|
PR SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART
|
Professional
|
Both
|
$1,258.00
|
|
|
Service Code
|
HCPCS 36224
|
| Min. Negotiated Rate |
$235.15 |
| Max. Negotiated Rate |
$2,995.59 |
| Rate for Payer: Aetna Commercial |
$481.96
|
| Rate for Payer: Aetna Medicare |
$374.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$481.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$517.92
|
| Rate for Payer: BCBS Complete |
$246.91
|
| Rate for Payer: BCBS MAPPO |
$359.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,419.54
|
| Rate for Payer: BCN Commercial |
$2,995.59
|
| Rate for Payer: BCN Medicare Advantage |
$359.67
|
| Rate for Payer: Cash Price |
$1,006.40
|
| Rate for Payer: Cash Price |
$1,006.40
|
| Rate for Payer: Cofinity Commercial |
$481.96
|
| Rate for Payer: Cofinity Commercial |
$517.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$359.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$377.65
|
| Rate for Payer: Meridian Medicaid |
$246.91
|
| Rate for Payer: Nomi Health Commercial |
$431.60
|
| Rate for Payer: PACE SWMI |
$359.67
|
| Rate for Payer: PHP Commercial |
$503.54
|
| Rate for Payer: PHP Medicare Advantage |
$359.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$817.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$581.28
|
| Rate for Payer: Priority Health Medicare |
$359.67
|
| Rate for Payer: Priority Health Narrow Network |
$581.28
|
| Rate for Payer: Priority Health SBD |
$581.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$359.67
|
| Rate for Payer: UHC Medicare Advantage |
$359.67
|
| Rate for Payer: UHCCP Medicaid |
$235.15
|
| Rate for Payer: UMR Bronson Commercial |
$578.68
|
|
|
PR SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$2,344.00
|
|
|
Service Code
|
HCPCS 36216
|
| Min. Negotiated Rate |
$170.83 |
| Max. Negotiated Rate |
$1,562.31 |
| Rate for Payer: Aetna Commercial |
$349.27
|
| Rate for Payer: Aetna Medicare |
$271.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$349.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.34
|
| Rate for Payer: BCBS Complete |
$179.37
|
| Rate for Payer: BCBS MAPPO |
$260.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,102.56
|
| Rate for Payer: BCN Commercial |
$1,562.31
|
| Rate for Payer: BCN Medicare Advantage |
$260.65
|
| Rate for Payer: Cash Price |
$1,875.20
|
| Rate for Payer: Cash Price |
$1,875.20
|
| Rate for Payer: Cofinity Commercial |
$349.27
|
| Rate for Payer: Cofinity Commercial |
$375.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.68
|
| Rate for Payer: Meridian Medicaid |
$179.37
|
| Rate for Payer: Nomi Health Commercial |
$312.78
|
| Rate for Payer: PACE SWMI |
$260.65
|
| Rate for Payer: PHP Commercial |
$364.91
|
| Rate for Payer: PHP Medicare Advantage |
$260.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$170.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,523.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$423.86
|
| Rate for Payer: Priority Health Medicare |
$260.65
|
| Rate for Payer: Priority Health Narrow Network |
$423.86
|
| Rate for Payer: Priority Health SBD |
$423.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.65
|
| Rate for Payer: UHC Medicare Advantage |
$260.65
|
| Rate for Payer: UHCCP Medicaid |
$170.83
|
| Rate for Payer: UMR Bronson Commercial |
$1,078.24
|
|
|
PR SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH
|
Professional
|
Both
|
$1,042.00
|
|
|
Service Code
|
HCPCS 36246
|
| Min. Negotiated Rate |
$157.19 |
| Max. Negotiated Rate |
$1,388.37 |
| Rate for Payer: Aetna Commercial |
$322.36
|
| Rate for Payer: Aetna Medicare |
$250.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.42
|
| Rate for Payer: BCBS Complete |
$165.05
|
| Rate for Payer: BCBS MAPPO |
$240.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,388.37
|
| Rate for Payer: BCN Commercial |
$1,224.14
|
| Rate for Payer: BCN Medicare Advantage |
$240.57
|
| Rate for Payer: Cash Price |
$833.60
|
| Rate for Payer: Cash Price |
$833.60
|
| Rate for Payer: Cofinity Commercial |
$322.36
|
| Rate for Payer: Cofinity Commercial |
$346.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$252.60
|
| Rate for Payer: Meridian Medicaid |
$165.05
|
| Rate for Payer: Nomi Health Commercial |
$288.68
|
| Rate for Payer: PACE SWMI |
$240.57
|
| Rate for Payer: PHP Commercial |
$336.80
|
| Rate for Payer: PHP Medicare Advantage |
$240.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$677.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$392.48
|
| Rate for Payer: Priority Health Medicare |
$240.57
|
| Rate for Payer: Priority Health Narrow Network |
$392.48
|
| Rate for Payer: Priority Health SBD |
$392.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$240.57
|
| Rate for Payer: UHC Medicare Advantage |
$240.57
|
| Rate for Payer: UHCCP Medicaid |
$157.19
|
| Rate for Payer: UMR Bronson Commercial |
$479.32
|
|
|
PR SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH
|
Professional
|
Both
|
$1,304.00
|
|
|
Service Code
|
HCPCS 36247
|
| Min. Negotiated Rate |
$185.52 |
| Max. Negotiated Rate |
$2,090.07 |
| Rate for Payer: Aetna Commercial |
$378.47
|
| Rate for Payer: Aetna Medicare |
$293.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.71
|
| Rate for Payer: BCBS Complete |
$194.80
|
| Rate for Payer: BCBS MAPPO |
$282.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,650.94
|
| Rate for Payer: BCN Commercial |
$2,090.07
|
| Rate for Payer: BCN Medicare Advantage |
$282.44
|
| Rate for Payer: Cash Price |
$1,043.20
|
| Rate for Payer: Cash Price |
$1,043.20
|
| Rate for Payer: Cofinity Commercial |
$378.47
|
| Rate for Payer: Cofinity Commercial |
$406.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.56
|
| Rate for Payer: Meridian Medicaid |
$194.80
|
| Rate for Payer: Nomi Health Commercial |
$338.93
|
| Rate for Payer: PACE SWMI |
$282.44
|
| Rate for Payer: PHP Commercial |
$395.42
|
| Rate for Payer: PHP Medicare Advantage |
$282.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$185.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$847.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$462.16
|
| Rate for Payer: Priority Health Medicare |
$282.44
|
| Rate for Payer: Priority Health Narrow Network |
$462.16
|
| Rate for Payer: Priority Health SBD |
$462.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$282.44
|
| Rate for Payer: UHC Medicare Advantage |
$282.44
|
| Rate for Payer: UHCCP Medicaid |
$185.52
|
| Rate for Payer: UMR Bronson Commercial |
$599.84
|
|
|
PR SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$1,377.00
|
|
|
Service Code
|
HCPCS 36217
|
| Min. Negotiated Rate |
$212.36 |
| Max. Negotiated Rate |
$2,617.35 |
| Rate for Payer: Aetna Commercial |
$434.98
|
| Rate for Payer: Aetna Medicare |
$337.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.44
|
| Rate for Payer: BCBS Complete |
$222.98
|
| Rate for Payer: BCBS MAPPO |
$324.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,410.56
|
| Rate for Payer: BCN Commercial |
$2,617.35
|
| Rate for Payer: BCN Medicare Advantage |
$324.61
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$434.98
|
| Rate for Payer: Cofinity Commercial |
$467.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.84
|
| Rate for Payer: Meridian Medicaid |
$222.98
|
| Rate for Payer: Nomi Health Commercial |
$389.53
|
| Rate for Payer: PACE SWMI |
$324.61
|
| Rate for Payer: PHP Commercial |
$454.45
|
| Rate for Payer: PHP Medicare Advantage |
$324.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$520.12
|
| Rate for Payer: Priority Health Medicare |
$324.61
|
| Rate for Payer: Priority Health Narrow Network |
$520.12
|
| Rate for Payer: Priority Health SBD |
$520.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.61
|
| Rate for Payer: UHC Medicare Advantage |
$324.61
|
| Rate for Payer: UHCCP Medicaid |
$212.36
|
| Rate for Payer: UMR Bronson Commercial |
$633.42
|
|
|
PR SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH
|
Professional
|
Both
|
$835.00
|
|
|
Service Code
|
HCPCS 36245
|
| Min. Negotiated Rate |
$147.61 |
| Max. Negotiated Rate |
$1,828.14 |
| Rate for Payer: Aetna Commercial |
$301.00
|
| Rate for Payer: Aetna Medicare |
$233.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$323.47
|
| Rate for Payer: BCBS Complete |
$154.99
|
| Rate for Payer: BCBS MAPPO |
$224.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,012.22
|
| Rate for Payer: BCN Commercial |
$1,828.14
|
| Rate for Payer: BCN Medicare Advantage |
$224.63
|
| Rate for Payer: Cash Price |
$668.00
|
| Rate for Payer: Cash Price |
$668.00
|
| Rate for Payer: Cofinity Commercial |
$301.00
|
| Rate for Payer: Cofinity Commercial |
$323.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$224.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$235.86
|
| Rate for Payer: Meridian Medicaid |
$154.99
|
| Rate for Payer: Nomi Health Commercial |
$269.56
|
| Rate for Payer: PACE SWMI |
$224.63
|
| Rate for Payer: PHP Commercial |
$314.48
|
| Rate for Payer: PHP Medicare Advantage |
$224.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$147.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$542.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$365.90
|
| Rate for Payer: Priority Health Medicare |
$224.63
|
| Rate for Payer: Priority Health Narrow Network |
$365.90
|
| Rate for Payer: Priority Health SBD |
$365.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$224.63
|
| Rate for Payer: UHC Medicare Advantage |
$224.63
|
| Rate for Payer: UHCCP Medicaid |
$147.61
|
| Rate for Payer: UMR Bronson Commercial |
$384.10
|
|
|
PR SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$918.00
|
|
|
Service Code
|
HCPCS 36215
|
| Min. Negotiated Rate |
$133.76 |
| Max. Negotiated Rate |
$1,519.78 |
| Rate for Payer: Aetna Commercial |
$271.22
|
| Rate for Payer: Aetna Medicare |
$210.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$291.46
|
| Rate for Payer: BCBS Complete |
$140.45
|
| Rate for Payer: BCBS MAPPO |
$202.40
|
| Rate for Payer: BCBS Trust/PPO |
$781.36
|
| Rate for Payer: BCN Commercial |
$1,519.78
|
| Rate for Payer: BCN Medicare Advantage |
$202.40
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cofinity Commercial |
$271.22
|
| Rate for Payer: Cofinity Commercial |
$291.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$202.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$212.52
|
| Rate for Payer: Meridian Medicaid |
$140.45
|
| Rate for Payer: Nomi Health Commercial |
$242.88
|
| Rate for Payer: PACE SWMI |
$202.40
|
| Rate for Payer: PHP Commercial |
$283.36
|
| Rate for Payer: PHP Medicare Advantage |
$202.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$330.27
|
| Rate for Payer: Priority Health Medicare |
$202.40
|
| Rate for Payer: Priority Health Narrow Network |
$330.27
|
| Rate for Payer: Priority Health SBD |
$330.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$202.40
|
| Rate for Payer: UHC Medicare Advantage |
$202.40
|
| Rate for Payer: UHCCP Medicaid |
$133.76
|
| Rate for Payer: UMR Bronson Commercial |
$422.28
|
|
|
PR SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH
|
Professional
|
Both
|
$243.00
|
|
|
Service Code
|
HCPCS 36248
|
| Min. Negotiated Rate |
$30.25 |
| Max. Negotiated Rate |
$1,877.58 |
| Rate for Payer: Aetna Commercial |
$61.44
|
| Rate for Payer: Aetna Medicare |
$47.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.02
|
| Rate for Payer: BCBS Complete |
$31.76
|
| Rate for Payer: BCBS MAPPO |
$45.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,877.58
|
| Rate for Payer: BCN Commercial |
$171.52
|
| Rate for Payer: BCN Medicare Advantage |
$45.85
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cofinity Commercial |
$61.44
|
| Rate for Payer: Cofinity Commercial |
$66.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.14
|
| Rate for Payer: Meridian Medicaid |
$31.76
|
| Rate for Payer: Nomi Health Commercial |
$55.02
|
| Rate for Payer: PACE SWMI |
$45.85
|
| Rate for Payer: PHP Commercial |
$64.19
|
| Rate for Payer: PHP Medicare Advantage |
$45.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.45
|
| Rate for Payer: Priority Health Medicare |
$45.85
|
| Rate for Payer: Priority Health Narrow Network |
$74.45
|
| Rate for Payer: Priority Health SBD |
$74.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.85
|
| Rate for Payer: UHC Medicare Advantage |
$45.85
|
| Rate for Payer: UHCCP Medicaid |
$30.25
|
| Rate for Payer: UMR Bronson Commercial |
$111.78
|
|
|
PR SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$328.00
|
|
|
Service Code
|
HCPCS 36218
|
| Min. Negotiated Rate |
$33.02 |
| Max. Negotiated Rate |
$489.73 |
| Rate for Payer: Aetna Commercial |
$67.48
|
| Rate for Payer: Aetna Medicare |
$52.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.52
|
| Rate for Payer: BCBS Complete |
$34.67
|
| Rate for Payer: BCBS MAPPO |
$50.36
|
| Rate for Payer: BCBS Trust/PPO |
$489.73
|
| Rate for Payer: BCN Commercial |
$304.94
|
| Rate for Payer: BCN Medicare Advantage |
$50.36
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cofinity Commercial |
$67.48
|
| Rate for Payer: Cofinity Commercial |
$72.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.88
|
| Rate for Payer: Meridian Medicaid |
$34.67
|
| Rate for Payer: Nomi Health Commercial |
$60.43
|
| Rate for Payer: PACE SWMI |
$50.36
|
| Rate for Payer: PHP Commercial |
$70.50
|
| Rate for Payer: PHP Medicare Advantage |
$50.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81.90
|
| Rate for Payer: Priority Health Medicare |
$50.36
|
| Rate for Payer: Priority Health Narrow Network |
$81.90
|
| Rate for Payer: Priority Health SBD |
$81.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.36
|
| Rate for Payer: UHC Medicare Advantage |
$50.36
|
| Rate for Payer: UHCCP Medicaid |
$33.02
|
| Rate for Payer: UMR Bronson Commercial |
$150.88
|
|
|
PR SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART
|
Professional
|
Both
|
$956.00
|
|
|
Service Code
|
HCPCS 36015
|
| Min. Negotiated Rate |
$107.99 |
| Max. Negotiated Rate |
$1,252.48 |
| Rate for Payer: Aetna Commercial |
$219.18
|
| Rate for Payer: Aetna Medicare |
$170.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.54
|
| Rate for Payer: BCBS Complete |
$113.39
|
| Rate for Payer: BCBS MAPPO |
$163.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,087.24
|
| Rate for Payer: BCN Commercial |
$1,252.48
|
| Rate for Payer: BCN Medicare Advantage |
$163.57
|
| Rate for Payer: Cash Price |
$764.80
|
| Rate for Payer: Cash Price |
$764.80
|
| Rate for Payer: Cofinity Commercial |
$219.18
|
| Rate for Payer: Cofinity Commercial |
$235.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$171.75
|
| Rate for Payer: Meridian Medicaid |
$113.39
|
| Rate for Payer: Nomi Health Commercial |
$196.28
|
| Rate for Payer: PACE SWMI |
$163.57
|
| Rate for Payer: PHP Commercial |
$229.00
|
| Rate for Payer: PHP Medicare Advantage |
$163.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$621.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$265.37
|
| Rate for Payer: Priority Health Medicare |
$163.57
|
| Rate for Payer: Priority Health Narrow Network |
$265.37
|
| Rate for Payer: Priority Health SBD |
$265.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.57
|
| Rate for Payer: UHC Medicare Advantage |
$163.57
|
| Rate for Payer: UHCCP Medicaid |
$107.99
|
| Rate for Payer: UMR Bronson Commercial |
$439.76
|
|
|
PR SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH
|
Professional
|
Both
|
$747.00
|
|
|
Service Code
|
HCPCS 36011
|
| Min. Negotiated Rate |
$97.55 |
| Max. Negotiated Rate |
$2,329.71 |
| Rate for Payer: Aetna Commercial |
$198.87
|
| Rate for Payer: Aetna Medicare |
$154.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.71
|
| Rate for Payer: BCBS Complete |
$102.43
|
| Rate for Payer: BCBS MAPPO |
$148.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,329.71
|
| Rate for Payer: BCN Commercial |
$1,185.05
|
| Rate for Payer: BCN Medicare Advantage |
$148.41
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cofinity Commercial |
$198.87
|
| Rate for Payer: Cofinity Commercial |
$213.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$155.83
|
| Rate for Payer: Meridian Medicaid |
$102.43
|
| Rate for Payer: Nomi Health Commercial |
$178.09
|
| Rate for Payer: PACE SWMI |
$148.41
|
| Rate for Payer: PHP Commercial |
$207.77
|
| Rate for Payer: PHP Medicare Advantage |
$148.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$485.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$241.98
|
| Rate for Payer: Priority Health Medicare |
$148.41
|
| Rate for Payer: Priority Health Narrow Network |
$241.98
|
| Rate for Payer: Priority Health SBD |
$241.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$148.41
|
| Rate for Payer: UHC Medicare Advantage |
$148.41
|
| Rate for Payer: UHCCP Medicaid |
$97.55
|
| Rate for Payer: UMR Bronson Commercial |
$343.62
|
|
|
PR SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC
|
Professional
|
Both
|
$980.00
|
|
|
Service Code
|
HCPCS 36012
|
| Min. Negotiated Rate |
$109.48 |
| Max. Negotiated Rate |
$1,531.54 |
| Rate for Payer: Aetna Commercial |
$223.31
|
| Rate for Payer: Aetna Medicare |
$173.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.98
|
| Rate for Payer: BCBS Complete |
$114.95
|
| Rate for Payer: BCBS MAPPO |
$166.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,531.54
|
| Rate for Payer: BCN Commercial |
$1,227.56
|
| Rate for Payer: BCN Medicare Advantage |
$166.65
|
| Rate for Payer: Cash Price |
$784.00
|
| Rate for Payer: Cash Price |
$784.00
|
| Rate for Payer: Cofinity Commercial |
$223.31
|
| Rate for Payer: Cofinity Commercial |
$239.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.98
|
| Rate for Payer: Meridian Medicaid |
$114.95
|
| Rate for Payer: Nomi Health Commercial |
$199.98
|
| Rate for Payer: PACE SWMI |
$166.65
|
| Rate for Payer: PHP Commercial |
$233.31
|
| Rate for Payer: PHP Medicare Advantage |
$166.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$269.64
|
| Rate for Payer: Priority Health Medicare |
$166.65
|
| Rate for Payer: Priority Health Narrow Network |
$269.64
|
| Rate for Payer: Priority Health SBD |
$269.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.65
|
| Rate for Payer: UHC Medicare Advantage |
$166.65
|
| Rate for Payer: UHCCP Medicaid |
$109.48
|
| Rate for Payer: UMR Bronson Commercial |
$450.80
|
|
|
PR SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY
|
Professional
|
Both
|
$1,788.00
|
|
|
Service Code
|
HCPCS 36225
|
| Min. Negotiated Rate |
$208.10 |
| Max. Negotiated Rate |
$2,276.75 |
| Rate for Payer: Aetna Commercial |
$426.94
|
| Rate for Payer: Aetna Medicare |
$331.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.80
|
| Rate for Payer: BCBS Complete |
$218.50
|
| Rate for Payer: BCBS MAPPO |
$318.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,878.11
|
| Rate for Payer: BCN Commercial |
$2,276.75
|
| Rate for Payer: BCN Medicare Advantage |
$318.61
|
| Rate for Payer: Cash Price |
$1,430.40
|
| Rate for Payer: Cash Price |
$1,430.40
|
| Rate for Payer: Cofinity Commercial |
$426.94
|
| Rate for Payer: Cofinity Commercial |
$458.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$334.54
|
| Rate for Payer: Meridian Medicaid |
$218.50
|
| Rate for Payer: Nomi Health Commercial |
$382.33
|
| Rate for Payer: PACE SWMI |
$318.61
|
| Rate for Payer: PHP Commercial |
$446.05
|
| Rate for Payer: PHP Medicare Advantage |
$318.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$513.20
|
| Rate for Payer: Priority Health Medicare |
$318.61
|
| Rate for Payer: Priority Health Narrow Network |
$513.20
|
| Rate for Payer: Priority Health SBD |
$513.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$318.61
|
| Rate for Payer: UHC Medicare Advantage |
$318.61
|
| Rate for Payer: UHCCP Medicaid |
$208.10
|
| Rate for Payer: UMR Bronson Commercial |
$822.48
|
|
|
PR SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY
|
Professional
|
Both
|
$1,260.00
|
|
|
Service Code
|
HCPCS 36226
|
| Min. Negotiated Rate |
$233.45 |
| Max. Negotiated Rate |
$2,912.03 |
| Rate for Payer: Aetna Commercial |
$478.46
|
| Rate for Payer: Aetna Medicare |
$371.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$514.17
|
| Rate for Payer: BCBS Complete |
$245.12
|
| Rate for Payer: BCBS MAPPO |
$357.06
|
| Rate for Payer: BCBS Trust/PPO |
$726.41
|
| Rate for Payer: BCN Commercial |
$2,912.03
|
| Rate for Payer: BCN Medicare Advantage |
$357.06
|
| Rate for Payer: Cash Price |
$1,008.00
|
| Rate for Payer: Cash Price |
$1,008.00
|
| Rate for Payer: Cofinity Commercial |
$478.46
|
| Rate for Payer: Cofinity Commercial |
$514.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.91
|
| Rate for Payer: Meridian Medicaid |
$245.12
|
| Rate for Payer: Nomi Health Commercial |
$428.47
|
| Rate for Payer: PACE SWMI |
$357.06
|
| Rate for Payer: PHP Commercial |
$499.88
|
| Rate for Payer: PHP Medicare Advantage |
$357.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$233.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$819.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$577.56
|
| Rate for Payer: Priority Health Medicare |
$357.06
|
| Rate for Payer: Priority Health Narrow Network |
$577.56
|
| Rate for Payer: Priority Health SBD |
$577.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$357.06
|
| Rate for Payer: UHC Medicare Advantage |
$357.06
|
| Rate for Payer: UHCCP Medicaid |
$233.45
|
| Rate for Payer: UMR Bronson Commercial |
$579.60
|
|
|
PR SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC
|
Professional
|
Both
|
$398.00
|
|
|
Service Code
|
HCPCS 36227
|
| Min. Negotiated Rate |
$76.89 |
| Max. Negotiated Rate |
$1,296.45 |
| Rate for Payer: Aetna Commercial |
$157.76
|
| Rate for Payer: Aetna Medicare |
$122.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.53
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$117.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,296.45
|
| Rate for Payer: BCN Commercial |
$351.85
|
| Rate for Payer: BCN Medicare Advantage |
$117.73
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cofinity Commercial |
$157.76
|
| Rate for Payer: Cofinity Commercial |
$169.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.62
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: Nomi Health Commercial |
$141.28
|
| Rate for Payer: PACE SWMI |
$117.73
|
| Rate for Payer: PHP Commercial |
$164.82
|
| Rate for Payer: PHP Medicare Advantage |
$117.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$190.39
|
| Rate for Payer: Priority Health Medicare |
$117.73
|
| Rate for Payer: Priority Health Narrow Network |
$190.39
|
| Rate for Payer: Priority Health SBD |
$190.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$117.73
|
| Rate for Payer: UHC Medicare Advantage |
$117.73
|
| Rate for Payer: UHCCP Medicaid |
$76.89
|
| Rate for Payer: UMR Bronson Commercial |
$183.08
|
|
|
PR SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT
|
Professional
|
Both
|
$567.00
|
|
|
Service Code
|
HCPCS 95806
|
| Min. Negotiated Rate |
$27.48 |
| Max. Negotiated Rate |
$410.49 |
| Rate for Payer: Aetna Commercial |
$117.88
|
| Rate for Payer: Aetna Commercial |
$117.88
|
| Rate for Payer: Aetna Medicare |
$91.49
|
| Rate for Payer: Aetna Medicare |
$91.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.88
|
| Rate for Payer: BCBS Complete |
$28.85
|
| Rate for Payer: BCBS Complete |
$28.85
|
| Rate for Payer: BCBS MAPPO |
$87.97
|
| Rate for Payer: BCBS MAPPO |
$87.97
|
| Rate for Payer: BCBS Trust/PPO |
$410.49
|
| Rate for Payer: BCBS Trust/PPO |
$410.49
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: BCN Medicare Advantage |
$87.97
|
| Rate for Payer: BCN Medicare Advantage |
$87.97
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cash Price |
$453.60
|
| Rate for Payer: Cofinity Commercial |
$117.88
|
| Rate for Payer: Cofinity Commercial |
$126.68
|
| Rate for Payer: Cofinity Commercial |
$126.68
|
| Rate for Payer: Cofinity Commercial |
$117.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.37
|
| Rate for Payer: Meridian Medicaid |
$28.85
|
| Rate for Payer: Meridian Medicaid |
$28.85
|
| Rate for Payer: Nomi Health Commercial |
$105.56
|
| Rate for Payer: Nomi Health Commercial |
$105.56
|
| Rate for Payer: PACE SWMI |
$87.97
|
| Rate for Payer: PACE SWMI |
$87.97
|
| Rate for Payer: PHP Commercial |
$123.16
|
| Rate for Payer: PHP Commercial |
$123.16
|
| Rate for Payer: PHP Medicare Advantage |
$87.97
|
| Rate for Payer: PHP Medicare Advantage |
$87.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$368.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.00
|
| Rate for Payer: Priority Health Medicare |
$87.97
|
| Rate for Payer: Priority Health Medicare |
$87.97
|
| Rate for Payer: Priority Health Narrow Network |
$128.00
|
| Rate for Payer: Priority Health Narrow Network |
$128.00
|
| Rate for Payer: Priority Health SBD |
$58.35
|
| Rate for Payer: Priority Health SBD |
$58.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.97
|
| Rate for Payer: UHC Medicare Advantage |
$87.97
|
| Rate for Payer: UHC Medicare Advantage |
$87.97
|
| Rate for Payer: UHCCP Medicaid |
$27.48
|
| Rate for Payer: UHCCP Medicaid |
$27.48
|
| Rate for Payer: UMR Bronson Commercial |
$68.54
|
| Rate for Payer: UMR Bronson Commercial |
$260.82
|
|
|
PR SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN
|
Professional
|
Both
|
$1,489.00
|
|
|
Service Code
|
HCPCS 95807
|
| Min. Negotiated Rate |
$36.85 |
| Max. Negotiated Rate |
$967.85 |
| Rate for Payer: Aetna Commercial |
$497.18
|
| Rate for Payer: Aetna Commercial |
$497.18
|
| Rate for Payer: Aetna Medicare |
$385.87
|
| Rate for Payer: Aetna Medicare |
$385.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$497.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$534.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$534.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$497.18
|
| Rate for Payer: BCBS Complete |
$38.69
|
| Rate for Payer: BCBS Complete |
$38.69
|
| Rate for Payer: BCBS MAPPO |
$371.03
|
| Rate for Payer: BCBS MAPPO |
$371.03
|
| Rate for Payer: BCBS Trust/PPO |
$78.19
|
| Rate for Payer: BCBS Trust/PPO |
$78.19
|
| Rate for Payer: BCN Commercial |
$453.53
|
| Rate for Payer: BCN Commercial |
$453.53
|
| Rate for Payer: BCN Medicare Advantage |
$371.03
|
| Rate for Payer: BCN Medicare Advantage |
$371.03
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cash Price |
$1,191.20
|
| Rate for Payer: Cash Price |
$1,191.20
|
| Rate for Payer: Cofinity Commercial |
$497.18
|
| Rate for Payer: Cofinity Commercial |
$534.28
|
| Rate for Payer: Cofinity Commercial |
$534.28
|
| Rate for Payer: Cofinity Commercial |
$497.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$389.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$389.58
|
| Rate for Payer: Meridian Medicaid |
$38.69
|
| Rate for Payer: Meridian Medicaid |
$38.69
|
| Rate for Payer: Nomi Health Commercial |
$445.24
|
| Rate for Payer: Nomi Health Commercial |
$445.24
|
| Rate for Payer: PACE SWMI |
$371.03
|
| Rate for Payer: PACE SWMI |
$371.03
|
| Rate for Payer: PHP Commercial |
$519.44
|
| Rate for Payer: PHP Commercial |
$519.44
|
| Rate for Payer: PHP Medicare Advantage |
$371.03
|
| Rate for Payer: PHP Medicare Advantage |
$371.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$967.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$556.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$556.35
|
| Rate for Payer: Priority Health Medicare |
$371.03
|
| Rate for Payer: Priority Health Medicare |
$371.03
|
| Rate for Payer: Priority Health Narrow Network |
$556.35
|
| Rate for Payer: Priority Health Narrow Network |
$556.35
|
| Rate for Payer: Priority Health SBD |
$78.70
|
| Rate for Payer: Priority Health SBD |
$78.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$371.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$371.03
|
| Rate for Payer: UHC Medicare Advantage |
$371.03
|
| Rate for Payer: UHC Medicare Advantage |
$371.03
|
| Rate for Payer: UHCCP Medicaid |
$36.85
|
| Rate for Payer: UHCCP Medicaid |
$36.85
|
| Rate for Payer: UMR Bronson Commercial |
$68.08
|
| Rate for Payer: UMR Bronson Commercial |
$684.94
|
|
|
PR SLING OPERATION STRESS INCONTINENCE
|
Professional
|
Both
|
$2,280.00
|
|
|
Service Code
|
HCPCS 57288
|
| Min. Negotiated Rate |
$477.97 |
| Max. Negotiated Rate |
$2,553.80 |
| Rate for Payer: Aetna Commercial |
$954.11
|
| Rate for Payer: Aetna Medicare |
$740.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,025.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$954.11
|
| Rate for Payer: BCBS Complete |
$501.87
|
| Rate for Payer: BCBS MAPPO |
$712.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,553.80
|
| Rate for Payer: BCN Commercial |
$1,508.40
|
| Rate for Payer: BCN Medicare Advantage |
$712.02
|
| Rate for Payer: Cash Price |
$1,824.00
|
| Rate for Payer: Cash Price |
$1,824.00
|
| Rate for Payer: Cofinity Commercial |
$1,025.31
|
| Rate for Payer: Cofinity Commercial |
$954.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$712.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$747.62
|
| Rate for Payer: Meridian Medicaid |
$501.87
|
| Rate for Payer: Nomi Health Commercial |
$854.42
|
| Rate for Payer: PACE SWMI |
$712.02
|
| Rate for Payer: PHP Commercial |
$996.83
|
| Rate for Payer: PHP Medicare Advantage |
$712.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$477.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,482.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,112.14
|
| Rate for Payer: Priority Health Medicare |
$712.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,112.14
|
| Rate for Payer: Priority Health SBD |
$1,112.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$712.02
|
| Rate for Payer: UHC Medicare Advantage |
$712.02
|
| Rate for Payer: UHCCP Medicaid |
$477.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,048.80
|
|
|
PR SLING OPRATION CORRJ MALE URINARY INCONTINENCE
|
Professional
|
Both
|
$1,677.00
|
|
|
Service Code
|
HCPCS 53440
|
| Min. Negotiated Rate |
$482.23 |
| Max. Negotiated Rate |
$2,746.63 |
| Rate for Payer: Aetna Commercial |
$963.80
|
| Rate for Payer: Aetna Medicare |
$748.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,035.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.80
|
| Rate for Payer: BCBS Complete |
$506.34
|
| Rate for Payer: BCBS MAPPO |
$719.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,746.63
|
| Rate for Payer: BCN Commercial |
$1,085.84
|
| Rate for Payer: BCN Medicare Advantage |
$719.25
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cofinity Commercial |
$1,035.72
|
| Rate for Payer: Cofinity Commercial |
$963.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$719.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$755.21
|
| Rate for Payer: Meridian Medicaid |
$506.34
|
| Rate for Payer: Nomi Health Commercial |
$863.10
|
| Rate for Payer: PACE SWMI |
$719.25
|
| Rate for Payer: PHP Commercial |
$1,006.95
|
| Rate for Payer: PHP Medicare Advantage |
$719.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,198.35
|
| Rate for Payer: Priority Health Medicare |
$719.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,198.35
|
| Rate for Payer: Priority Health SBD |
$1,198.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$719.25
|
| Rate for Payer: UHC Medicare Advantage |
$719.25
|
| Rate for Payer: UHCCP Medicaid |
$482.23
|
| Rate for Payer: UMR Bronson Commercial |
$771.42
|
|
|
PR SLINGS
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS A4565
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$7.97 |
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: BCN Commercial |
$7.97
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.80
|
| Rate for Payer: UMR Bronson Commercial |
$5.52
|
|
|
PR SLITTING PREPUCE DORSAL/LAT SPX XCP NEWBORN
|
Professional
|
Both
|
$335.00
|
|
|
Service Code
|
HCPCS 54001
|
| Min. Negotiated Rate |
$90.95 |
| Max. Negotiated Rate |
$1,072.45 |
| Rate for Payer: Aetna Commercial |
$180.43
|
| Rate for Payer: Aetna Medicare |
$140.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.43
|
| Rate for Payer: BCBS Complete |
$95.50
|
| Rate for Payer: BCBS MAPPO |
$134.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,072.45
|
| Rate for Payer: BCN Commercial |
$289.29
|
| Rate for Payer: BCN Medicare Advantage |
$134.65
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cofinity Commercial |
$180.43
|
| Rate for Payer: Cofinity Commercial |
$193.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.38
|
| Rate for Payer: Meridian Medicaid |
$95.50
|
| Rate for Payer: Nomi Health Commercial |
$161.58
|
| Rate for Payer: PACE SWMI |
$134.65
|
| Rate for Payer: PHP Commercial |
$188.51
|
| Rate for Payer: PHP Medicare Advantage |
$134.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$225.30
|
| Rate for Payer: Priority Health Medicare |
$134.65
|
| Rate for Payer: Priority Health Narrow Network |
$225.30
|
| Rate for Payer: Priority Health SBD |
$225.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.65
|
| Rate for Payer: UHC Medicare Advantage |
$134.65
|
| Rate for Payer: UHCCP Medicaid |
$90.95
|
| Rate for Payer: UMR Bronson Commercial |
$154.10
|
|
|
PR SLP STDY UNATND W/HRT RATE/O2 SAT/RESP/SLP TIME
|
Professional
|
Both
|
$91.00
|
|
|
Service Code
|
HCPCS 95800
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$545.73 |
| Rate for Payer: Aetna Commercial |
$155.87
|
| Rate for Payer: Aetna Commercial |
$155.87
|
| Rate for Payer: Aetna Medicare |
$120.97
|
| Rate for Payer: Aetna Medicare |
$120.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.87
|
| Rate for Payer: BCBS Complete |
$25.72
|
| Rate for Payer: BCBS Complete |
$25.72
|
| Rate for Payer: BCBS MAPPO |
$116.32
|
| Rate for Payer: BCBS MAPPO |
$116.32
|
| Rate for Payer: BCBS Trust/PPO |
$545.73
|
| Rate for Payer: BCBS Trust/PPO |
$545.73
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: BCN Commercial |
$173.02
|
| Rate for Payer: BCN Medicare Advantage |
$116.32
|
| Rate for Payer: BCN Medicare Advantage |
$116.32
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cofinity Commercial |
$155.87
|
| Rate for Payer: Cofinity Commercial |
$167.50
|
| Rate for Payer: Cofinity Commercial |
$167.50
|
| Rate for Payer: Cofinity Commercial |
$155.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.14
|
| Rate for Payer: Meridian Medicaid |
$25.72
|
| Rate for Payer: Meridian Medicaid |
$25.72
|
| Rate for Payer: Nomi Health Commercial |
$139.58
|
| Rate for Payer: Nomi Health Commercial |
$139.58
|
| Rate for Payer: PACE SWMI |
$116.32
|
| Rate for Payer: PACE SWMI |
$116.32
|
| Rate for Payer: PHP Commercial |
$162.85
|
| Rate for Payer: PHP Commercial |
$162.85
|
| Rate for Payer: PHP Medicare Advantage |
$116.32
|
| Rate for Payer: PHP Medicare Advantage |
$116.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.54
|
| Rate for Payer: Priority Health Medicare |
$116.32
|
| Rate for Payer: Priority Health Medicare |
$116.32
|
| Rate for Payer: Priority Health Narrow Network |
$184.54
|
| Rate for Payer: Priority Health Narrow Network |
$184.54
|
| Rate for Payer: Priority Health SBD |
$52.46
|
| Rate for Payer: Priority Health SBD |
$52.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.32
|
| Rate for Payer: UHC Medicare Advantage |
$116.32
|
| Rate for Payer: UHC Medicare Advantage |
$116.32
|
| Rate for Payer: UHCCP Medicaid |
$24.50
|
| Rate for Payer: UHCCP Medicaid |
$24.50
|
| Rate for Payer: UMR Bronson Commercial |
$140.76
|
| Rate for Payer: UMR Bronson Commercial |
$41.86
|
|
|
PR SMOKE/TOBACCO COUNSELNG 3-10
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS G0375
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$13.00 |
| Rate for Payer: Aetna Medicare |
$10.00
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
| Rate for Payer: UMR Bronson Commercial |
$9.20
|
|
|
PR SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 12002
|
| Min. Negotiated Rate |
$37.49 |
| Max. Negotiated Rate |
$517.72 |
| Rate for Payer: Aetna Commercial |
$76.39
|
| Rate for Payer: Aetna Medicare |
$59.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.09
|
| Rate for Payer: BCBS Complete |
$39.36
|
| Rate for Payer: BCBS MAPPO |
$57.01
|
| Rate for Payer: BCBS Trust/PPO |
$517.72
|
| Rate for Payer: BCN Commercial |
$167.13
|
| Rate for Payer: BCN Medicare Advantage |
$57.01
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$82.09
|
| Rate for Payer: Cofinity Commercial |
$76.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.86
|
| Rate for Payer: Meridian Medicaid |
$39.36
|
| Rate for Payer: Nomi Health Commercial |
$68.41
|
| Rate for Payer: PACE SWMI |
$57.01
|
| Rate for Payer: PHP Commercial |
$79.81
|
| Rate for Payer: PHP Medicare Advantage |
$57.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$79.47
|
| Rate for Payer: Priority Health Medicare |
$57.01
|
| Rate for Payer: Priority Health Narrow Network |
$79.47
|
| Rate for Payer: Priority Health SBD |
$79.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.01
|
| Rate for Payer: UHC Medicare Advantage |
$57.01
|
| Rate for Payer: UHCCP Medicaid |
$37.49
|
| Rate for Payer: UMR Bronson Commercial |
$140.76
|
|
|
PR SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM
|
Professional
|
Both
|
$573.00
|
|
|
Service Code
|
HCPCS 12005
|
| Min. Negotiated Rate |
$60.07 |
| Max. Negotiated Rate |
$561.29 |
| Rate for Payer: Aetna Commercial |
$123.39
|
| Rate for Payer: Aetna Medicare |
$95.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.60
|
| Rate for Payer: BCBS Complete |
$63.07
|
| Rate for Payer: BCBS MAPPO |
$92.08
|
| Rate for Payer: BCBS Trust/PPO |
$561.29
|
| Rate for Payer: BCN Commercial |
$259.49
|
| Rate for Payer: BCN Medicare Advantage |
$92.08
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cofinity Commercial |
$123.39
|
| Rate for Payer: Cofinity Commercial |
$132.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.68
|
| Rate for Payer: Meridian Medicaid |
$63.07
|
| Rate for Payer: Nomi Health Commercial |
$110.50
|
| Rate for Payer: PACE SWMI |
$92.08
|
| Rate for Payer: PHP Commercial |
$128.91
|
| Rate for Payer: PHP Medicare Advantage |
$92.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.77
|
| Rate for Payer: Priority Health Medicare |
$92.08
|
| Rate for Payer: Priority Health Narrow Network |
$127.77
|
| Rate for Payer: Priority Health SBD |
$127.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.08
|
| Rate for Payer: UHC Medicare Advantage |
$92.08
|
| Rate for Payer: UHCCP Medicaid |
$60.07
|
| Rate for Payer: UMR Bronson Commercial |
$263.58
|
|
