |
$281.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$137.51
|
| Rate for Payer: UHC Exchange |
$281.88
|
| Rate for Payer: UHC Medicaid |
$87.12
|
| Rate for Payer: UHCCP Medicaid |
$87.12
|
| Rate for Payer: UMR Bronson Commercial |
$353.74
|
|
|
PR SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC
|
Professional
|
Both
|
$1,009.00
|
|
|
Service Code
|
HCPCS 36012
|
| Min. Negotiated Rate |
$97.98 |
| Max. Negotiated Rate |
$756.75 |
| Rate for Payer: Aetna Commercial |
$207.28
|
| Rate for Payer: Aetna Medicare |
$160.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.75
|
| Rate for Payer: BCBS Complete |
$102.88
|
| Rate for Payer: BCBS MAPPO |
$154.69
|
| Rate for Payer: BCN Commercial |
$255.97
|
| Rate for Payer: BCN Medicare Advantage |
$154.69
|
| Rate for Payer: Cash Price |
$807.20
|
| Rate for Payer: Cash Price |
$807.20
|
| Rate for Payer: Cofinity Commercial |
$207.28
|
| Rate for Payer: Cofinity Commercial |
$222.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.42
|
| Rate for Payer: Meridian Medicaid |
$102.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$170.16
|
| Rate for Payer: Nomi Health Commercial |
$185.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$756.75
|
| Rate for Payer: PACE SWMI |
$154.69
|
| Rate for Payer: PHP Commercial |
$216.57
|
| Rate for Payer: PHP Medicare Advantage |
$154.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$275.25
|
| Rate for Payer: Priority Health Medicare |
$154.69
|
| Rate for Payer: Priority Health SBD |
$275.25
|
| Rate for Payer: Priority Health Tiered Network |
$275.25
|
| Rate for Payer: Railroad Medicare Medicare |
$154.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.18
|
| Rate for Payer: UHC Core |
$311.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$154.69
|
| Rate for Payer: UHC Exchange |
$311.18
|
| Rate for Payer: UHC Medicaid |
$97.98
|
| Rate for Payer: UHCCP Medicaid |
$97.98
|
| Rate for Payer: UMR Bronson Commercial |
$464.14
|
|
|
PR SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY
|
Professional
|
Both
|
$1,842.00
|
|
|
Service Code
|
HCPCS 36225
|
| Min. Negotiated Rate |
$187.65 |
| Max. Negotiated Rate |
$1,381.50 |
| Rate for Payer: Aetna Commercial |
$398.19
|
| Rate for Payer: Aetna Medicare |
$309.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$398.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$427.91
|
| Rate for Payer: BCBS Complete |
$197.03
|
| Rate for Payer: BCBS MAPPO |
$297.16
|
| Rate for Payer: BCN Commercial |
$486.53
|
| Rate for Payer: BCN Medicare Advantage |
$297.16
|
| Rate for Payer: Cash Price |
$1,473.60
|
| Rate for Payer: Cash Price |
$1,473.60
|
| Rate for Payer: Cofinity Commercial |
$398.19
|
| Rate for Payer: Cofinity Commercial |
$427.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.02
|
| Rate for Payer: Meridian Medicaid |
$197.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$326.88
|
| Rate for Payer: Nomi Health Commercial |
$356.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,381.50
|
| Rate for Payer: PACE SWMI |
$297.16
|
| Rate for Payer: PHP Commercial |
$416.02
|
| Rate for Payer: PHP Medicare Advantage |
$297.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$523.21
|
| Rate for Payer: Priority Health Medicare |
$297.16
|
| Rate for Payer: Priority Health SBD |
$523.21
|
| Rate for Payer: Priority Health Tiered Network |
$523.21
|
| Rate for Payer: Railroad Medicare Medicare |
$297.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$563.45
|
| Rate for Payer: UHC Core |
$563.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$297.16
|
| Rate for Payer: UHC Exchange |
$563.45
|
| Rate for Payer: UHC Medicaid |
$187.65
|
| Rate for Payer: UHCCP Medicaid |
$187.65
|
| Rate for Payer: UMR Bronson Commercial |
$847.32
|
|
|
PR SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY
|
Professional
|
Both
|
$1,298.00
|
|
|
Service Code
|
HCPCS 36226
|
| Min. Negotiated Rate |
$210.02 |
| Max. Negotiated Rate |
$973.50 |
| Rate for Payer: Aetna Commercial |
$445.19
|
| Rate for Payer: Aetna Medicare |
$345.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$445.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.41
|
| Rate for Payer: BCBS Complete |
$220.52
|
| Rate for Payer: BCBS MAPPO |
$332.23
|
| Rate for Payer: BCN Commercial |
$545.79
|
| Rate for Payer: BCN Medicare Advantage |
$332.23
|
| Rate for Payer: Cash Price |
$1,038.40
|
| Rate for Payer: Cash Price |
$1,038.40
|
| Rate for Payer: Cofinity Commercial |
$445.19
|
| Rate for Payer: Cofinity Commercial |
$478.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$348.84
|
| Rate for Payer: Meridian Medicaid |
$220.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$365.45
|
| Rate for Payer: Nomi Health Commercial |
$398.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$973.50
|
| Rate for Payer: PACE SWMI |
$332.23
|
| Rate for Payer: PHP Commercial |
$465.12
|
| Rate for Payer: PHP Medicare Advantage |
$332.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$586.93
|
| Rate for Payer: Priority Health Medicare |
$332.23
|
| Rate for Payer: Priority Health SBD |
$586.93
|
| Rate for Payer: Priority Health Tiered Network |
$586.93
|
| Rate for Payer: Railroad Medicare Medicare |
$332.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$631.95
|
| Rate for Payer: UHC Core |
$631.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$332.23
|
| Rate for Payer: UHC Exchange |
$631.95
|
| Rate for Payer: UHC Medicaid |
$210.02
|
| Rate for Payer: UHCCP Medicaid |
$210.02
|
| Rate for Payer: UMR Bronson Commercial |
$597.08
|
|
|
PR SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
HCPCS 36227
|
| Min. Negotiated Rate |
$69.01 |
| Max. Negotiated Rate |
$307.50 |
| Rate for Payer: Aetna Commercial |
$146.62
|
| Rate for Payer: Aetna Medicare |
$113.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.56
|
| Rate for Payer: BCBS Complete |
$72.46
|
| Rate for Payer: BCBS MAPPO |
$109.42
|
| Rate for Payer: BCN Commercial |
$179.77
|
| Rate for Payer: BCN Medicare Advantage |
$109.42
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$146.62
|
| Rate for Payer: Cofinity Commercial |
$157.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.89
|
| Rate for Payer: Meridian Medicaid |
$72.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.36
|
| Rate for Payer: Nomi Health Commercial |
$131.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.50
|
| Rate for Payer: PACE SWMI |
$109.42
|
| Rate for Payer: PHP Commercial |
$153.19
|
| Rate for Payer: PHP Medicare Advantage |
$109.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$193.32
|
| Rate for Payer: Priority Health Medicare |
$109.42
|
| Rate for Payer: Priority Health SBD |
$193.32
|
| Rate for Payer: Priority Health Tiered Network |
$193.32
|
| Rate for Payer: Railroad Medicare Medicare |
$109.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.77
|
| Rate for Payer: UHC Core |
$209.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$109.42
|
| Rate for Payer: UHC Exchange |
$209.77
|
| Rate for Payer: UHC Medicaid |
$69.01
|
| Rate for Payer: UHCCP Medicaid |
$69.01
|
| Rate for Payer: UMR Bronson Commercial |
$188.60
|
|
|
PR SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT
|
Professional
|
Both
|
$584.00
|
|
|
Service Code
|
HCPCS 95806
|
| Min. Negotiated Rate |
$97.31 |
| Max. Negotiated Rate |
$438.00 |
| Rate for Payer: Aetna Commercial |
$130.40
|
| Rate for Payer: Aetna Commercial |
$130.40
|
| Rate for Payer: Aetna Medicare |
$101.20
|
| Rate for Payer: Aetna Medicare |
$101.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.40
|
| Rate for Payer: BCBS MAPPO |
$97.31
|
| Rate for Payer: BCBS MAPPO |
$97.31
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: BCN Medicare Advantage |
$97.31
|
| Rate for Payer: BCN Medicare Advantage |
$97.31
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$467.20
|
| Rate for Payer: Cash Price |
$467.20
|
| Rate for Payer: Cofinity Commercial |
$140.13
|
| Rate for Payer: Cofinity Commercial |
$140.13
|
| Rate for Payer: Cofinity Commercial |
$130.40
|
| Rate for Payer: Cofinity Commercial |
$130.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.04
|
| Rate for Payer: Nomi Health Commercial |
$116.77
|
| Rate for Payer: Nomi Health Commercial |
$116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$438.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.75
|
| Rate for Payer: PACE SWMI |
$97.31
|
| Rate for Payer: PACE SWMI |
$97.31
|
| Rate for Payer: PHP Commercial |
$136.23
|
| Rate for Payer: PHP Commercial |
$136.23
|
| Rate for Payer: PHP Medicare Advantage |
$97.31
|
| Rate for Payer: PHP Medicare Advantage |
$97.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$132.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$132.27
|
| Rate for Payer: Priority Health Medicare |
$97.31
|
| Rate for Payer: Priority Health Medicare |
$97.31
|
| Rate for Payer: Priority Health SBD |
$132.27
|
| Rate for Payer: Priority Health SBD |
$132.27
|
| Rate for Payer: Priority Health Tiered Network |
$132.27
|
| Rate for Payer: Priority Health Tiered Network |
$132.27
|
| Rate for Payer: Railroad Medicare Medicare |
$97.31
|
| Rate for Payer: Railroad Medicare Medicare |
$97.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.24
|
| Rate for Payer: UHC Core |
$180.24
|
| Rate for Payer: UHC Core |
$180.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.31
|
| Rate for Payer: UHC Exchange |
$180.24
|
| Rate for Payer: UHC Exchange |
$180.24
|
| Rate for Payer: UMR Bronson Commercial |
$70.38
|
| Rate for Payer: UMR Bronson Commercial |
$268.64
|
|
|
PR SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN
|
Professional
|
Both
|
$1,534.00
|
|
|
Service Code
|
HCPCS 95807
|
| Min. Negotiated Rate |
$409.83 |
| Max. Negotiated Rate |
$1,150.50 |
| Rate for Payer: Aetna Commercial |
$549.17
|
| Rate for Payer: Aetna Commercial |
$549.17
|
| Rate for Payer: Aetna Medicare |
$426.22
|
| Rate for Payer: Aetna Medicare |
$426.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$549.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$590.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$590.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$549.17
|
| Rate for Payer: BCBS MAPPO |
$409.83
|
| Rate for Payer: BCBS MAPPO |
$409.83
|
| Rate for Payer: BCN Commercial |
$487.73
|
| Rate for Payer: BCN Commercial |
$487.73
|
| Rate for Payer: BCN Medicare Advantage |
$409.83
|
| Rate for Payer: BCN Medicare Advantage |
$409.83
|
| Rate for Payer: Cash Price |
$121.60
|
| Rate for Payer: Cash Price |
$121.60
|
| Rate for Payer: Cash Price |
$1,227.20
|
| Rate for Payer: Cash Price |
$1,227.20
|
| Rate for Payer: Cofinity Commercial |
$590.16
|
| Rate for Payer: Cofinity Commercial |
$590.16
|
| Rate for Payer: Cofinity Commercial |
$549.17
|
| Rate for Payer: Cofinity Commercial |
$549.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$430.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$430.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$450.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$450.81
|
| Rate for Payer: Nomi Health Commercial |
$491.80
|
| Rate for Payer: Nomi Health Commercial |
$491.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,150.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.00
|
| Rate for Payer: PACE SWMI |
$409.83
|
| Rate for Payer: PACE SWMI |
$409.83
|
| Rate for Payer: PHP Commercial |
$573.76
|
| Rate for Payer: PHP Commercial |
$573.76
|
| Rate for Payer: PHP Medicare Advantage |
$409.83
|
| Rate for Payer: PHP Medicare Advantage |
$409.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$570.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$570.38
|
| Rate for Payer: Priority Health Medicare |
$409.83
|
| Rate for Payer: Priority Health Medicare |
$409.83
|
| Rate for Payer: Priority Health SBD |
$570.38
|
| Rate for Payer: Priority Health SBD |
$570.38
|
| Rate for Payer: Priority Health Tiered Network |
$570.38
|
| Rate for Payer: Priority Health Tiered Network |
$570.38
|
| Rate for Payer: Railroad Medicare Medicare |
$409.83
|
| Rate for Payer: Railroad Medicare Medicare |
$409.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$617.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$617.87
|
| Rate for Payer: UHC Core |
$617.87
|
| Rate for Payer: UHC Core |
$617.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$409.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$409.83
|
| Rate for Payer: UHC Exchange |
$617.87
|
| Rate for Payer: UHC Exchange |
$617.87
|
| Rate for Payer: UMR Bronson Commercial |
$69.92
|
| Rate for Payer: UMR Bronson Commercial |
$705.64
|
|
|
PR SLING OPERATION STRESS INCONTINENCE
|
Professional
|
Both
|
$2,348.00
|
|
|
Service Code
|
HCPCS 57288
|
| Min. Negotiated Rate |
$423.23 |
| Max. Negotiated Rate |
$1,761.00 |
| Rate for Payer: Aetna Commercial |
$876.48
|
| Rate for Payer: Aetna Medicare |
$680.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$876.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$941.89
|
| Rate for Payer: BCBS Complete |
$444.39
|
| Rate for Payer: BCBS MAPPO |
$654.09
|
| Rate for Payer: BCN Commercial |
$1,543.82
|
| Rate for Payer: BCN Medicare Advantage |
$654.09
|
| Rate for Payer: Cash Price |
$1,878.40
|
| Rate for Payer: Cash Price |
$1,878.40
|
| Rate for Payer: Cofinity Commercial |
$876.48
|
| Rate for Payer: Cofinity Commercial |
$941.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$654.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$686.79
|
| Rate for Payer: Meridian Medicaid |
$444.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$719.50
|
| Rate for Payer: Nomi Health Commercial |
$784.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,761.00
|
| Rate for Payer: PACE SWMI |
$654.09
|
| Rate for Payer: PHP Commercial |
$915.73
|
| Rate for Payer: PHP Medicare Advantage |
$654.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,131.76
|
| Rate for Payer: Priority Health Medicare |
$654.09
|
| Rate for Payer: Priority Health SBD |
$1,131.76
|
| Rate for Payer: Priority Health Tiered Network |
$1,131.76
|
| Rate for Payer: Railroad Medicare Medicare |
$654.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,291.20
|
| Rate for Payer: UHC Core |
$1,291.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$654.09
|
| Rate for Payer: UHC Exchange |
$1,291.20
|
| Rate for Payer: UHC Medicaid |
$423.23
|
| Rate for Payer: UHCCP Medicaid |
$423.23
|
| Rate for Payer: UMR Bronson Commercial |
$1,080.08
|
|
|
PR SLING OPRATION CORRJ MALE URINARY INCONTINENCE
|
Professional
|
Both
|
$1,727.00
|
|
|
Service Code
|
HCPCS 53440
|
| Min. Negotiated Rate |
$434.52 |
| Max. Negotiated Rate |
$1,328.52 |
| Rate for Payer: Aetna Commercial |
$900.49
|
| Rate for Payer: Aetna Medicare |
$698.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$900.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$967.69
|
| Rate for Payer: BCBS Complete |
$456.25
|
| Rate for Payer: BCBS MAPPO |
$672.01
|
| Rate for Payer: BCN Commercial |
$1,127.43
|
| Rate for Payer: BCN Medicare Advantage |
$672.01
|
| Rate for Payer: Cash Price |
$1,381.60
|
| Rate for Payer: Cash Price |
$1,381.60
|
| Rate for Payer: Cofinity Commercial |
$900.49
|
| Rate for Payer: Cofinity Commercial |
$967.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$672.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$705.61
|
| Rate for Payer: Meridian Medicaid |
$456.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$739.21
|
| Rate for Payer: Nomi Health Commercial |
$806.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,295.25
|
| Rate for Payer: PACE SWMI |
$672.01
|
| Rate for Payer: PHP Commercial |
$940.81
|
| Rate for Payer: PHP Medicare Advantage |
$672.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$434.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,228.13
|
| Rate for Payer: Priority Health Medicare |
$672.01
|
| Rate for Payer: Priority Health SBD |
$1,228.13
|
| Rate for Payer: Priority Health Tiered Network |
$1,228.13
|
| Rate for Payer: Railroad Medicare Medicare |
$672.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,328.52
|
| Rate for Payer: UHC Core |
$1,328.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$672.01
|
| Rate for Payer: UHC Exchange |
$1,328.52
|
| Rate for Payer: UHC Medicaid |
$434.52
|
| Rate for Payer: UHCCP Medicaid |
$434.52
|
| Rate for Payer: UMR Bronson Commercial |
$794.42
|
|
|
PR SLINGS
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS A4565
|
| Min. Negotiated Rate |
$3.58 |
| Max. Negotiated Rate |
$15.81 |
| Rate for Payer: Aetna Commercial |
$14.71
|
| Rate for Payer: Aetna Medicare |
$11.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.81
|
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: BCBS MAPPO |
$10.98
|
| Rate for Payer: BCN Commercial |
$10.51
|
| Rate for Payer: BCN Medicare Advantage |
$10.98
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$14.71
|
| Rate for Payer: Cofinity Commercial |
$15.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.08
|
| Rate for Payer: Nomi Health Commercial |
$13.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.00
|
| Rate for Payer: PACE SWMI |
$10.98
|
| Rate for Payer: PHP Commercial |
$15.37
|
| Rate for Payer: PHP Medicare Advantage |
$10.98
|
| Rate for Payer: Priority Health Medicare |
$10.98
|
| Rate for Payer: Railroad Medicare Medicare |
$10.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.58
|
| Rate for Payer: UHC Core |
$3.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.98
|
| Rate for Payer: UHC Exchange |
$3.58
|
| Rate for Payer: UMR Bronson Commercial |
$5.52
|
|
|
PR SLITTING PREPUCE DORSAL/LAT SPX XCP NEWBORN
|
Professional
|
Both
|
$345.00
|
|
|
Service Code
|
HCPCS 54001
|
| Min. Negotiated Rate |
$82.64 |
| Max. Negotiated Rate |
$258.75 |
| Rate for Payer: Aetna Commercial |
$169.64
|
| Rate for Payer: Aetna Medicare |
$131.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.64
|
| Rate for Payer: BCBS Complete |
$86.77
|
| Rate for Payer: BCBS MAPPO |
$126.60
|
| Rate for Payer: BCN Commercial |
$212.64
|
| Rate for Payer: BCN Medicare Advantage |
$126.60
|
| Rate for Payer: Cash Price |
$276.00
|
| Rate for Payer: Cash Price |
$276.00
|
| Rate for Payer: Cofinity Commercial |
$182.30
|
| Rate for Payer: Cofinity Commercial |
$169.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.93
|
| Rate for Payer: Meridian Medicaid |
$86.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$139.26
|
| Rate for Payer: Nomi Health Commercial |
$151.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$258.75
|
| Rate for Payer: PACE SWMI |
$126.60
|
| Rate for Payer: PHP Commercial |
$177.24
|
| Rate for Payer: PHP Medicare Advantage |
$126.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$231.63
|
| Rate for Payer: Priority Health Medicare |
$126.60
|
| Rate for Payer: Priority Health SBD |
$231.63
|
| Rate for Payer: Priority Health Tiered Network |
$231.63
|
| Rate for Payer: Railroad Medicare Medicare |
$126.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.37
|
| Rate for Payer: UHC Core |
$244.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$126.60
|
| Rate for Payer: UHC Exchange |
$244.37
|
| Rate for Payer: UHC Medicaid |
$82.64
|
| Rate for Payer: UHCCP Medicaid |
$82.64
|
| Rate for Payer: UMR Bronson Commercial |
$158.70
|
|
|
PR SLP STDY UNATND W/HRT RATE/O2 SAT/RESP/SLP TIME
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
HCPCS 95800
|
| Min. Negotiated Rate |
$43.24 |
| Max. Negotiated Rate |
$253.20 |
| Rate for Payer: Aetna Commercial |
$176.67
|
| Rate for Payer: Aetna Commercial |
$176.67
|
| Rate for Payer: Aetna Medicare |
$137.11
|
| Rate for Payer: Aetna Medicare |
$137.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.67
|
| Rate for Payer: BCBS MAPPO |
$131.84
|
| Rate for Payer: BCBS MAPPO |
$131.84
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: BCN Medicare Advantage |
$131.84
|
| Rate for Payer: BCN Medicare Advantage |
$131.84
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cofinity Commercial |
$189.85
|
| Rate for Payer: Cofinity Commercial |
$189.85
|
| Rate for Payer: Cofinity Commercial |
$176.67
|
| Rate for Payer: Cofinity Commercial |
$176.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$138.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$138.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.02
|
| Rate for Payer: Nomi Health Commercial |
$158.21
|
| Rate for Payer: Nomi Health Commercial |
$158.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.25
|
| Rate for Payer: PACE SWMI |
$131.84
|
| Rate for Payer: PACE SWMI |
$131.84
|
| Rate for Payer: PHP Commercial |
$184.58
|
| Rate for Payer: PHP Commercial |
$184.58
|
| Rate for Payer: PHP Medicare Advantage |
$131.84
|
| Rate for Payer: PHP Medicare Advantage |
$131.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$176.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$176.80
|
| Rate for Payer: Priority Health Medicare |
$131.84
|
| Rate for Payer: Priority Health Medicare |
$131.84
|
| Rate for Payer: Priority Health SBD |
$176.80
|
| Rate for Payer: Priority Health SBD |
$176.80
|
| Rate for Payer: Priority Health Tiered Network |
$176.80
|
| Rate for Payer: Priority Health Tiered Network |
$176.80
|
| Rate for Payer: Railroad Medicare Medicare |
$131.84
|
| Rate for Payer: Railroad Medicare Medicare |
$131.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.20
|
| Rate for Payer: UHC Core |
$253.20
|
| Rate for Payer: UHC Core |
$253.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$131.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$131.84
|
| Rate for Payer: UHC Exchange |
$253.20
|
| Rate for Payer: UHC Exchange |
$253.20
|
| Rate for Payer: UMR Bronson Commercial |
$144.90
|
| Rate for Payer: UMR Bronson Commercial |
$43.24
|
|
|
PR SMOKE/TOBACCO COUNSELNG 3-10
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS G0375
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$15.75 |
| Rate for Payer: Aetna Medicare |
$10.50
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
| Rate for Payer: UMR Bronson Commercial |
$9.66
|
|
|
PR SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM
|
Professional
|
Both
|
$315.00
|
|
|
Service Code
|
HCPCS 12002
|
| Min. Negotiated Rate |
$36.64 |
| Max. Negotiated Rate |
$236.25 |
| Rate for Payer: Aetna Commercial |
$76.93
|
| Rate for Payer: Aetna Medicare |
$59.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.67
|
| Rate for Payer: BCBS Complete |
$38.47
|
| Rate for Payer: BCBS MAPPO |
$57.41
|
| Rate for Payer: BCN Commercial |
$87.65
|
| Rate for Payer: BCN Medicare Advantage |
$57.41
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cofinity Commercial |
$82.67
|
| Rate for Payer: Cofinity Commercial |
$76.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.28
|
| Rate for Payer: Meridian Medicaid |
$38.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.15
|
| Rate for Payer: Nomi Health Commercial |
$68.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.25
|
| Rate for Payer: PACE SWMI |
$57.41
|
| Rate for Payer: PHP Commercial |
$80.37
|
| Rate for Payer: PHP Medicare Advantage |
$57.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$80.22
|
| Rate for Payer: Priority Health Medicare |
$57.41
|
| Rate for Payer: Priority Health SBD |
$80.22
|
| Rate for Payer: Priority Health Tiered Network |
$80.22
|
| Rate for Payer: Railroad Medicare Medicare |
$57.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.64
|
| Rate for Payer: UHC Core |
$106.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$57.41
|
| Rate for Payer: UHC Exchange |
$106.64
|
| Rate for Payer: UHC Medicaid |
$36.64
|
| Rate for Payer: UHCCP Medicaid |
$36.64
|
| Rate for Payer: UMR Bronson Commercial |
$144.90
|
|
|
PR SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM
|
Professional
|
Both
|
$590.00
|
|
|
Service Code
|
HCPCS 12005
|
| Min. Negotiated Rate |
$57.30 |
| Max. Negotiated Rate |
$442.50 |
| Rate for Payer: Aetna Commercial |
$121.55
|
| Rate for Payer: Aetna Medicare |
$94.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.62
|
| Rate for Payer: BCBS Complete |
$60.16
|
| Rate for Payer: BCBS MAPPO |
$90.71
|
| Rate for Payer: BCN Commercial |
$140.43
|
| Rate for Payer: BCN Medicare Advantage |
$90.71
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Cofinity Commercial |
$121.55
|
| Rate for Payer: Cofinity Commercial |
$130.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.25
|
| Rate for Payer: Meridian Medicaid |
$60.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$99.78
|
| Rate for Payer: Nomi Health Commercial |
$108.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$442.50
|
| Rate for Payer: PACE SWMI |
$90.71
|
| Rate for Payer: PHP Commercial |
$126.99
|
| Rate for Payer: PHP Medicare Advantage |
$90.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$128.53
|
| Rate for Payer: Priority Health Medicare |
$90.71
|
| Rate for Payer: Priority Health SBD |
$128.53
|
| Rate for Payer: Priority Health Tiered Network |
$128.53
|
| Rate for Payer: Railroad Medicare Medicare |
$90.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.41
|
| Rate for Payer: UHC Core |
$173.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$90.71
|
| Rate for Payer: UHC Exchange |
$173.41
|
| Rate for Payer: UHC Medicaid |
$57.30
|
| Rate for Payer: UHCCP Medicaid |
$57.30
|
| Rate for Payer: UMR Bronson Commercial |
$271.40
|
|
|
PR SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM
|
Professional
|
Both
|
$753.00
|
|
|
Service Code
|
HCPCS 12006
|
| Min. Negotiated Rate |
$69.65 |
| Max. Negotiated Rate |
$564.75 |
| Rate for Payer: Aetna Commercial |
$147.63
|
| Rate for Payer: Aetna Medicare |
$114.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.64
|
| Rate for Payer: BCBS Complete |
$73.13
|
| Rate for Payer: BCBS MAPPO |
$110.17
|
| Rate for Payer: BCN Commercial |
$173.80
|
| Rate for Payer: BCN Medicare Advantage |
$110.17
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cofinity Commercial |
$147.63
|
| Rate for Payer: Cofinity Commercial |
$158.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.68
|
| Rate for Payer: Meridian Medicaid |
$73.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$121.19
|
| Rate for Payer: Nomi Health Commercial |
$132.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$564.75
|
| Rate for Payer: PACE SWMI |
$110.17
|
| Rate for Payer: PHP Commercial |
$154.24
|
| Rate for Payer: PHP Medicare Advantage |
$110.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$159.07
|
| Rate for Payer: Priority Health Medicare |
$110.17
|
| Rate for Payer: Priority Health SBD |
$159.07
|
| Rate for Payer: Priority Health Tiered Network |
$159.07
|
| Rate for Payer: Railroad Medicare Medicare |
$110.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.26
|
| Rate for Payer: UHC Core |
$212.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$110.17
|
| Rate for Payer: UHC Exchange |
$212.26
|
| Rate for Payer: UHC Medicaid |
$69.65
|
| Rate for Payer: UHCCP Medicaid |
$69.65
|
| Rate for Payer: UMR Bronson Commercial |
$346.38
|
|
|
PR SO 8 ABD RESTRAINT PRE OTS
|
Professional
|
Both
|
$71.00
|
|
|
Service Code
|
HCPCS L3650
|
| Min. Negotiated Rate |
$26.28 |
| Max. Negotiated Rate |
$116.06 |
| Rate for Payer: Aetna Commercial |
$108.00
|
| Rate for Payer: Aetna Medicare |
$83.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.06
|
| Rate for Payer: BCBS Complete |
$28.40
|
| Rate for Payer: BCBS MAPPO |
$80.60
|
| Rate for Payer: BCN Commercial |
$77.17
|
| Rate for Payer: BCN Medicare Advantage |
$80.60
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cofinity Commercial |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$108.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.66
|
| Rate for Payer: Nomi Health Commercial |
$96.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.25
|
| Rate for Payer: PACE SWMI |
$80.60
|
| Rate for Payer: PHP Commercial |
$112.84
|
| Rate for Payer: PHP Medicare Advantage |
$80.60
|
| Rate for Payer: Priority Health Medicare |
$80.60
|
| Rate for Payer: Railroad Medicare Medicare |
$80.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.28
|
| Rate for Payer: UHC Core |
$26.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.60
|
| Rate for Payer: UHC Exchange |
$26.28
|
| Rate for Payer: UMR Bronson Commercial |
$32.66
|
|
|
PR SPECIAL CASTING MATERIAL
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS A4590
|
| Min. Negotiated Rate |
$10.30 |
| Max. Negotiated Rate |
$59.25 |
| Rate for Payer: Aetna Commercial |
$19.84
|
| Rate for Payer: Aetna Medicare |
$39.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.84
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: BCN Commercial |
$25.00
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.30
|
| Rate for Payer: UHC Core |
$10.30
|
| Rate for Payer: UHC Exchange |
$10.30
|
| Rate for Payer: UMR Bronson Commercial |
$36.34
|
|
|
PR SPEECH AUDIOMETRY THRESHOLD
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 92555
|
| Min. Negotiated Rate |
$19.32 |
| Max. Negotiated Rate |
$45.32 |
| Rate for Payer: Aetna Commercial |
$36.46
|
| Rate for Payer: Aetna Medicare |
$28.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.18
|
| Rate for Payer: BCBS MAPPO |
$27.21
|
| Rate for Payer: BCN Commercial |
$45.32
|
| Rate for Payer: BCN Medicare Advantage |
$27.21
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$36.46
|
| Rate for Payer: Cofinity Commercial |
$39.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.93
|
| Rate for Payer: Nomi Health Commercial |
$32.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.50
|
| Rate for Payer: PACE SWMI |
$27.21
|
| Rate for Payer: PHP Commercial |
$38.09
|
| Rate for Payer: PHP Medicare Advantage |
$27.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$41.80
|
| Rate for Payer: Priority Health Medicare |
$27.21
|
| Rate for Payer: Priority Health SBD |
$41.80
|
| Rate for Payer: Priority Health Tiered Network |
$41.80
|
| Rate for Payer: Railroad Medicare Medicare |
$27.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.68
|
| Rate for Payer: UHC Core |
$35.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27.21
|
| Rate for Payer: UHC Exchange |
$35.68
|
| Rate for Payer: UMR Bronson Commercial |
$19.32
|
|
|
PR SPEECH AUDIOMETRY THRESHOLD SPEECH RECOGNIJ
|
Professional
|
Both
|
$68.00
|
|
|
Service Code
|
HCPCS 92556
|
| Min. Negotiated Rate |
$31.28 |
| Max. Negotiated Rate |
$70.22 |
| Rate for Payer: Aetna Commercial |
$56.90
|
| Rate for Payer: Aetna Medicare |
$44.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.14
|
| Rate for Payer: BCBS MAPPO |
$42.46
|
| Rate for Payer: BCN Commercial |
$70.22
|
| Rate for Payer: BCN Medicare Advantage |
$42.46
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cofinity Commercial |
$61.14
|
| Rate for Payer: Cofinity Commercial |
$56.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.71
|
| Rate for Payer: Nomi Health Commercial |
$50.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.00
|
| Rate for Payer: PACE SWMI |
$42.46
|
| Rate for Payer: PHP Commercial |
$59.44
|
| Rate for Payer: PHP Medicare Advantage |
$42.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$64.76
|
| Rate for Payer: Priority Health Medicare |
$42.46
|
| Rate for Payer: Priority Health SBD |
$64.76
|
| Rate for Payer: Priority Health Tiered Network |
$64.76
|
| Rate for Payer: Railroad Medicare Medicare |
$42.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.93
|
| Rate for Payer: UHC Core |
$56.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$42.46
|
| Rate for Payer: UHC Exchange |
$56.93
|
| Rate for Payer: UMR Bronson Commercial |
$31.28
|
|
|
PR SPHINCTEROTOMY ANAL DIVISION SPHINCTER SPX
|
Professional
|
Both
|
$927.00
|
|
|
Service Code
|
HCPCS 46080
|
| Min. Negotiated Rate |
$95.64 |
| Max. Negotiated Rate |
$695.25 |
| Rate for Payer: Aetna Commercial |
$197.80
|
| Rate for Payer: Aetna Medicare |
$153.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.56
|
| Rate for Payer: BCBS Complete |
$100.42
|
| Rate for Payer: BCBS MAPPO |
$147.61
|
| Rate for Payer: BCN Commercial |
$239.03
|
| Rate for Payer: BCN Medicare Advantage |
$147.61
|
| Rate for Payer: Cash Price |
$741.60
|
| Rate for Payer: Cash Price |
$741.60
|
| Rate for Payer: Cofinity Commercial |
$197.80
|
| Rate for Payer: Cofinity Commercial |
$212.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.99
|
| Rate for Payer: Meridian Medicaid |
$100.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$162.37
|
| Rate for Payer: Nomi Health Commercial |
$177.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$695.25
|
| Rate for Payer: PACE SWMI |
$147.61
|
| Rate for Payer: PHP Commercial |
$206.65
|
| Rate for Payer: PHP Medicare Advantage |
$147.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$291.24
|
| Rate for Payer: Priority Health Medicare |
$147.61
|
| Rate for Payer: Priority Health SBD |
$291.24
|
| Rate for Payer: Priority Health Tiered Network |
$291.24
|
| Rate for Payer: Railroad Medicare Medicare |
$147.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$280.45
|
| Rate for Payer: UHC Core |
$280.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$147.61
|
| Rate for Payer: UHC Exchange |
$280.45
|
| Rate for Payer: UHC Medicaid |
$95.64
|
| Rate for Payer: UHCCP Medicaid |
$95.64
|
| Rate for Payer: UMR Bronson Commercial |
$426.42
|
|
|
PR SPHNCTROP ANAL INCONTINENCE/PROLAPSE ADULT
|
Professional
|
Both
|
$1,555.00
|
|
|
Service Code
|
HCPCS 46750
|
| Min. Negotiated Rate |
$438.14 |
| Max. Negotiated Rate |
$1,368.23 |
| Rate for Payer: Aetna Commercial |
$906.62
|
| Rate for Payer: Aetna Medicare |
$703.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$906.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$974.28
|
| Rate for Payer: BCBS Complete |
$460.05
|
| Rate for Payer: BCBS MAPPO |
$676.58
|
| Rate for Payer: BCN Commercial |
$1,122.94
|
| Rate for Payer: BCN Medicare Advantage |
$676.58
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cofinity Commercial |
$906.62
|
| Rate for Payer: Cofinity Commercial |
$974.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$676.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$710.41
|
| Rate for Payer: Meridian Medicaid |
$460.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$744.24
|
| Rate for Payer: Nomi Health Commercial |
$811.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,166.25
|
| Rate for Payer: PACE SWMI |
$676.58
|
| Rate for Payer: PHP Commercial |
$947.21
|
| Rate for Payer: PHP Medicare Advantage |
$676.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$438.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,368.23
|
| Rate for Payer: Priority Health Medicare |
$676.58
|
| Rate for Payer: Priority Health SBD |
$1,368.23
|
| Rate for Payer: Priority Health Tiered Network |
$1,368.23
|
| Rate for Payer: Railroad Medicare Medicare |
$676.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,324.33
|
| Rate for Payer: UHC Core |
$1,324.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$676.58
|
| Rate for Payer: UHC Exchange |
$1,324.33
|
| Rate for Payer: UHC Medicaid |
$438.14
|
| Rate for Payer: UHCCP Medicaid |
$438.14
|
| Rate for Payer: UMR Bronson Commercial |
$715.30
|
|
|
PR SPHNCTROP ANAL INCONTINENCE/PROLAPSE CHLD
|
Professional
|
Both
|
$1,340.00
|
|
|
Service Code
|
HCPCS 46751
|
| Min. Negotiated Rate |
$423.44 |
| Max. Negotiated Rate |
$1,238.39 |
| Rate for Payer: Aetna Commercial |
$871.08
|
| Rate for Payer: Aetna Medicare |
$676.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$871.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$936.09
|
| Rate for Payer: BCBS Complete |
$444.61
|
| Rate for Payer: BCBS MAPPO |
$650.06
|
| Rate for Payer: BCN Commercial |
$1,016.38
|
| Rate for Payer: BCN Medicare Advantage |
$650.06
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cofinity Commercial |
$871.08
|
| Rate for Payer: Cofinity Commercial |
$936.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$650.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$682.56
|
| Rate for Payer: Meridian Medicaid |
$444.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$715.07
|
| Rate for Payer: Nomi Health Commercial |
$780.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,005.00
|
| Rate for Payer: PACE SWMI |
$650.06
|
| Rate for Payer: PHP Commercial |
$910.08
|
| Rate for Payer: PHP Medicare Advantage |
$650.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,238.39
|
| Rate for Payer: Priority Health Medicare |
$650.06
|
| Rate for Payer: Priority Health SBD |
$1,238.39
|
| Rate for Payer: Priority Health Tiered Network |
$1,238.39
|
| Rate for Payer: Railroad Medicare Medicare |
$650.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,166.43
|
| Rate for Payer: UHC Core |
$1,166.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$650.06
|
| Rate for Payer: UHC Exchange |
$1,166.43
|
| Rate for Payer: UHC Medicaid |
$423.44
|
| Rate for Payer: UHCCP Medicaid |
$423.44
|
| Rate for Payer: UMR Bronson Commercial |
$616.40
|
|
|
PR SPHNCTROP ANAL LEVATOR MUSC IMBRCJ
|
Professional
|
Both
|
$1,945.00
|
|
|
Service Code
|
HCPCS 46761
|
| Min. Negotiated Rate |
$529.31 |
| Max. Negotiated Rate |
$1,664.95 |
| Rate for Payer: Aetna Commercial |
$1,098.45
|
| Rate for Payer: Aetna Medicare |
$852.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,098.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,180.43
|
| Rate for Payer: BCBS Complete |
$555.78
|
| Rate for Payer: BCBS MAPPO |
$819.74
|
| Rate for Payer: BCN Commercial |
$1,366.46
|
| Rate for Payer: BCN Medicare Advantage |
$819.74
|
| Rate for Payer: Cash Price |
$1,556.00
|
| Rate for Payer: Cash Price |
$1,556.00
|
| Rate for Payer: Cofinity Commercial |
$1,098.45
|
| Rate for Payer: Cofinity Commercial |
$1,180.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$819.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$860.73
|
| Rate for Payer: Meridian Medicaid |
$555.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$901.71
|
| Rate for Payer: Nomi Health Commercial |
$983.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,458.75
|
| Rate for Payer: PACE SWMI |
$819.74
|
| Rate for Payer: PHP Commercial |
$1,147.64
|
| Rate for Payer: PHP Medicare Advantage |
$819.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$529.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,664.95
|
| Rate for Payer: Priority Health Medicare |
$819.74
|
| Rate for Payer: Priority Health SBD |
$1,664.95
|
| Rate for Payer: Priority Health Tiered Network |
$1,664.95
|
| Rate for Payer: Railroad Medicare Medicare |
$819.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,626.00
|
| Rate for Payer: UHC Core |
$1,626.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$819.74
|
| Rate for Payer: UHC Exchange |
$1,626.00
|
| Rate for Payer: UHC Medicaid |
$529.31
|
| Rate for Payer: UHCCP Medicaid |
$529.31
|
| Rate for Payer: UMR Bronson Commercial |
$894.70
|
|
