|
PR TESTOSTERONE ENANTHATE INJ
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS J3130
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$21.45 |
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: UMR Bronson Commercial |
$15.18
|
|
|
PR TESTOSTERONE PELLET 75 MG
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS S0189
|
| Min. Negotiated Rate |
$48.80 |
| Max. Negotiated Rate |
$79.30 |
| Rate for Payer: Aetna Medicare |
$61.00
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: UMR Bronson Commercial |
$56.12
|
|
|
PR TESTOSTERONE UNDECANOATE 1MG
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS J3145
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.25 |
| Rate for Payer: Aetna Commercial |
$2.77
|
| Rate for Payer: Aetna Medicare |
$2.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.98
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: BCBS MAPPO |
$2.07
|
| Rate for Payer: BCN Medicare Advantage |
$2.07
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cofinity Commercial |
$2.77
|
| Rate for Payer: Cofinity Commercial |
$2.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.17
|
| Rate for Payer: Nomi Health Commercial |
$2.48
|
| Rate for Payer: PACE SWMI |
$2.07
|
| Rate for Payer: PHP Commercial |
$2.90
|
| Rate for Payer: PHP Medicare Advantage |
$2.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.25
|
| Rate for Payer: Priority Health Medicare |
$2.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.07
|
| Rate for Payer: UHC Medicare Advantage |
$2.07
|
| Rate for Payer: UMR Bronson Commercial |
$2.30
|
|
|
PR TETANUS IMMUNIZATION, IM
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 90703
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$29.25 |
| Rate for Payer: Aetna Medicare |
$22.50
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: UMR Bronson Commercial |
$20.70
|
|
|
PR THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 97530
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$47.35 |
| Rate for Payer: Aetna Commercial |
$44.06
|
| Rate for Payer: Aetna Medicare |
$34.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.35
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS MAPPO |
$32.88
|
| Rate for Payer: BCN Medicare Advantage |
$32.88
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$44.06
|
| Rate for Payer: Cofinity Commercial |
$47.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.52
|
| Rate for Payer: Nomi Health Commercial |
$39.46
|
| Rate for Payer: PACE SWMI |
$32.88
|
| Rate for Payer: PHP Commercial |
$46.03
|
| Rate for Payer: PHP Medicare Advantage |
$32.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health Medicare |
$32.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.88
|
| Rate for Payer: UHC Medicare Advantage |
$32.88
|
| Rate for Payer: UMR Bronson Commercial |
$25.76
|
|
|
PR THERAPEUTIC APHERESIS PLASMA PHERESIS
|
Professional
|
Both
|
$869.00
|
|
|
Service Code
|
HCPCS 36514
|
| Min. Negotiated Rate |
$88.19 |
| Max. Negotiated Rate |
$564.85 |
| Rate for Payer: Aetna Commercial |
$118.17
|
| Rate for Payer: Aetna Medicare |
$91.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.17
|
| Rate for Payer: BCBS Complete |
$347.60
|
| Rate for Payer: BCBS MAPPO |
$88.19
|
| Rate for Payer: BCN Medicare Advantage |
$88.19
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cofinity Commercial |
$126.99
|
| Rate for Payer: Cofinity Commercial |
$118.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.60
|
| Rate for Payer: Nomi Health Commercial |
$105.83
|
| Rate for Payer: PACE SWMI |
$88.19
|
| Rate for Payer: PHP Commercial |
$123.47
|
| Rate for Payer: PHP Medicare Advantage |
$88.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.85
|
| Rate for Payer: Priority Health Medicare |
$88.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.19
|
| Rate for Payer: UHC Medicare Advantage |
$88.19
|
| Rate for Payer: UMR Bronson Commercial |
$399.74
|
|
|
PR THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 97150
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$24.24 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$17.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.55
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: BCBS MAPPO |
$16.83
|
| Rate for Payer: BCN Medicare Advantage |
$16.83
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$24.24
|
| Rate for Payer: Cofinity Commercial |
$22.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.67
|
| Rate for Payer: Nomi Health Commercial |
$20.20
|
| Rate for Payer: PACE SWMI |
$16.83
|
| Rate for Payer: PHP Commercial |
$23.56
|
| Rate for Payer: PHP Medicare Advantage |
$16.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.10
|
| Rate for Payer: Priority Health Medicare |
$16.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.83
|
| Rate for Payer: UHC Medicare Advantage |
$16.83
|
| Rate for Payer: UMR Bronson Commercial |
$15.64
|
|
|
PR THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 96372
|
| Min. Negotiated Rate |
$13.25 |
| Max. Negotiated Rate |
$28.60 |
| Rate for Payer: Aetna Commercial |
$17.75
|
| Rate for Payer: Aetna Medicare |
$13.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.75
|
| Rate for Payer: BCBS Complete |
$17.60
|
| Rate for Payer: BCBS MAPPO |
$13.25
|
| Rate for Payer: BCN Medicare Advantage |
$13.25
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$19.08
|
| Rate for Payer: Cofinity Commercial |
$17.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.91
|
| Rate for Payer: Nomi Health Commercial |
$15.90
|
| Rate for Payer: PACE SWMI |
$13.25
|
| Rate for Payer: PHP Commercial |
$18.55
|
| Rate for Payer: PHP Medicare Advantage |
$13.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.60
|
| Rate for Payer: Priority Health Medicare |
$13.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.25
|
| Rate for Payer: UHC Medicare Advantage |
$13.25
|
| Rate for Payer: UMR Bronson Commercial |
$20.24
|
|
|
PR THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 97110
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$39.76 |
| Rate for Payer: Aetna Commercial |
$37.00
|
| Rate for Payer: Aetna Medicare |
$28.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.00
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS MAPPO |
$27.61
|
| Rate for Payer: BCN Medicare Advantage |
$27.61
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$39.76
|
| Rate for Payer: Cofinity Commercial |
$37.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.99
|
| Rate for Payer: Nomi Health Commercial |
$33.13
|
| Rate for Payer: PACE SWMI |
$27.61
|
| Rate for Payer: PHP Commercial |
$38.65
|
| Rate for Payer: PHP Medicare Advantage |
$27.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.45
|
| Rate for Payer: Priority Health Medicare |
$27.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.61
|
| Rate for Payer: UHC Medicare Advantage |
$27.61
|
| Rate for Payer: UMR Bronson Commercial |
$24.38
|
|
|
PR THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 62329
|
| Min. Negotiated Rate |
$91.20 |
| Max. Negotiated Rate |
$148.20 |
| Rate for Payer: Aetna Commercial |
$133.93
|
| Rate for Payer: Aetna Medicare |
$103.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.93
|
| Rate for Payer: BCBS Complete |
$91.20
|
| Rate for Payer: BCBS MAPPO |
$99.95
|
| Rate for Payer: BCN Medicare Advantage |
$99.95
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$143.93
|
| Rate for Payer: Cofinity Commercial |
$133.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.95
|
| Rate for Payer: Nomi Health Commercial |
$119.94
|
| Rate for Payer: PACE SWMI |
$99.95
|
| Rate for Payer: PHP Commercial |
$139.93
|
| Rate for Payer: PHP Medicare Advantage |
$99.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.20
|
| Rate for Payer: Priority Health Medicare |
$99.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.95
|
| Rate for Payer: UHC Medicare Advantage |
$99.95
|
| Rate for Payer: UMR Bronson Commercial |
$104.88
|
|
|
PR THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF
|
Professional
|
Both
|
$471.00
|
|
|
Service Code
|
HCPCS 62272
|
| Min. Negotiated Rate |
$91.59 |
| Max. Negotiated Rate |
$306.15 |
| Rate for Payer: Aetna Commercial |
$122.73
|
| Rate for Payer: Aetna Medicare |
$95.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.73
|
| Rate for Payer: BCBS Complete |
$188.40
|
| Rate for Payer: BCBS MAPPO |
$91.59
|
| Rate for Payer: BCN Medicare Advantage |
$91.59
|
| Rate for Payer: Cash Price |
$376.80
|
| Rate for Payer: Cash Price |
$376.80
|
| Rate for Payer: Cofinity Commercial |
$131.89
|
| Rate for Payer: Cofinity Commercial |
$122.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.17
|
| Rate for Payer: Nomi Health Commercial |
$109.91
|
| Rate for Payer: PACE SWMI |
$91.59
|
| Rate for Payer: PHP Commercial |
$128.23
|
| Rate for Payer: PHP Medicare Advantage |
$91.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$306.15
|
| Rate for Payer: Priority Health Medicare |
$91.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.59
|
| Rate for Payer: UHC Medicare Advantage |
$91.59
|
| Rate for Payer: UMR Bronson Commercial |
$216.66
|
|
|
PR THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG
|
Professional
|
Both
|
$107.00
|
|
|
Service Code
|
HCPCS 96374
|
| Min. Negotiated Rate |
$31.63 |
| Max. Negotiated Rate |
$69.55 |
| Rate for Payer: Aetna Commercial |
$42.38
|
| Rate for Payer: Aetna Medicare |
$32.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.38
|
| Rate for Payer: BCBS Complete |
$42.80
|
| Rate for Payer: BCBS MAPPO |
$31.63
|
| Rate for Payer: BCN Medicare Advantage |
$31.63
|
| Rate for Payer: Cash Price |
$85.60
|
| Rate for Payer: Cash Price |
$85.60
|
| Rate for Payer: Cofinity Commercial |
$45.55
|
| Rate for Payer: Cofinity Commercial |
$42.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.21
|
| Rate for Payer: Nomi Health Commercial |
$37.96
|
| Rate for Payer: PACE SWMI |
$31.63
|
| Rate for Payer: PHP Commercial |
$44.28
|
| Rate for Payer: PHP Medicare Advantage |
$31.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.55
|
| Rate for Payer: Priority Health Medicare |
$31.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.63
|
| Rate for Payer: UHC Medicare Advantage |
$31.63
|
| Rate for Payer: UMR Bronson Commercial |
$49.22
|
|
|
PR THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 97112
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$44.21 |
| Rate for Payer: Aetna Commercial |
$41.14
|
| Rate for Payer: Aetna Medicare |
$31.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.14
|
| Rate for Payer: BCBS Complete |
$22.00
|
| Rate for Payer: BCBS MAPPO |
$30.70
|
| Rate for Payer: BCN Medicare Advantage |
$30.70
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$44.21
|
| Rate for Payer: Cofinity Commercial |
$41.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.23
|
| Rate for Payer: Nomi Health Commercial |
$36.84
|
| Rate for Payer: PACE SWMI |
$30.70
|
| Rate for Payer: PHP Commercial |
$42.98
|
| Rate for Payer: PHP Medicare Advantage |
$30.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.75
|
| Rate for Payer: Priority Health Medicare |
$30.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.70
|
| Rate for Payer: UHC Medicare Advantage |
$30.70
|
| Rate for Payer: UMR Bronson Commercial |
$25.30
|
|
|
PR THER PX 1/> AREAS EACH 15 MINUTES MASSAGE
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 97124
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$40.61 |
| Rate for Payer: Aetna Commercial |
$37.79
|
| Rate for Payer: Aetna Medicare |
$29.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.79
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS MAPPO |
$28.20
|
| Rate for Payer: BCN Medicare Advantage |
$28.20
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$40.61
|
| Rate for Payer: Cofinity Commercial |
$37.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.61
|
| Rate for Payer: Nomi Health Commercial |
$33.84
|
| Rate for Payer: PACE SWMI |
$28.20
|
| Rate for Payer: PHP Commercial |
$39.48
|
| Rate for Payer: PHP Medicare Advantage |
$28.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health Medicare |
$28.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.20
|
| Rate for Payer: UHC Medicare Advantage |
$28.20
|
| Rate for Payer: UMR Bronson Commercial |
$19.78
|
|
|
PR THIGHPLASTY
|
Professional
|
Both
|
$4,590.00
|
|
|
Service Code
|
HCPCS 00538
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,836.00 |
| Max. Negotiated Rate |
$2,983.50 |
| Rate for Payer: Aetna Medicare |
$2,295.00
|
| Rate for Payer: BCBS Complete |
$1,836.00
|
| Rate for Payer: Cash Price |
$3,672.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,983.50
|
| Rate for Payer: UMR Bronson Commercial |
$2,111.40
|
|
|
PR THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING
|
Professional
|
Both
|
$529.00
|
|
|
Service Code
|
HCPCS 32555
|
| Min. Negotiated Rate |
$102.91 |
| Max. Negotiated Rate |
$343.85 |
| Rate for Payer: Aetna Commercial |
$137.90
|
| Rate for Payer: Aetna Medicare |
$107.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.19
|
| Rate for Payer: BCBS Complete |
$211.60
|
| Rate for Payer: BCBS MAPPO |
$102.91
|
| Rate for Payer: BCN Medicare Advantage |
$102.91
|
| Rate for Payer: Cash Price |
$423.20
|
| Rate for Payer: Cash Price |
$423.20
|
| Rate for Payer: Cofinity Commercial |
$137.90
|
| Rate for Payer: Cofinity Commercial |
$148.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.06
|
| Rate for Payer: Nomi Health Commercial |
$123.49
|
| Rate for Payer: PACE SWMI |
$102.91
|
| Rate for Payer: PHP Commercial |
$144.07
|
| Rate for Payer: PHP Medicare Advantage |
$102.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.85
|
| Rate for Payer: Priority Health Medicare |
$102.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.91
|
| Rate for Payer: UHC Medicare Advantage |
$102.91
|
| Rate for Payer: UMR Bronson Commercial |
$243.34
|
|
|
PR THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Facility
|
IP
|
$760.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
32554
|
| Min. Negotiated Rate |
$334.40 |
| Max. Negotiated Rate |
$684.00 |
| Rate for Payer: Aetna American Axle |
$494.00
|
| Rate for Payer: Aetna Commercial |
$646.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$494.00
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cofinity Commercial |
$532.00
|
| Rate for Payer: Cofinity Commercial |
$653.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$532.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$608.00
|
| Rate for Payer: Healthscope Commercial |
$684.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$532.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$570.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$646.00
|
| Rate for Payer: PHP Commercial |
$646.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$494.00
|
| Rate for Payer: Priority Health SBD |
$478.80
|
| Rate for Payer: UMR Bronson Commercial |
$334.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$570.00
|
|
|
PR THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Professional
|
Both
|
$760.00
|
|
|
Service Code
|
HCPCS 32554
|
| Min. Negotiated Rate |
$83.93 |
| Max. Negotiated Rate |
$494.00 |
| Rate for Payer: Aetna Commercial |
$112.47
|
| Rate for Payer: Aetna Medicare |
$87.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.47
|
| Rate for Payer: BCBS Complete |
$304.00
|
| Rate for Payer: BCBS MAPPO |
$83.93
|
| Rate for Payer: BCN Medicare Advantage |
$83.93
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cofinity Commercial |
$120.86
|
| Rate for Payer: Cofinity Commercial |
$112.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.13
|
| Rate for Payer: Nomi Health Commercial |
$100.72
|
| Rate for Payer: PACE SWMI |
$83.93
|
| Rate for Payer: PHP Commercial |
$117.50
|
| Rate for Payer: PHP Medicare Advantage |
$83.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$494.00
|
| Rate for Payer: Priority Health Medicare |
$83.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.93
|
| Rate for Payer: UHC Medicare Advantage |
$83.93
|
| Rate for Payer: UMR Bronson Commercial |
$349.60
|
|
|
PR THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Facility
|
OP
|
$760.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
32554
|
| Min. Negotiated Rate |
$281.20 |
| Max. Negotiated Rate |
$1,697.33 |
| Rate for Payer: Aetna American Axle |
$494.00
|
| Rate for Payer: Aetna Commercial |
$646.00
|
| Rate for Payer: Aetna Medicare |
$627.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$494.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$753.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$753.73
|
| Rate for Payer: BCBS Complete |
$339.36
|
| Rate for Payer: BCBS MAPPO |
$602.98
|
| Rate for Payer: BCN Medicare Advantage |
$602.98
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cofinity Commercial |
$653.60
|
| Rate for Payer: Cofinity Commercial |
$532.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$532.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$608.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.98
|
| Rate for Payer: Healthscope Commercial |
$684.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$532.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$570.00
|
| Rate for Payer: Mclaren Medicaid |
$323.20
|
| Rate for Payer: Mclaren Medicare |
$602.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.13
|
| Rate for Payer: Meridian Medicaid |
$339.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$693.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$646.00
|
| Rate for Payer: PACE Medicare |
$572.83
|
| Rate for Payer: PACE SWMI |
$602.98
|
| Rate for Payer: PHP Commercial |
$646.00
|
| Rate for Payer: PHP Medicare Advantage |
$602.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$494.00
|
| Rate for Payer: Priority Health Medicare |
$602.98
|
| Rate for Payer: Priority Health SBD |
$478.80
|
| Rate for Payer: Railroad Medicare Medicare |
$602.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,697.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$602.98
|
| Rate for Payer: UHC Exchange |
$1,152.36
|
| Rate for Payer: UHC Medicare Advantage |
$602.98
|
| Rate for Payer: UHCCP Medicaid |
$323.20
|
| Rate for Payer: UMR Bronson Commercial |
$281.20
|
| Rate for Payer: VA VA |
$602.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$570.00
|
|
|
PR THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Professional
|
Both
|
$760.00
|
|
|
Service Code
|
HCPCS 32554
|
| Hospital Charge Code |
32554
|
| Min. Negotiated Rate |
$83.93 |
| Max. Negotiated Rate |
$494.00 |
| Rate for Payer: Aetna Commercial |
$112.47
|
| Rate for Payer: Aetna Medicare |
$87.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.47
|
| Rate for Payer: BCBS Complete |
$304.00
|
| Rate for Payer: BCBS MAPPO |
$83.93
|
| Rate for Payer: BCN Medicare Advantage |
$83.93
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cofinity Commercial |
$112.47
|
| Rate for Payer: Cofinity Commercial |
$120.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.13
|
| Rate for Payer: Nomi Health Commercial |
$100.72
|
| Rate for Payer: PACE SWMI |
$83.93
|
| Rate for Payer: PHP Commercial |
$117.50
|
| Rate for Payer: PHP Medicare Advantage |
$83.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$494.00
|
| Rate for Payer: Priority Health Medicare |
$83.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.93
|
| Rate for Payer: UHC Medicare Advantage |
$83.93
|
| Rate for Payer: UMR Bronson Commercial |
$349.60
|
|
|
PR THORACOPLASTY SCHEDE TYPE/EXTRAPLEURAL
|
Professional
|
Both
|
$2,610.00
|
|
|
Service Code
|
HCPCS 32905
|
| Min. Negotiated Rate |
$1,044.00 |
| Max. Negotiated Rate |
$1,847.20 |
| Rate for Payer: Aetna Commercial |
$1,718.93
|
| Rate for Payer: Aetna Medicare |
$1,334.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,847.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,718.93
|
| Rate for Payer: BCBS Complete |
$1,044.00
|
| Rate for Payer: BCBS MAPPO |
$1,282.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,282.78
|
| Rate for Payer: Cash Price |
$2,088.00
|
| Rate for Payer: Cash Price |
$2,088.00
|
| Rate for Payer: Cofinity Commercial |
$1,847.20
|
| Rate for Payer: Cofinity Commercial |
$1,718.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,282.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,346.92
|
| Rate for Payer: Nomi Health Commercial |
$1,539.34
|
| Rate for Payer: PACE SWMI |
$1,282.78
|
| Rate for Payer: PHP Commercial |
$1,795.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,282.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,696.50
|
| Rate for Payer: Priority Health Medicare |
$1,282.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,282.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,282.78
|
| Rate for Payer: UMR Bronson Commercial |
$1,200.60
|
|
|
PR THORACOP SCHEDE TYP/XTRPLEURAL CLSR BRNCPLR FSTL
|
Professional
|
Both
|
$3,231.00
|
|
|
Service Code
|
HCPCS 32906
|
| Min. Negotiated Rate |
$1,292.40 |
| Max. Negotiated Rate |
$2,279.17 |
| Rate for Payer: Aetna Commercial |
$2,120.90
|
| Rate for Payer: Aetna Medicare |
$1,646.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,279.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,120.90
|
| Rate for Payer: BCBS Complete |
$1,292.40
|
| Rate for Payer: BCBS MAPPO |
$1,582.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,582.76
|
| Rate for Payer: Cash Price |
$2,584.80
|
| Rate for Payer: Cash Price |
$2,584.80
|
| Rate for Payer: Cofinity Commercial |
$2,279.17
|
| Rate for Payer: Cofinity Commercial |
$2,120.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,582.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,661.90
|
| Rate for Payer: Nomi Health Commercial |
$1,899.31
|
| Rate for Payer: PACE SWMI |
$1,582.76
|
| Rate for Payer: PHP Commercial |
$2,215.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,582.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,100.15
|
| Rate for Payer: Priority Health Medicare |
$1,582.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,582.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,582.76
|
| Rate for Payer: UMR Bronson Commercial |
$1,486.26
|
|
|
PR THORACOSCOPY CONTROL TRAUMATIC HEMORRHAGE
|
Professional
|
Both
|
$2,370.00
|
|
|
Service Code
|
HCPCS 32654
|
| Min. Negotiated Rate |
$948.00 |
| Max. Negotiated Rate |
$1,656.89 |
| Rate for Payer: Aetna Commercial |
$1,541.83
|
| Rate for Payer: Aetna Medicare |
$1,196.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,656.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,541.83
|
| Rate for Payer: BCBS Complete |
$948.00
|
| Rate for Payer: BCBS MAPPO |
$1,150.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,150.62
|
| Rate for Payer: Cash Price |
$1,896.00
|
| Rate for Payer: Cash Price |
$1,896.00
|
| Rate for Payer: Cofinity Commercial |
$1,656.89
|
| Rate for Payer: Cofinity Commercial |
$1,541.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,150.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,208.15
|
| Rate for Payer: Nomi Health Commercial |
$1,380.74
|
| Rate for Payer: PACE SWMI |
$1,150.62
|
| Rate for Payer: PHP Commercial |
$1,610.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,150.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,540.50
|
| Rate for Payer: Priority Health Medicare |
$1,150.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,150.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,150.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,090.20
|
|
|
PR THORACOSCOPY DX MEDIASTINAL SPACE W/BIOPSY SPX
|
Professional
|
Both
|
$1,413.00
|
|
|
Service Code
|
HCPCS 32606
|
| Min. Negotiated Rate |
$444.26 |
| Max. Negotiated Rate |
$918.45 |
| Rate for Payer: Aetna Commercial |
$595.31
|
| Rate for Payer: Aetna Medicare |
$462.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$639.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$595.31
|
| Rate for Payer: BCBS Complete |
$565.20
|
| Rate for Payer: BCBS MAPPO |
$444.26
|
| Rate for Payer: BCN Medicare Advantage |
$444.26
|
| Rate for Payer: Cash Price |
$1,130.40
|
| Rate for Payer: Cash Price |
$1,130.40
|
| Rate for Payer: Cofinity Commercial |
$639.73
|
| Rate for Payer: Cofinity Commercial |
$595.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$444.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$466.47
|
| Rate for Payer: Nomi Health Commercial |
$533.11
|
| Rate for Payer: PACE SWMI |
$444.26
|
| Rate for Payer: PHP Commercial |
$621.96
|
| Rate for Payer: PHP Medicare Advantage |
$444.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.45
|
| Rate for Payer: Priority Health Medicare |
$444.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$444.26
|
| Rate for Payer: UHC Medicare Advantage |
$444.26
|
| Rate for Payer: UMR Bronson Commercial |
$649.98
|
|
|
PR THORACOSCOPY DX PERICARDIAL SAC W/BIOPSY SPX
|
Professional
|
Both
|
$919.00
|
|
|
Service Code
|
HCPCS 32604
|
| Min. Negotiated Rate |
$367.60 |
| Max. Negotiated Rate |
$662.90 |
| Rate for Payer: Aetna Commercial |
$616.87
|
| Rate for Payer: Aetna Medicare |
$478.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$662.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.87
|
| Rate for Payer: BCBS Complete |
$367.60
|
| Rate for Payer: BCBS MAPPO |
$460.35
|
| Rate for Payer: BCN Medicare Advantage |
$460.35
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cofinity Commercial |
$662.90
|
| Rate for Payer: Cofinity Commercial |
$616.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$460.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$483.37
|
| Rate for Payer: Nomi Health Commercial |
$552.42
|
| Rate for Payer: PACE SWMI |
$460.35
|
| Rate for Payer: PHP Commercial |
$644.49
|
| Rate for Payer: PHP Medicare Advantage |
$460.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.35
|
| Rate for Payer: Priority Health Medicare |
$460.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$460.35
|
| Rate for Payer: UHC Medicare Advantage |
$460.35
|
| Rate for Payer: UMR Bronson Commercial |
$422.74
|
|
