|
PR SYNCHRONOUS AUDIO-VIDEO VISIT EST SF MDM 10 MIN
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 98004
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$85.50 |
| Rate for Payer: Aetna Medicare |
$57.00
|
| Rate for Payer: BCBS Complete |
$45.60
|
| Rate for Payer: BCN Commercial |
$43.40
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$45.24
|
| Rate for Payer: Priority Health SBD |
$45.24
|
| Rate for Payer: Priority Health Tiered Network |
$45.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.58
|
| Rate for Payer: UHC Core |
$50.58
|
| Rate for Payer: UHC Exchange |
$50.58
|
| Rate for Payer: UMR Bronson Commercial |
$52.44
|
|
|
PR SYNCHRONOUS AUDIO-VIDEO VISIT NEW LOW MDM 30 MIN
|
Professional
|
Both
|
$244.00
|
|
|
Service Code
|
HCPCS 98001
|
| Min. Negotiated Rate |
$93.27 |
| Max. Negotiated Rate |
$183.00 |
| Rate for Payer: Aetna Medicare |
$122.00
|
| Rate for Payer: BCBS Complete |
$97.60
|
| Rate for Payer: BCN Commercial |
$93.27
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$104.37
|
| Rate for Payer: Priority Health SBD |
$104.37
|
| Rate for Payer: Priority Health Tiered Network |
$104.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.65
|
| Rate for Payer: UHC Core |
$116.65
|
| Rate for Payer: UHC Exchange |
$116.65
|
| Rate for Payer: UMR Bronson Commercial |
$112.24
|
|
|
PR SYNCHRONOUS AUDIO-VIDEO VISIT NEW MOD MDM 45 MIN
|
Professional
|
Both
|
$366.00
|
|
|
Service Code
|
HCPCS 98002
|
| Min. Negotiated Rate |
$142.52 |
| Max. Negotiated Rate |
$274.50 |
| Rate for Payer: Aetna Medicare |
$183.00
|
| Rate for Payer: BCBS Complete |
$146.40
|
| Rate for Payer: BCN Commercial |
$142.52
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$169.32
|
| Rate for Payer: Priority Health SBD |
$169.32
|
| Rate for Payer: Priority Health Tiered Network |
$169.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.26
|
| Rate for Payer: UHC Core |
$189.26
|
| Rate for Payer: UHC Exchange |
$189.26
|
| Rate for Payer: UMR Bronson Commercial |
$168.36
|
|
|
PR SYNCHRONOUS AUDIO-VIDEO VISIT NEW SF MDM 15 MIN
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 98000
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$98.25 |
| Rate for Payer: Aetna Medicare |
$65.50
|
| Rate for Payer: BCBS Complete |
$52.40
|
| Rate for Payer: BCN Commercial |
$65.87
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$60.47
|
| Rate for Payer: Priority Health SBD |
$60.47
|
| Rate for Payer: Priority Health Tiered Network |
$60.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.56
|
| Rate for Payer: UHC Core |
$67.56
|
| Rate for Payer: UHC Exchange |
$67.56
|
| Rate for Payer: UMR Bronson Commercial |
$60.26
|
|
|
PR SYNCHRONOUS AUDIO-VIDEO VST EST HIGH MDM 40 MIN
|
Professional
|
Both
|
$366.00
|
|
|
Service Code
|
HCPCS 98007
|
| Min. Negotiated Rate |
$134.08 |
| Max. Negotiated Rate |
$274.50 |
| Rate for Payer: Aetna Medicare |
$183.00
|
| Rate for Payer: BCBS Complete |
$146.40
|
| Rate for Payer: BCN Commercial |
$134.08
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$169.32
|
| Rate for Payer: Priority Health SBD |
$169.32
|
| Rate for Payer: Priority Health Tiered Network |
$169.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.26
|
| Rate for Payer: UHC Core |
$189.26
|
| Rate for Payer: UHC Exchange |
$189.26
|
| Rate for Payer: UMR Bronson Commercial |
$168.36
|
|
|
PR SYNCHRONOUS AUDIO-VIDEO VST NEW HIGH MDM 60 MIN
|
Professional
|
Both
|
$491.00
|
|
|
Service Code
|
HCPCS 98003
|
| Min. Negotiated Rate |
$180.08 |
| Max. Negotiated Rate |
$368.25 |
| Rate for Payer: Aetna Medicare |
$245.50
|
| Rate for Payer: BCBS Complete |
$196.40
|
| Rate for Payer: BCN Commercial |
$180.08
|
| Rate for Payer: Cash Price |
$392.80
|
| Rate for Payer: Cash Price |
$392.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$368.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$227.55
|
| Rate for Payer: Priority Health SBD |
$227.55
|
| Rate for Payer: Priority Health Tiered Network |
$227.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.35
|
| Rate for Payer: UHC Core |
$254.35
|
| Rate for Payer: UHC Exchange |
$254.35
|
| Rate for Payer: UMR Bronson Commercial |
$225.86
|
|
|
PR SYNDACTYLIZATION TOES
|
Professional
|
Both
|
$878.00
|
|
|
Service Code
|
HCPCS 28280
|
| Min. Negotiated Rate |
$205.33 |
| Max. Negotiated Rate |
$658.50 |
| Rate for Payer: Aetna Commercial |
$419.39
|
| Rate for Payer: Aetna Medicare |
$325.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$450.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.39
|
| Rate for Payer: BCBS Complete |
$215.60
|
| Rate for Payer: BCBS MAPPO |
$312.98
|
| Rate for Payer: BCN Commercial |
$517.40
|
| Rate for Payer: BCN Medicare Advantage |
$312.98
|
| Rate for Payer: Cash Price |
$702.40
|
| Rate for Payer: Cash Price |
$702.40
|
| Rate for Payer: Cofinity Commercial |
$450.69
|
| Rate for Payer: Cofinity Commercial |
$419.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.63
|
| Rate for Payer: Meridian Medicaid |
$215.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$344.28
|
| Rate for Payer: Nomi Health Commercial |
$375.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$658.50
|
| Rate for Payer: PACE SWMI |
$312.98
|
| Rate for Payer: PHP Commercial |
$438.17
|
| Rate for Payer: PHP Medicare Advantage |
$312.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$553.09
|
| Rate for Payer: Priority Health Medicare |
$312.98
|
| Rate for Payer: Priority Health SBD |
$553.09
|
| Rate for Payer: Priority Health Tiered Network |
$553.09
|
| Rate for Payer: Railroad Medicare Medicare |
$312.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$607.71
|
| Rate for Payer: UHC Core |
$607.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$312.98
|
| Rate for Payer: UHC Exchange |
$607.71
|
| Rate for Payer: UHC Medicaid |
$205.33
|
| Rate for Payer: UHCCP Medicaid |
$205.33
|
| Rate for Payer: UMR Bronson Commercial |
$403.88
|
|
|
PR SYNOVECTOMY CARPOMETACARPAL JOINT
|
Professional
|
Both
|
$1,217.00
|
|
|
Service Code
|
HCPCS 26130
|
| Min. Negotiated Rate |
$292.45 |
| Max. Negotiated Rate |
$912.75 |
| Rate for Payer: Aetna Commercial |
$593.58
|
| Rate for Payer: Aetna Medicare |
$460.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$593.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$637.88
|
| Rate for Payer: BCBS Complete |
$307.07
|
| Rate for Payer: BCBS MAPPO |
$442.97
|
| Rate for Payer: BCN Commercial |
$725.06
|
| Rate for Payer: BCN Medicare Advantage |
$442.97
|
| Rate for Payer: Cash Price |
$973.60
|
| Rate for Payer: Cash Price |
$973.60
|
| Rate for Payer: Cofinity Commercial |
$593.58
|
| Rate for Payer: Cofinity Commercial |
$637.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$442.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$465.12
|
| Rate for Payer: Meridian Medicaid |
$307.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$487.27
|
| Rate for Payer: Nomi Health Commercial |
$531.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$912.75
|
| Rate for Payer: PACE SWMI |
$442.97
|
| Rate for Payer: PHP Commercial |
$620.16
|
| Rate for Payer: PHP Medicare Advantage |
$442.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$292.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$775.08
|
| Rate for Payer: Priority Health Medicare |
$442.97
|
| Rate for Payer: Priority Health SBD |
$775.08
|
| Rate for Payer: Priority Health Tiered Network |
$775.08
|
| Rate for Payer: Railroad Medicare Medicare |
$442.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$806.21
|
| Rate for Payer: UHC Core |
$806.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$442.97
|
| Rate for Payer: UHC Exchange |
$806.21
|
| Rate for Payer: UHC Medicaid |
$292.45
|
| Rate for Payer: UHCCP Medicaid |
$292.45
|
| Rate for Payer: UMR Bronson Commercial |
$559.82
|
|
|
PR SYNOVECTOMY EXTENSOR TENDON SHTH WRIST 1 CMPRT
|
Professional
|
Both
|
$1,314.00
|
|
|
Service Code
|
HCPCS 25118
|
| Min. Negotiated Rate |
$235.79 |
| Max. Negotiated Rate |
$985.50 |
| Rate for Payer: Aetna Commercial |
$477.62
|
| Rate for Payer: Aetna Medicare |
$370.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$477.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.26
|
| Rate for Payer: BCBS Complete |
$247.58
|
| Rate for Payer: BCBS MAPPO |
$356.43
|
| Rate for Payer: BCN Commercial |
$594.09
|
| Rate for Payer: BCN Medicare Advantage |
$356.43
|
| Rate for Payer: Cash Price |
$1,051.20
|
| Rate for Payer: Cash Price |
$1,051.20
|
| Rate for Payer: Cofinity Commercial |
$477.62
|
| Rate for Payer: Cofinity Commercial |
$513.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.25
|
| Rate for Payer: Meridian Medicaid |
$247.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$392.07
|
| Rate for Payer: Nomi Health Commercial |
$427.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$985.50
|
| Rate for Payer: PACE SWMI |
$356.43
|
| Rate for Payer: PHP Commercial |
$499.00
|
| Rate for Payer: PHP Medicare Advantage |
$356.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$635.06
|
| Rate for Payer: Priority Health Medicare |
$356.43
|
| Rate for Payer: Priority Health SBD |
$635.06
|
| Rate for Payer: Priority Health Tiered Network |
$635.06
|
| Rate for Payer: Railroad Medicare Medicare |
$356.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$657.98
|
| Rate for Payer: UHC Core |
$657.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$356.43
|
| Rate for Payer: UHC Exchange |
$657.98
|
| Rate for Payer: UHC Medicaid |
$235.79
|
| Rate for Payer: UHCCP Medicaid |
$235.79
|
| Rate for Payer: UMR Bronson Commercial |
$604.44
|
|
|
PR SYNOVECTOMY METATARSOPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,046.00
|
|
|
Service Code
|
HCPCS 28072
|
| Min. Negotiated Rate |
$199.16 |
| Max. Negotiated Rate |
$784.50 |
| Rate for Payer: Aetna Commercial |
$405.30
|
| Rate for Payer: Aetna Medicare |
$314.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$435.54
|
| Rate for Payer: BCBS Complete |
$209.12
|
| Rate for Payer: BCBS MAPPO |
$302.46
|
| Rate for Payer: BCN Commercial |
$495.99
|
| Rate for Payer: BCN Medicare Advantage |
$302.46
|
| Rate for Payer: Cash Price |
$836.80
|
| Rate for Payer: Cash Price |
$836.80
|
| Rate for Payer: Cofinity Commercial |
$405.30
|
| Rate for Payer: Cofinity Commercial |
$435.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.58
|
| Rate for Payer: Meridian Medicaid |
$209.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$332.71
|
| Rate for Payer: Nomi Health Commercial |
$362.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$784.50
|
| Rate for Payer: PACE SWMI |
$302.46
|
| Rate for Payer: PHP Commercial |
$423.44
|
| Rate for Payer: PHP Medicare Advantage |
$302.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$530.20
|
| Rate for Payer: Priority Health Medicare |
$302.46
|
| Rate for Payer: Priority Health SBD |
$530.20
|
| Rate for Payer: Priority Health Tiered Network |
$530.20
|
| Rate for Payer: Railroad Medicare Medicare |
$302.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$558.23
|
| Rate for Payer: UHC Core |
$558.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$302.46
|
| Rate for Payer: UHC Exchange |
$558.23
|
| Rate for Payer: UHC Medicaid |
$199.16
|
| Rate for Payer: UHCCP Medicaid |
$199.16
|
| Rate for Payer: UMR Bronson Commercial |
$481.16
|
|
|
PR SYNVCT MTCARPHLNGL JT W/INTRNSC RLS&XTNSR HOOD
|
Professional
|
Both
|
$1,778.00
|
|
|
Service Code
|
HCPCS 26135
|
| Min. Negotiated Rate |
$331.22 |
| Max. Negotiated Rate |
$1,333.50 |
| Rate for Payer: Aetna Commercial |
$675.25
|
| Rate for Payer: Aetna Medicare |
$524.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$675.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$725.64
|
| Rate for Payer: BCBS Complete |
$347.78
|
| Rate for Payer: BCBS MAPPO |
$503.92
|
| Rate for Payer: BCN Commercial |
$854.04
|
| Rate for Payer: BCN Medicare Advantage |
$503.92
|
| Rate for Payer: Cash Price |
$1,422.40
|
| Rate for Payer: Cash Price |
$1,422.40
|
| Rate for Payer: Cofinity Commercial |
$675.25
|
| Rate for Payer: Cofinity Commercial |
$725.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$503.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$529.12
|
| Rate for Payer: Meridian Medicaid |
$347.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$554.31
|
| Rate for Payer: Nomi Health Commercial |
$604.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,333.50
|
| Rate for Payer: PACE SWMI |
$503.92
|
| Rate for Payer: PHP Commercial |
$705.49
|
| Rate for Payer: PHP Medicare Advantage |
$503.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$331.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$912.94
|
| Rate for Payer: Priority Health Medicare |
$503.92
|
| Rate for Payer: Priority Health SBD |
$912.94
|
| Rate for Payer: Priority Health Tiered Network |
$912.94
|
| Rate for Payer: Railroad Medicare Medicare |
$503.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$959.49
|
| Rate for Payer: UHC Core |
$959.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$503.92
|
| Rate for Payer: UHC Exchange |
$959.49
|
| Rate for Payer: UHC Medicaid |
$331.22
|
| Rate for Payer: UHCCP Medicaid |
$331.22
|
| Rate for Payer: UMR Bronson Commercial |
$817.88
|
|
|
PR SYNVCT PROX IPHAL JT W/XTNSR RCNSTJ EA IPHAL JT
|
Professional
|
Both
|
$1,520.00
|
|
|
Service Code
|
HCPCS 26140
|
| Min. Negotiated Rate |
$306.51 |
| Max. Negotiated Rate |
$1,140.00 |
| Rate for Payer: Aetna Commercial |
$623.60
|
| Rate for Payer: Aetna Medicare |
$483.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.13
|
| Rate for Payer: BCBS Complete |
$321.84
|
| Rate for Payer: BCBS MAPPO |
$465.37
|
| Rate for Payer: BCN Commercial |
$783.32
|
| Rate for Payer: BCN Medicare Advantage |
$465.37
|
| Rate for Payer: Cash Price |
$1,216.00
|
| Rate for Payer: Cash Price |
$1,216.00
|
| Rate for Payer: Cofinity Commercial |
$623.60
|
| Rate for Payer: Cofinity Commercial |
$670.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$465.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$488.64
|
| Rate for Payer: Meridian Medicaid |
$321.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$511.91
|
| Rate for Payer: Nomi Health Commercial |
$558.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,140.00
|
| Rate for Payer: PACE SWMI |
$465.37
|
| Rate for Payer: PHP Commercial |
$651.52
|
| Rate for Payer: PHP Medicare Advantage |
$465.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$306.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$837.35
|
| Rate for Payer: Priority Health Medicare |
$465.37
|
| Rate for Payer: Priority Health SBD |
$837.35
|
| Rate for Payer: Priority Health Tiered Network |
$837.35
|
| Rate for Payer: Railroad Medicare Medicare |
$465.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$876.96
|
| Rate for Payer: UHC Core |
$876.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$465.37
|
| Rate for Payer: UHC Exchange |
$876.96
|
| Rate for Payer: UHC Medicaid |
$306.51
|
| Rate for Payer: UHCCP Medicaid |
$306.51
|
| Rate for Payer: UMR Bronson Commercial |
$699.20
|
|
|
PR SYNVCT TDN SHTH RAD FLXR TDN PALM&/FNGR EA TDN
|
Professional
|
Both
|
$1,730.00
|
|
|
Service Code
|
HCPCS 26145
|
| Min. Negotiated Rate |
$310.55 |
| Max. Negotiated Rate |
$1,297.50 |
| Rate for Payer: Aetna Commercial |
$632.13
|
| Rate for Payer: Aetna Medicare |
$490.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$632.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$679.31
|
| Rate for Payer: BCBS Complete |
$326.08
|
| Rate for Payer: BCBS MAPPO |
$471.74
|
| Rate for Payer: BCN Commercial |
$796.77
|
| Rate for Payer: BCN Medicare Advantage |
$471.74
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cofinity Commercial |
$632.13
|
| Rate for Payer: Cofinity Commercial |
$679.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$471.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$495.33
|
| Rate for Payer: Meridian Medicaid |
$326.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$518.91
|
| Rate for Payer: Nomi Health Commercial |
$566.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,297.50
|
| Rate for Payer: PACE SWMI |
$471.74
|
| Rate for Payer: PHP Commercial |
$660.44
|
| Rate for Payer: PHP Medicare Advantage |
$471.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$310.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$851.72
|
| Rate for Payer: Priority Health Medicare |
$471.74
|
| Rate for Payer: Priority Health SBD |
$851.72
|
| Rate for Payer: Priority Health Tiered Network |
$851.72
|
| Rate for Payer: Railroad Medicare Medicare |
$471.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$891.77
|
| Rate for Payer: UHC Core |
$891.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$471.74
|
| Rate for Payer: UHC Exchange |
$891.77
|
| Rate for Payer: UHC Medicaid |
$310.55
|
| Rate for Payer: UHCCP Medicaid |
$310.55
|
| Rate for Payer: UMR Bronson Commercial |
$795.80
|
|
|
PR SYNVCT XTNSR TDN SHTH WRST 1 RESCJ DSTL ULNA
|
Professional
|
Both
|
$1,850.00
|
|
|
Service Code
|
HCPCS 25119
|
| Min. Negotiated Rate |
$310.34 |
| Max. Negotiated Rate |
$1,387.50 |
| Rate for Payer: Aetna Commercial |
$631.50
|
| Rate for Payer: Aetna Medicare |
$490.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$631.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$678.63
|
| Rate for Payer: BCBS Complete |
$325.86
|
| Rate for Payer: BCBS MAPPO |
$471.27
|
| Rate for Payer: BCN Commercial |
$774.86
|
| Rate for Payer: BCN Medicare Advantage |
$471.27
|
| Rate for Payer: Cash Price |
$1,480.00
|
| Rate for Payer: Cash Price |
$1,480.00
|
| Rate for Payer: Cofinity Commercial |
$631.50
|
| Rate for Payer: Cofinity Commercial |
$678.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$471.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$494.83
|
| Rate for Payer: Meridian Medicaid |
$325.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$518.40
|
| Rate for Payer: Nomi Health Commercial |
$565.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,387.50
|
| Rate for Payer: PACE SWMI |
$471.27
|
| Rate for Payer: PHP Commercial |
$659.78
|
| Rate for Payer: PHP Medicare Advantage |
$471.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$310.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$828.30
|
| Rate for Payer: Priority Health Medicare |
$471.27
|
| Rate for Payer: Priority Health SBD |
$828.30
|
| Rate for Payer: Priority Health Tiered Network |
$828.30
|
| Rate for Payer: Railroad Medicare Medicare |
$471.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$859.98
|
| Rate for Payer: UHC Core |
$859.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$471.27
|
| Rate for Payer: UHC Exchange |
$859.98
|
| Rate for Payer: UHC Medicaid |
$310.34
|
| Rate for Payer: UHCCP Medicaid |
$310.34
|
| Rate for Payer: UMR Bronson Commercial |
$851.00
|
|
|
PR SYNVISC OR SYNVISC-ONE
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS J7325
|
| Min. Negotiated Rate |
$6.96 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: Aetna Commercial |
$9.33
|
| Rate for Payer: Aetna Medicare |
$7.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.02
|
| Rate for Payer: BCBS MAPPO |
$6.96
|
| Rate for Payer: BCBS Trust/PPO |
$7.70
|
| Rate for Payer: BCN Commercial |
$10.87
|
| Rate for Payer: BCN Medicare Advantage |
$6.96
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$10.02
|
| Rate for Payer: Cofinity Commercial |
$9.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.66
|
| Rate for Payer: Nomi Health Commercial |
$8.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: PACE SWMI |
$6.96
|
| Rate for Payer: PHP Commercial |
$9.74
|
| Rate for Payer: PHP Medicare Advantage |
$6.96
|
| Rate for Payer: Priority Health Medicare |
$6.96
|
| Rate for Payer: Railroad Medicare Medicare |
$6.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.56
|
| Rate for Payer: UHC Core |
$7.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.96
|
| Rate for Payer: UHC Exchange |
$7.56
|
| Rate for Payer: UMR Bronson Commercial |
$24.38
|
|
|
PR TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION
|
Professional
|
Both
|
$108.00
|
|
|
Service Code
|
HCPCS 11103
|
| Min. Negotiated Rate |
$11.29 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Aetna Commercial |
$23.49
|
| Rate for Payer: Aetna Medicare |
$18.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.49
|
| Rate for Payer: BCBS Complete |
$11.85
|
| Rate for Payer: BCBS MAPPO |
$17.53
|
| Rate for Payer: BCN Commercial |
$25.53
|
| Rate for Payer: BCN Medicare Advantage |
$17.53
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cofinity Commercial |
$25.24
|
| Rate for Payer: Cofinity Commercial |
$23.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.41
|
| Rate for Payer: Meridian Medicaid |
$11.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.28
|
| Rate for Payer: Nomi Health Commercial |
$21.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.00
|
| Rate for Payer: PACE SWMI |
$17.53
|
| Rate for Payer: PHP Commercial |
$24.54
|
| Rate for Payer: PHP Medicare Advantage |
$17.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29.63
|
| Rate for Payer: Priority Health Medicare |
$17.53
|
| Rate for Payer: Priority Health SBD |
$29.63
|
| Rate for Payer: Priority Health Tiered Network |
$29.63
|
| Rate for Payer: Railroad Medicare Medicare |
$17.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.64
|
| Rate for Payer: UHC Core |
$39.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.53
|
| Rate for Payer: UHC Exchange |
$39.64
|
| Rate for Payer: UHC Medicaid |
$11.29
|
| Rate for Payer: UHCCP Medicaid |
$11.29
|
| Rate for Payer: UMR Bronson Commercial |
$49.68
|
|
|
PR TANGENTIAL BIOPSY SKIN SINGLE LESION
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 11102
|
| Min. Negotiated Rate |
$19.17 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Aetna Commercial |
$39.85
|
| Rate for Payer: Aetna Medicare |
$30.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.83
|
| Rate for Payer: BCBS Complete |
$20.13
|
| Rate for Payer: BCBS MAPPO |
$29.74
|
| Rate for Payer: BCN Commercial |
$43.98
|
| Rate for Payer: BCN Medicare Advantage |
$29.74
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$39.85
|
| Rate for Payer: Cofinity Commercial |
$42.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.23
|
| Rate for Payer: Meridian Medicaid |
$20.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.71
|
| Rate for Payer: Nomi Health Commercial |
$35.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.00
|
| Rate for Payer: PACE SWMI |
$29.74
|
| Rate for Payer: PHP Commercial |
$41.64
|
| Rate for Payer: PHP Medicare Advantage |
$29.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51.05
|
| Rate for Payer: Priority Health Medicare |
$29.74
|
| Rate for Payer: Priority Health SBD |
$51.05
|
| Rate for Payer: Priority Health Tiered Network |
$51.05
|
| Rate for Payer: Railroad Medicare Medicare |
$29.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.30
|
| Rate for Payer: UHC Core |
$68.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.74
|
| Rate for Payer: UHC Exchange |
$68.30
|
| Rate for Payer: UHC Medicaid |
$19.17
|
| Rate for Payer: UHCCP Medicaid |
$19.17
|
| Rate for Payer: UMR Bronson Commercial |
$92.00
|
|
|
PR TAP BLOCK UNILATERAL BY INJECTION(S)
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 64486
|
| Min. Negotiated Rate |
$30.89 |
| Max. Negotiated Rate |
$100.43 |
| Rate for Payer: Aetna Commercial |
$64.68
|
| Rate for Payer: Aetna Medicare |
$50.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.51
|
| Rate for Payer: BCBS Complete |
$32.43
|
| Rate for Payer: BCBS MAPPO |
$48.27
|
| Rate for Payer: BCN Commercial |
$77.18
|
| Rate for Payer: BCN Medicare Advantage |
$48.27
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$64.68
|
| Rate for Payer: Cofinity Commercial |
$69.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.68
|
| Rate for Payer: Meridian Medicaid |
$32.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.10
|
| Rate for Payer: Nomi Health Commercial |
$57.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.75
|
| Rate for Payer: PACE SWMI |
$48.27
|
| Rate for Payer: PHP Commercial |
$67.58
|
| Rate for Payer: PHP Medicare Advantage |
$48.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$89.66
|
| Rate for Payer: Priority Health Medicare |
$48.27
|
| Rate for Payer: Priority Health SBD |
$89.66
|
| Rate for Payer: Priority Health Tiered Network |
$89.66
|
| Rate for Payer: Railroad Medicare Medicare |
$48.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.43
|
| Rate for Payer: UHC Core |
$100.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$48.27
|
| Rate for Payer: UHC Exchange |
$100.43
|
| Rate for Payer: UHC Medicaid |
$30.89
|
| Rate for Payer: UHCCP Medicaid |
$30.89
|
| Rate for Payer: UMR Bronson Commercial |
$53.82
|
|
|
PR TATTOOING INCL MICROPIGMENTATION 6.0 CM/<
|
Professional
|
Both
|
$333.00
|
|
|
Service Code
|
HCPCS 11920
|
| Min. Negotiated Rate |
$65.39 |
| Max. Negotiated Rate |
$249.75 |
| Rate for Payer: Aetna Commercial |
$134.27
|
| Rate for Payer: Aetna Medicare |
$104.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.29
|
| Rate for Payer: BCBS Complete |
$68.66
|
| Rate for Payer: BCBS MAPPO |
$100.20
|
| Rate for Payer: BCN Commercial |
$171.30
|
| Rate for Payer: BCN Medicare Advantage |
$100.20
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cofinity Commercial |
$134.27
|
| Rate for Payer: Cofinity Commercial |
$144.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.21
|
| Rate for Payer: Meridian Medicaid |
$68.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$110.22
|
| Rate for Payer: Nomi Health Commercial |
$120.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$249.75
|
| Rate for Payer: PACE SWMI |
$100.20
|
| Rate for Payer: PHP Commercial |
$140.28
|
| Rate for Payer: PHP Medicare Advantage |
$100.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$156.79
|
| Rate for Payer: Priority Health Medicare |
$100.20
|
| Rate for Payer: Priority Health SBD |
$156.79
|
| Rate for Payer: Priority Health Tiered Network |
$156.79
|
| Rate for Payer: Railroad Medicare Medicare |
$100.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.66
|
| Rate for Payer: UHC Core |
$195.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$100.20
|
| Rate for Payer: UHC Exchange |
$195.66
|
| Rate for Payer: UHC Medicaid |
$65.39
|
| Rate for Payer: UHCCP Medicaid |
$65.39
|
| Rate for Payer: UMR Bronson Commercial |
$153.18
|
|
|
PR TATTOOING INCL MICROPIGMENTATION 6.1-20.0 CM
|
Professional
|
Both
|
$383.00
|
|
|
Service Code
|
HCPCS 11921
|
| Min. Negotiated Rate |
$73.91 |
| Max. Negotiated Rate |
$287.25 |
| Rate for Payer: Aetna Commercial |
$152.51
|
| Rate for Payer: Aetna Medicare |
$118.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.89
|
| Rate for Payer: BCBS Complete |
$77.61
|
| Rate for Payer: BCBS MAPPO |
$113.81
|
| Rate for Payer: BCN Commercial |
$196.20
|
| Rate for Payer: BCN Medicare Advantage |
$113.81
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cofinity Commercial |
$152.51
|
| Rate for Payer: Cofinity Commercial |
$163.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.50
|
| Rate for Payer: Meridian Medicaid |
$77.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$125.19
|
| Rate for Payer: Nomi Health Commercial |
$136.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$287.25
|
| Rate for Payer: PACE SWMI |
$113.81
|
| Rate for Payer: PHP Commercial |
$159.33
|
| Rate for Payer: PHP Medicare Advantage |
$113.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$179.58
|
| Rate for Payer: Priority Health Medicare |
$113.81
|
| Rate for Payer: Priority Health SBD |
$179.58
|
| Rate for Payer: Priority Health Tiered Network |
$179.58
|
| Rate for Payer: Railroad Medicare Medicare |
$113.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.00
|
| Rate for Payer: UHC Core |
$231.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$113.81
|
| Rate for Payer: UHC Exchange |
$231.00
|
| Rate for Payer: UHC Medicaid |
$73.91
|
| Rate for Payer: UHCCP Medicaid |
$73.91
|
| Rate for Payer: UMR Bronson Commercial |
$176.18
|
|
|
PR TATTOOING INCL MICROPIGMENTATION EA 20.0 CM
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 11922
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$93.75 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: Aetna Medicare |
$25.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.89
|
| Rate for Payer: BCBS Complete |
$16.33
|
| Rate for Payer: BCBS MAPPO |
$24.23
|
| Rate for Payer: BCN Commercial |
$42.33
|
| Rate for Payer: BCN Medicare Advantage |
$24.23
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$32.47
|
| Rate for Payer: Cofinity Commercial |
$34.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.44
|
| Rate for Payer: Meridian Medicaid |
$16.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.65
|
| Rate for Payer: Nomi Health Commercial |
$29.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.75
|
| Rate for Payer: PACE SWMI |
$24.23
|
| Rate for Payer: PHP Commercial |
$33.92
|
| Rate for Payer: PHP Medicare Advantage |
$24.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$38.74
|
| Rate for Payer: Priority Health Medicare |
$24.23
|
| Rate for Payer: Priority Health SBD |
$38.74
|
| Rate for Payer: Priority Health Tiered Network |
$38.74
|
| Rate for Payer: Railroad Medicare Medicare |
$24.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.50
|
| Rate for Payer: UHC Core |
$52.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.23
|
| Rate for Payer: UHC Exchange |
$52.50
|
| Rate for Payer: UHC Medicaid |
$15.55
|
| Rate for Payer: UHCCP Medicaid |
$15.55
|
| Rate for Payer: UMR Bronson Commercial |
$57.50
|
|
|
PR TC99M DISOFENIN
|
Professional
|
Both
|
$263.00
|
|
|
Service Code
|
HCPCS A9510
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$197.25 |
| Rate for Payer: Aetna Commercial |
$67.20
|
| Rate for Payer: Aetna Medicare |
$131.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.20
|
| Rate for Payer: BCN Commercial |
$60.00
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.80
|
| Rate for Payer: UHC Core |
$79.80
|
| Rate for Payer: UHC Exchange |
$79.80
|
| Rate for Payer: UMR Bronson Commercial |
$120.98
|
|
|
PR TC99M MEBROFENIN
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS A9537
|
| Min. Negotiated Rate |
$53.10 |
| Max. Negotiated Rate |
$187.50 |
| Rate for Payer: Aetna Commercial |
$53.10
|
| Rate for Payer: Aetna Medicare |
$125.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.10
|
| Rate for Payer: BCN Commercial |
$69.79
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.50
|
| Rate for Payer: UHC Core |
$56.50
|
| Rate for Payer: UHC Exchange |
$56.50
|
| Rate for Payer: UMR Bronson Commercial |
$115.00
|
|
|
PR TC99M MEDRONATE
|
Professional
|
Both
|
$95.00
|
|
|
Service Code
|
HCPCS A9503
|
| Min. Negotiated Rate |
$12.48 |
| Max. Negotiated Rate |
$71.25 |
| Rate for Payer: Aetna Commercial |
$12.48
|
| Rate for Payer: Aetna Medicare |
$47.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.48
|
| Rate for Payer: BCN Commercial |
$35.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.00
|
| Rate for Payer: UHC Core |
$13.00
|
| Rate for Payer: UHC Exchange |
$13.00
|
| Rate for Payer: UMR Bronson Commercial |
$43.70
|
|
|
PR TC99M PERTECHNETATE
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS A9512
|
| Min. Negotiated Rate |
$1.50 |
| Max. Negotiated Rate |
$15.75 |
| Rate for Payer: Aetna Commercial |
$1.50
|
| Rate for Payer: Aetna Medicare |
$10.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.50
|
| Rate for Payer: BCN Commercial |
$3.00
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.72
|
| Rate for Payer: UHC Core |
$1.72
|
| Rate for Payer: UHC Exchange |
$1.72
|
| Rate for Payer: UMR Bronson Commercial |
$9.66
|
|
