|
PR VISUAL REINFORCEMENT AUDIOMETRY
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 92579
|
| Min. Negotiated Rate |
$29.19 |
| Max. Negotiated Rate |
$61.55 |
| Rate for Payer: Aetna Commercial |
$39.11
|
| Rate for Payer: Aetna Medicare |
$30.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.03
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: BCBS MAPPO |
$29.19
|
| Rate for Payer: BCN Commercial |
$54.78
|
| Rate for Payer: BCN Medicare Advantage |
$29.19
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$42.03
|
| Rate for Payer: Cofinity Commercial |
$39.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.11
|
| Rate for Payer: Nomi Health Commercial |
$35.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.25
|
| Rate for Payer: PACE SWMI |
$29.19
|
| Rate for Payer: PHP Commercial |
$40.87
|
| Rate for Payer: PHP Medicare Advantage |
$29.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$50.52
|
| Rate for Payer: Priority Health Medicare |
$29.19
|
| Rate for Payer: Priority Health SBD |
$50.52
|
| Rate for Payer: Priority Health Tiered Network |
$50.52
|
| Rate for Payer: Railroad Medicare Medicare |
$29.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.55
|
| Rate for Payer: UHC Core |
$61.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.19
|
| Rate for Payer: UHC Exchange |
$61.55
|
| Rate for Payer: UMR Bronson Commercial |
$36.34
|
|
|
PR VITAL CAPACITY TOTAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 94150
|
| Min. Negotiated Rate |
$20.70 |
| Max. Negotiated Rate |
$38.19 |
| Rate for Payer: Aetna Commercial |
$26.29
|
| Rate for Payer: Aetna Medicare |
$22.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.29
|
| Rate for Payer: BCN Commercial |
$37.85
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$34.90
|
| Rate for Payer: Priority Health SBD |
$34.90
|
| Rate for Payer: Priority Health Tiered Network |
$34.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.19
|
| Rate for Payer: UHC Core |
$38.19
|
| Rate for Payer: UHC Exchange |
$38.19
|
| Rate for Payer: UMR Bronson Commercial |
$20.70
|
|
|
PR VITAMIN B12 INJECTION
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS J3420
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$3.75 |
| Rate for Payer: Aetna Commercial |
$0.90
|
| Rate for Payer: Aetna Medicare |
$0.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.96
|
| Rate for Payer: BCBS MAPPO |
$0.67
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.05
|
| Rate for Payer: BCN Medicare Advantage |
$0.67
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cofinity Commercial |
$0.90
|
| Rate for Payer: Cofinity Commercial |
$0.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.74
|
| Rate for Payer: Nomi Health Commercial |
$0.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.75
|
| Rate for Payer: PACE SWMI |
$0.67
|
| Rate for Payer: PHP Commercial |
$0.94
|
| Rate for Payer: PHP Medicare Advantage |
$0.67
|
| Rate for Payer: Priority Health Medicare |
$0.67
|
| Rate for Payer: Railroad Medicare Medicare |
$0.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.64
|
| Rate for Payer: UHC Core |
$0.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.67
|
| Rate for Payer: UHC Exchange |
$0.64
|
| Rate for Payer: UMR Bronson Commercial |
$2.30
|
|
|
PR VITAMIN K PHYTONADIONE INJ
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS J3430
|
| Min. Negotiated Rate |
$1.48 |
| Max. Negotiated Rate |
$4.55 |
| Rate for Payer: Aetna Commercial |
$4.23
|
| Rate for Payer: Aetna Medicare |
$3.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.55
|
| Rate for Payer: BCBS MAPPO |
$3.16
|
| Rate for Payer: BCBS Trust/PPO |
$1.48
|
| Rate for Payer: BCN Commercial |
$2.24
|
| Rate for Payer: BCN Medicare Advantage |
$3.16
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cofinity Commercial |
$4.55
|
| Rate for Payer: Cofinity Commercial |
$4.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.48
|
| Rate for Payer: Nomi Health Commercial |
$3.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.75
|
| Rate for Payer: PACE SWMI |
$3.16
|
| Rate for Payer: PHP Commercial |
$4.42
|
| Rate for Payer: PHP Medicare Advantage |
$3.16
|
| Rate for Payer: Priority Health Medicare |
$3.16
|
| Rate for Payer: Railroad Medicare Medicare |
$3.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.81
|
| Rate for Payer: UHC Core |
$2.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.16
|
| Rate for Payer: UHC Exchange |
$2.81
|
| Rate for Payer: UMR Bronson Commercial |
$2.30
|
|
|
PR VLVP MITRAL VALVE W/BYPASS RAD RCNSTJ W/WO RING
|
Professional
|
Both
|
$5,278.00
|
|
|
Service Code
|
HCPCS 33427
|
| Min. Negotiated Rate |
$1,449.68 |
| Max. Negotiated Rate |
$4,358.56 |
| Rate for Payer: Aetna Commercial |
$3,052.96
|
| Rate for Payer: Aetna Medicare |
$2,369.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,052.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,280.80
|
| Rate for Payer: BCBS Complete |
$1,522.16
|
| Rate for Payer: BCBS MAPPO |
$2,278.33
|
| Rate for Payer: BCN Commercial |
$3,579.98
|
| Rate for Payer: BCN Medicare Advantage |
$2,278.33
|
| Rate for Payer: Cash Price |
$4,222.40
|
| Rate for Payer: Cash Price |
$4,222.40
|
| Rate for Payer: Cofinity Commercial |
$3,052.96
|
| Rate for Payer: Cofinity Commercial |
$3,280.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,278.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,392.25
|
| Rate for Payer: Meridian Medicaid |
$1,522.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,506.16
|
| Rate for Payer: Nomi Health Commercial |
$2,734.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,958.50
|
| Rate for Payer: PACE SWMI |
$2,278.33
|
| Rate for Payer: PHP Commercial |
$3,189.66
|
| Rate for Payer: PHP Medicare Advantage |
$2,278.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,449.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,849.82
|
| Rate for Payer: Priority Health Medicare |
$2,278.33
|
| Rate for Payer: Priority Health SBD |
$3,849.82
|
| Rate for Payer: Priority Health Tiered Network |
$3,849.82
|
| Rate for Payer: Railroad Medicare Medicare |
$2,278.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,358.56
|
| Rate for Payer: UHC Core |
$4,358.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,278.33
|
| Rate for Payer: UHC Exchange |
$4,358.56
|
| Rate for Payer: UHC Medicaid |
$1,449.68
|
| Rate for Payer: UHCCP Medicaid |
$1,449.68
|
| Rate for Payer: UMR Bronson Commercial |
$2,427.88
|
|
|
PR VLVP MITRAL VALVE W/CARD BYP W/PROSTC RING
|
Professional
|
Both
|
$9,170.00
|
|
|
Service Code
|
HCPCS 33426
|
| Min. Negotiated Rate |
$1,423.27 |
| Max. Negotiated Rate |
$6,877.50 |
| Rate for Payer: Aetna Commercial |
$2,995.64
|
| Rate for Payer: Aetna Medicare |
$2,324.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,995.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,219.19
|
| Rate for Payer: BCBS Complete |
$1,494.43
|
| Rate for Payer: BCBS MAPPO |
$2,235.55
|
| Rate for Payer: BCN Commercial |
$3,502.80
|
| Rate for Payer: BCN Medicare Advantage |
$2,235.55
|
| Rate for Payer: Cash Price |
$7,336.00
|
| Rate for Payer: Cash Price |
$7,336.00
|
| Rate for Payer: Cofinity Commercial |
$2,995.64
|
| Rate for Payer: Cofinity Commercial |
$3,219.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,235.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,347.33
|
| Rate for Payer: Meridian Medicaid |
$1,494.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,459.11
|
| Rate for Payer: Nomi Health Commercial |
$2,682.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,877.50
|
| Rate for Payer: PACE SWMI |
$2,235.55
|
| Rate for Payer: PHP Commercial |
$3,129.77
|
| Rate for Payer: PHP Medicare Advantage |
$2,235.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,423.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,766.81
|
| Rate for Payer: Priority Health Medicare |
$2,235.55
|
| Rate for Payer: Priority Health SBD |
$3,766.81
|
| Rate for Payer: Priority Health Tiered Network |
$3,766.81
|
| Rate for Payer: Railroad Medicare Medicare |
$2,235.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,247.22
|
| Rate for Payer: UHC Core |
$4,247.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,235.55
|
| Rate for Payer: UHC Exchange |
$4,247.22
|
| Rate for Payer: UHC Medicaid |
$1,423.27
|
| Rate for Payer: UHCCP Medicaid |
$1,423.27
|
| Rate for Payer: UMR Bronson Commercial |
$4,218.20
|
|
|
PR VNPNXR <3 YEARS PHY/QHP SKILL FEMORAL/JUGULAR VN
|
Professional
|
Both
|
$85.00
|
|
|
Service Code
|
HCPCS 36400
|
| Min. Negotiated Rate |
$10.01 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Aetna Commercial |
$20.84
|
| Rate for Payer: Aetna Medicare |
$16.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.39
|
| Rate for Payer: BCBS Complete |
$10.51
|
| Rate for Payer: BCBS MAPPO |
$15.55
|
| Rate for Payer: BCN Commercial |
$27.39
|
| Rate for Payer: BCN Medicare Advantage |
$15.55
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cofinity Commercial |
$20.84
|
| Rate for Payer: Cofinity Commercial |
$22.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.33
|
| Rate for Payer: Meridian Medicaid |
$10.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.11
|
| Rate for Payer: Nomi Health Commercial |
$18.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.75
|
| Rate for Payer: PACE SWMI |
$15.55
|
| Rate for Payer: PHP Commercial |
$21.77
|
| Rate for Payer: PHP Medicare Advantage |
$15.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29.45
|
| Rate for Payer: Priority Health Medicare |
$15.55
|
| Rate for Payer: Priority Health SBD |
$29.45
|
| Rate for Payer: Priority Health Tiered Network |
$29.45
|
| Rate for Payer: Railroad Medicare Medicare |
$15.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.22
|
| Rate for Payer: UHC Core |
$33.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.55
|
| Rate for Payer: UHC Exchange |
$33.22
|
| Rate for Payer: UHC Medicaid |
$10.01
|
| Rate for Payer: UHCCP Medicaid |
$10.01
|
| Rate for Payer: UMR Bronson Commercial |
$39.10
|
|
|
PR VNPNXR 3 YEARS/> PHYS/QHP SKILL DX/THER PURPOSES
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 36410
|
| Min. Negotiated Rate |
$7.99 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna Commercial |
$10.71
|
| Rate for Payer: Aetna Medicare |
$8.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.51
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: BCBS MAPPO |
$7.99
|
| Rate for Payer: BCN Commercial |
$13.45
|
| Rate for Payer: BCN Medicare Advantage |
$7.99
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cofinity Commercial |
$11.51
|
| Rate for Payer: Cofinity Commercial |
$10.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.79
|
| Rate for Payer: Nomi Health Commercial |
$9.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.00
|
| Rate for Payer: PACE SWMI |
$7.99
|
| Rate for Payer: PHP Commercial |
$11.19
|
| Rate for Payer: PHP Medicare Advantage |
$7.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14.45
|
| Rate for Payer: Priority Health Medicare |
$7.99
|
| Rate for Payer: Priority Health SBD |
$14.45
|
| Rate for Payer: Priority Health Tiered Network |
$14.45
|
| Rate for Payer: Railroad Medicare Medicare |
$7.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.58
|
| Rate for Payer: UHC Core |
$16.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.99
|
| Rate for Payer: UHC Exchange |
$16.58
|
| Rate for Payer: UMR Bronson Commercial |
$16.56
|
|
|
PR VNPNXR <3 YEARS PHYS/QHP SKILL OTHER VEIN
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 36406
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: Aetna Commercial |
$10.20
|
| Rate for Payer: Aetna Medicare |
$7.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.96
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS MAPPO |
$7.61
|
| Rate for Payer: BCN Commercial |
$12.95
|
| Rate for Payer: BCN Medicare Advantage |
$7.61
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cofinity Commercial |
$10.96
|
| Rate for Payer: Cofinity Commercial |
$10.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.99
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.37
|
| Rate for Payer: Nomi Health Commercial |
$9.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.50
|
| Rate for Payer: PACE SWMI |
$7.61
|
| Rate for Payer: PHP Commercial |
$10.65
|
| Rate for Payer: PHP Medicare Advantage |
$7.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.92
|
| Rate for Payer: Priority Health Medicare |
$7.61
|
| Rate for Payer: Priority Health SBD |
$13.92
|
| Rate for Payer: Priority Health Tiered Network |
$13.92
|
| Rate for Payer: Railroad Medicare Medicare |
$7.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.38
|
| Rate for Payer: UHC Core |
$15.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.61
|
| Rate for Payer: UHC Exchange |
$15.38
|
| Rate for Payer: UHC Medicaid |
$4.90
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
| Rate for Payer: UMR Bronson Commercial |
$17.48
|
|
|
PR VOID PRESSURE STUDIES INTRAABDOMINAL
|
Professional
|
Both
|
$534.00
|
|
|
Service Code
|
HCPCS 51797
|
| Min. Negotiated Rate |
$144.27 |
| Max. Negotiated Rate |
$400.50 |
| Rate for Payer: Aetna Commercial |
$193.32
|
| Rate for Payer: Aetna Medicare |
$150.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.75
|
| Rate for Payer: BCBS MAPPO |
$144.27
|
| Rate for Payer: BCN Commercial |
$247.99
|
| Rate for Payer: BCN Medicare Advantage |
$144.27
|
| Rate for Payer: Cash Price |
$427.20
|
| Rate for Payer: Cash Price |
$427.20
|
| Rate for Payer: Cofinity Commercial |
$193.32
|
| Rate for Payer: Cofinity Commercial |
$207.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$158.70
|
| Rate for Payer: Nomi Health Commercial |
$173.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$400.50
|
| Rate for Payer: PACE SWMI |
$144.27
|
| Rate for Payer: PHP Commercial |
$201.98
|
| Rate for Payer: PHP Medicare Advantage |
$144.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$270.15
|
| Rate for Payer: Priority Health Medicare |
$144.27
|
| Rate for Payer: Priority Health SBD |
$270.15
|
| Rate for Payer: Priority Health Tiered Network |
$270.15
|
| Rate for Payer: Railroad Medicare Medicare |
$144.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.58
|
| Rate for Payer: UHC Core |
$269.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$144.27
|
| Rate for Payer: UHC Exchange |
$269.58
|
| Rate for Payer: UMR Bronson Commercial |
$245.64
|
|
|
PR VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRK
|
Professional
|
Both
|
$144.00
|
|
|
Service Code
|
HCPCS 92540
|
| Min. Negotiated Rate |
$66.24 |
| Max. Negotiated Rate |
$169.32 |
| Rate for Payer: Aetna Commercial |
$132.55
|
| Rate for Payer: Aetna Medicare |
$102.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.44
|
| Rate for Payer: BCBS MAPPO |
$98.92
|
| Rate for Payer: BCN Commercial |
$156.37
|
| Rate for Payer: BCN Medicare Advantage |
$98.92
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cofinity Commercial |
$142.44
|
| Rate for Payer: Cofinity Commercial |
$132.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.81
|
| Rate for Payer: Nomi Health Commercial |
$118.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$108.00
|
| Rate for Payer: PACE SWMI |
$98.92
|
| Rate for Payer: PHP Commercial |
$138.49
|
| Rate for Payer: PHP Medicare Advantage |
$98.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$144.21
|
| Rate for Payer: Priority Health Medicare |
$98.92
|
| Rate for Payer: Priority Health SBD |
$144.21
|
| Rate for Payer: Priority Health Tiered Network |
$144.21
|
| Rate for Payer: Railroad Medicare Medicare |
$98.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.32
|
| Rate for Payer: UHC Core |
$169.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.92
|
| Rate for Payer: UHC Exchange |
$169.32
|
| Rate for Payer: UMR Bronson Commercial |
$66.24
|
|
|
PR VULVECTOMY RADICAL PARTIAL
|
Professional
|
Both
|
$1,672.00
|
|
|
Service Code
|
HCPCS 56630
|
| Min. Negotiated Rate |
$572.54 |
| Max. Negotiated Rate |
$1,647.36 |
| Rate for Payer: Aetna Commercial |
$1,185.34
|
| Rate for Payer: Aetna Medicare |
$919.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,185.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,273.80
|
| Rate for Payer: BCBS Complete |
$601.17
|
| Rate for Payer: BCBS MAPPO |
$884.58
|
| Rate for Payer: BCN Commercial |
$1,444.14
|
| Rate for Payer: BCN Medicare Advantage |
$884.58
|
| Rate for Payer: Cash Price |
$1,337.60
|
| Rate for Payer: Cash Price |
$1,337.60
|
| Rate for Payer: Cofinity Commercial |
$1,185.34
|
| Rate for Payer: Cofinity Commercial |
$1,273.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$884.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$928.81
|
| Rate for Payer: Meridian Medicaid |
$601.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$973.04
|
| Rate for Payer: Nomi Health Commercial |
$1,061.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,254.00
|
| Rate for Payer: PACE SWMI |
$884.58
|
| Rate for Payer: PHP Commercial |
$1,238.41
|
| Rate for Payer: PHP Medicare Advantage |
$884.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$572.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,462.61
|
| Rate for Payer: Priority Health Medicare |
$884.58
|
| Rate for Payer: Priority Health SBD |
$1,462.61
|
| Rate for Payer: Priority Health Tiered Network |
$1,462.61
|
| Rate for Payer: Railroad Medicare Medicare |
$884.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,647.36
|
| Rate for Payer: UHC Core |
$1,647.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$884.58
|
| Rate for Payer: UHC Exchange |
$1,647.36
|
| Rate for Payer: UHC Medicaid |
$572.54
|
| Rate for Payer: UHCCP Medicaid |
$572.54
|
| Rate for Payer: UMR Bronson Commercial |
$769.12
|
|
|
PR VULVECTOMY SIMPLE PARTIAL
|
Professional
|
Both
|
$1,618.00
|
|
|
Service Code
|
HCPCS 56620
|
| Min. Negotiated Rate |
$348.68 |
| Max. Negotiated Rate |
$1,213.50 |
| Rate for Payer: Aetna Commercial |
$712.12
|
| Rate for Payer: Aetna Medicare |
$552.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$712.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$765.26
|
| Rate for Payer: BCBS Complete |
$366.11
|
| Rate for Payer: BCBS MAPPO |
$531.43
|
| Rate for Payer: BCN Commercial |
$883.42
|
| Rate for Payer: BCN Medicare Advantage |
$531.43
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cash Price |
$1,294.40
|
| Rate for Payer: Cofinity Commercial |
$712.12
|
| Rate for Payer: Cofinity Commercial |
$765.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$531.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$558.00
|
| Rate for Payer: Meridian Medicaid |
$366.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$584.57
|
| Rate for Payer: Nomi Health Commercial |
$637.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,213.50
|
| Rate for Payer: PACE SWMI |
$531.43
|
| Rate for Payer: PHP Commercial |
$744.00
|
| Rate for Payer: PHP Medicare Advantage |
$531.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$894.72
|
| Rate for Payer: Priority Health Medicare |
$531.43
|
| Rate for Payer: Priority Health SBD |
$894.72
|
| Rate for Payer: Priority Health Tiered Network |
$894.72
|
| Rate for Payer: Railroad Medicare Medicare |
$531.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$961.16
|
| Rate for Payer: UHC Core |
$961.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$531.43
|
| Rate for Payer: UHC Exchange |
$961.16
|
| Rate for Payer: UHC Medicaid |
$348.68
|
| Rate for Payer: UHCCP Medicaid |
$348.68
|
| Rate for Payer: UMR Bronson Commercial |
$744.28
|
|
|
PR WEDGE EXCISION SKIN NAIL FOLD
|
Professional
|
Both
|
$280.00
|
|
|
Service Code
|
HCPCS 11765
|
| Min. Negotiated Rate |
$56.87 |
| Max. Negotiated Rate |
$210.00 |
| Rate for Payer: Aetna Commercial |
$114.61
|
| Rate for Payer: Aetna Medicare |
$88.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.16
|
| Rate for Payer: BCBS Complete |
$59.71
|
| Rate for Payer: BCBS MAPPO |
$85.53
|
| Rate for Payer: BCN Commercial |
$110.74
|
| Rate for Payer: BCN Medicare Advantage |
$85.53
|
| Rate for Payer: Cash Price |
$224.00
|
| Rate for Payer: Cash Price |
$224.00
|
| Rate for Payer: Cofinity Commercial |
$114.61
|
| Rate for Payer: Cofinity Commercial |
$123.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.81
|
| Rate for Payer: Meridian Medicaid |
$59.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$94.08
|
| Rate for Payer: Nomi Health Commercial |
$102.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.00
|
| Rate for Payer: PACE SWMI |
$85.53
|
| Rate for Payer: PHP Commercial |
$119.74
|
| Rate for Payer: PHP Medicare Advantage |
$85.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$128.53
|
| Rate for Payer: Priority Health Medicare |
$85.53
|
| Rate for Payer: Priority Health SBD |
$128.53
|
| Rate for Payer: Priority Health Tiered Network |
$128.53
|
| Rate for Payer: Railroad Medicare Medicare |
$85.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.67
|
| Rate for Payer: UHC Core |
$158.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$85.53
|
| Rate for Payer: UHC Exchange |
$158.67
|
| Rate for Payer: UHC Medicaid |
$56.87
|
| Rate for Payer: UHCCP Medicaid |
$56.87
|
| Rate for Payer: UMR Bronson Commercial |
$128.80
|
|
|
PR WEDGE RESCJ/BISCTJ OVARY UNI/BI
|
Professional
|
Both
|
$1,987.00
|
|
|
Service Code
|
HCPCS 58920
|
| Min. Negotiated Rate |
$402.57 |
| Max. Negotiated Rate |
$1,490.25 |
| Rate for Payer: Aetna Commercial |
$837.50
|
| Rate for Payer: Aetna Medicare |
$650.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$837.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$900.00
|
| Rate for Payer: BCBS Complete |
$422.70
|
| Rate for Payer: BCBS MAPPO |
$625.00
|
| Rate for Payer: BCN Commercial |
$1,070.66
|
| Rate for Payer: BCN Medicare Advantage |
$625.00
|
| Rate for Payer: Cash Price |
$1,589.60
|
| Rate for Payer: Cash Price |
$1,589.60
|
| Rate for Payer: Cofinity Commercial |
$837.50
|
| Rate for Payer: Cofinity Commercial |
$900.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.25
|
| Rate for Payer: Meridian Medicaid |
$422.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$687.50
|
| Rate for Payer: Nomi Health Commercial |
$750.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,490.25
|
| Rate for Payer: PACE SWMI |
$625.00
|
| Rate for Payer: PHP Commercial |
$875.00
|
| Rate for Payer: PHP Medicare Advantage |
$625.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$402.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,084.35
|
| Rate for Payer: Priority Health Medicare |
$625.00
|
| Rate for Payer: Priority Health SBD |
$1,084.35
|
| Rate for Payer: Priority Health Tiered Network |
$1,084.35
|
| Rate for Payer: Railroad Medicare Medicare |
$625.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,257.97
|
| Rate for Payer: UHC Core |
$1,257.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.00
|
| Rate for Payer: UHC Exchange |
$1,257.97
|
| Rate for Payer: UHC Medicaid |
$402.57
|
| Rate for Payer: UHCCP Medicaid |
$402.57
|
| Rate for Payer: UMR Bronson Commercial |
$914.02
|
|
|
PR WEDGING CAST EXCEPT CLUBFOOT CASTS
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 29740
|
| Min. Negotiated Rate |
$38.55 |
| Max. Negotiated Rate |
$123.26 |
| Rate for Payer: Aetna Commercial |
$80.33
|
| Rate for Payer: Aetna Medicare |
$62.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.33
|
| Rate for Payer: BCBS Complete |
$40.48
|
| Rate for Payer: BCBS MAPPO |
$59.95
|
| Rate for Payer: BCN Commercial |
$103.08
|
| Rate for Payer: BCN Medicare Advantage |
$59.95
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$80.33
|
| Rate for Payer: Cofinity Commercial |
$86.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.95
|
| Rate for Payer: Meridian Medicaid |
$40.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.94
|
| Rate for Payer: Nomi Health Commercial |
$71.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.75
|
| Rate for Payer: PACE SWMI |
$59.95
|
| Rate for Payer: PHP Commercial |
$83.93
|
| Rate for Payer: PHP Medicare Advantage |
$59.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$110.20
|
| Rate for Payer: Priority Health Medicare |
$59.95
|
| Rate for Payer: Priority Health SBD |
$110.20
|
| Rate for Payer: Priority Health Tiered Network |
$110.20
|
| Rate for Payer: Railroad Medicare Medicare |
$59.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.26
|
| Rate for Payer: UHC Core |
$123.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$59.95
|
| Rate for Payer: UHC Exchange |
$123.26
|
| Rate for Payer: UHC Medicaid |
$38.55
|
| Rate for Payer: UHCCP Medicaid |
$38.55
|
| Rate for Payer: UMR Bronson Commercial |
$53.82
|
|
|
PR WESTONE MUSICIAN EAR PLUGS
|
Professional
|
Both
|
$305.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$122.00 |
| Max. Negotiated Rate |
$228.75 |
| Rate for Payer: Aetna Medicare |
$152.50
|
| Rate for Payer: BCBS Complete |
$122.00
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.75
|
| Rate for Payer: UMR Bronson Commercial |
$140.30
|
|
|
PR WET MOUNTS/ W PREPARATIONS
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS Q0111
|
| Min. Negotiated Rate |
$5.52 |
| Max. Negotiated Rate |
$26.70 |
| Rate for Payer: Aetna Commercial |
$24.84
|
| Rate for Payer: Aetna Medicare |
$19.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.70
|
| Rate for Payer: BCBS MAPPO |
$18.54
|
| Rate for Payer: BCN Commercial |
$12.75
|
| Rate for Payer: BCN Medicare Advantage |
$18.54
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$24.84
|
| Rate for Payer: Cofinity Commercial |
$26.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.39
|
| Rate for Payer: Nomi Health Commercial |
$22.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.00
|
| Rate for Payer: PACE SWMI |
$18.54
|
| Rate for Payer: PHP Commercial |
$25.96
|
| Rate for Payer: PHP Medicare Advantage |
$18.54
|
| Rate for Payer: Priority Health Medicare |
$18.54
|
| Rate for Payer: Railroad Medicare Medicare |
$18.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.07
|
| Rate for Payer: UHC Core |
$9.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.54
|
| Rate for Payer: UHC Exchange |
$9.07
|
| Rate for Payer: UMR Bronson Commercial |
$5.52
|
|
|
PR WHFO, RIGID W/O JOINTS
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS L3808
|
| Min. Negotiated Rate |
$129.91 |
| Max. Negotiated Rate |
$573.74 |
| Rate for Payer: Aetna Commercial |
$533.90
|
| Rate for Payer: Aetna Medicare |
$414.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.74
|
| Rate for Payer: BCBS Complete |
$137.20
|
| Rate for Payer: BCBS MAPPO |
$398.43
|
| Rate for Payer: BCN Commercial |
$381.46
|
| Rate for Payer: BCN Medicare Advantage |
$398.43
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$533.90
|
| Rate for Payer: Cofinity Commercial |
$573.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.27
|
| Rate for Payer: Nomi Health Commercial |
$478.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.25
|
| Rate for Payer: PACE SWMI |
$398.43
|
| Rate for Payer: PHP Commercial |
$557.80
|
| Rate for Payer: PHP Medicare Advantage |
$398.43
|
| Rate for Payer: Priority Health Medicare |
$398.43
|
| Rate for Payer: Railroad Medicare Medicare |
$398.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.91
|
| Rate for Payer: UHC Core |
$129.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.43
|
| Rate for Payer: UHC Exchange |
$129.91
|
| Rate for Payer: UMR Bronson Commercial |
$157.78
|
|
|
PR WHFO W/O JOINTS PRE CST
|
Professional
|
Both
|
$241.00
|
|
|
Service Code
|
HCPCS L3807
|
| Min. Negotiated Rate |
$91.19 |
| Max. Negotiated Rate |
$402.72 |
| Rate for Payer: Aetna Commercial |
$374.76
|
| Rate for Payer: Aetna Medicare |
$290.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.72
|
| Rate for Payer: BCBS Complete |
$96.40
|
| Rate for Payer: BCBS MAPPO |
$279.67
|
| Rate for Payer: BCN Commercial |
$267.76
|
| Rate for Payer: BCN Medicare Advantage |
$279.67
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cofinity Commercial |
$402.72
|
| Rate for Payer: Cofinity Commercial |
$374.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$307.64
|
| Rate for Payer: Nomi Health Commercial |
$335.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.75
|
| Rate for Payer: PACE SWMI |
$279.67
|
| Rate for Payer: PHP Commercial |
$391.54
|
| Rate for Payer: PHP Medicare Advantage |
$279.67
|
| Rate for Payer: Priority Health Medicare |
$279.67
|
| Rate for Payer: Railroad Medicare Medicare |
$279.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.19
|
| Rate for Payer: UHC Core |
$91.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$279.67
|
| Rate for Payer: UHC Exchange |
$91.19
|
| Rate for Payer: UMR Bronson Commercial |
$110.86
|
|
|
PR WHO COCK-UP NONMOLDE PRE OTS
|
Professional
|
Both
|
$71.00
|
|
|
Service Code
|
HCPCS L3908
|
| Min. Negotiated Rate |
$26.74 |
| Max. Negotiated Rate |
$118.08 |
| Rate for Payer: Aetna Commercial |
$109.88
|
| Rate for Payer: Aetna Medicare |
$85.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.08
|
| Rate for Payer: BCBS Complete |
$28.40
|
| Rate for Payer: BCBS MAPPO |
$82.00
|
| Rate for Payer: BCN Commercial |
$78.51
|
| Rate for Payer: BCN Medicare Advantage |
$82.00
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cofinity Commercial |
$109.88
|
| Rate for Payer: Cofinity Commercial |
$118.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$98.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.25
|
| Rate for Payer: PACE SWMI |
$82.00
|
| Rate for Payer: PHP Commercial |
$114.80
|
| Rate for Payer: PHP Medicare Advantage |
$82.00
|
| Rate for Payer: Priority Health Medicare |
$82.00
|
| Rate for Payer: Railroad Medicare Medicare |
$82.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.74
|
| Rate for Payer: UHC Core |
$26.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$82.00
|
| Rate for Payer: UHC Exchange |
$26.74
|
| Rate for Payer: UMR Bronson Commercial |
$32.66
|
|
|
PR WHO W/NONTORSION JNT(S) CF
|
Professional
|
Both
|
$954.00
|
|
|
Service Code
|
HCPCS L3905
|
| Min. Negotiated Rate |
$361.66 |
| Max. Negotiated Rate |
$1,597.19 |
| Rate for Payer: Aetna Commercial |
$1,486.27
|
| Rate for Payer: Aetna Medicare |
$1,153.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,486.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,597.19
|
| Rate for Payer: BCBS Complete |
$381.60
|
| Rate for Payer: BCBS MAPPO |
$1,109.16
|
| Rate for Payer: BCN Commercial |
$1,061.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,109.16
|
| Rate for Payer: Cash Price |
$763.20
|
| Rate for Payer: Cash Price |
$763.20
|
| Rate for Payer: Cofinity Commercial |
$1,597.19
|
| Rate for Payer: Cofinity Commercial |
$1,486.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,109.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,164.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,220.08
|
| Rate for Payer: Nomi Health Commercial |
$1,330.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$715.50
|
| Rate for Payer: PACE SWMI |
$1,109.16
|
| Rate for Payer: PHP Commercial |
$1,552.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,109.16
|
| Rate for Payer: Priority Health Medicare |
$1,109.16
|
| Rate for Payer: Railroad Medicare Medicare |
$1,109.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$361.66
|
| Rate for Payer: UHC Core |
$361.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,109.16
|
| Rate for Payer: UHC Exchange |
$361.66
|
| Rate for Payer: UMR Bronson Commercial |
$438.84
|
|
|
PR WHO W/O JOINTS CF
|
Professional
|
Both
|
$487.00
|
|
|
Service Code
|
HCPCS L3906
|
| Min. Negotiated Rate |
$184.82 |
| Max. Negotiated Rate |
$816.18 |
| Rate for Payer: Aetna Commercial |
$759.50
|
| Rate for Payer: Aetna Medicare |
$589.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$816.18
|
| Rate for Payer: BCBS Complete |
$194.80
|
| Rate for Payer: BCBS MAPPO |
$566.79
|
| Rate for Payer: BCN Commercial |
$542.66
|
| Rate for Payer: BCN Medicare Advantage |
$566.79
|
| Rate for Payer: Cash Price |
$389.60
|
| Rate for Payer: Cash Price |
$389.60
|
| Rate for Payer: Cofinity Commercial |
$759.50
|
| Rate for Payer: Cofinity Commercial |
$816.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$595.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$623.47
|
| Rate for Payer: Nomi Health Commercial |
$680.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$365.25
|
| Rate for Payer: PACE SWMI |
$566.79
|
| Rate for Payer: PHP Commercial |
$793.51
|
| Rate for Payer: PHP Medicare Advantage |
$566.79
|
| Rate for Payer: Priority Health Medicare |
$566.79
|
| Rate for Payer: Railroad Medicare Medicare |
$566.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.82
|
| Rate for Payer: UHC Core |
$184.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$566.79
|
| Rate for Payer: UHC Exchange |
$184.82
|
| Rate for Payer: UMR Bronson Commercial |
$224.02
|
|
|
PR WINDOWING CAST
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 29730
|
| Min. Negotiated Rate |
$24.71 |
| Max. Negotiated Rate |
$87.75 |
| Rate for Payer: Aetna Commercial |
$51.40
|
| Rate for Payer: Aetna Medicare |
$39.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.24
|
| Rate for Payer: BCBS Complete |
$25.95
|
| Rate for Payer: BCBS MAPPO |
$38.36
|
| Rate for Payer: BCN Commercial |
$66.73
|
| Rate for Payer: BCN Medicare Advantage |
$38.36
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$51.40
|
| Rate for Payer: Cofinity Commercial |
$55.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.28
|
| Rate for Payer: Meridian Medicaid |
$25.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.20
|
| Rate for Payer: Nomi Health Commercial |
$46.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.75
|
| Rate for Payer: PACE SWMI |
$38.36
|
| Rate for Payer: PHP Commercial |
$53.70
|
| Rate for Payer: PHP Medicare Advantage |
$38.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$71.32
|
| Rate for Payer: Priority Health Medicare |
$38.36
|
| Rate for Payer: Priority Health SBD |
$71.32
|
| Rate for Payer: Priority Health Tiered Network |
$71.32
|
| Rate for Payer: Railroad Medicare Medicare |
$38.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.40
|
| Rate for Payer: UHC Core |
$76.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38.36
|
| Rate for Payer: UHC Exchange |
$76.40
|
| Rate for Payer: UHC Medicaid |
$24.71
|
| Rate for Payer: UHCCP Medicaid |
$24.71
|
| Rate for Payer: UMR Bronson Commercial |
$53.82
|
|
|
PR WORK HARDENING/CONDITIONING 1ST 2 HR
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 97545
|
| Min. Negotiated Rate |
$81.60 |
| Max. Negotiated Rate |
$189.41 |
| Rate for Payer: Aetna Commercial |
$119.94
|
| Rate for Payer: Aetna Medicare |
$102.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.94
|
| Rate for Payer: BCBS Complete |
$81.60
|
| Rate for Payer: BCN Commercial |
$189.41
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$89.48
|
| Rate for Payer: Priority Health SBD |
$89.48
|
| Rate for Payer: Priority Health Tiered Network |
$89.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.21
|
| Rate for Payer: UHC Core |
$142.21
|
| Rate for Payer: UHC Exchange |
$142.21
|
| Rate for Payer: UMR Bronson Commercial |
$93.84
|
|
