|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 11056
|
| Min. Negotiated Rate |
$21.23 |
| Max. Negotiated Rate |
$79.30 |
| Rate for Payer: Aetna Commercial |
$28.45
|
| Rate for Payer: Aetna Medicare |
$22.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.45
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: BCBS MAPPO |
$21.23
|
| Rate for Payer: BCN Medicare Advantage |
$21.23
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$30.57
|
| Rate for Payer: Cofinity Commercial |
$28.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.23
|
| Rate for Payer: Healthscope Commercial |
$39.28
|
| Rate for Payer: Healthscope Commercial |
$33.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.30
|
| Rate for Payer: Nomi Health Commercial |
$25.48
|
| Rate for Payer: PACE SWMI |
$21.23
|
| Rate for Payer: PHP Medicare Advantage |
$21.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: Priority Health Medicare |
$21.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.23
|
| Rate for Payer: UHC Medicare Advantage |
$21.23
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 11057
|
| Min. Negotiated Rate |
$26.96 |
| Max. Negotiated Rate |
$95.55 |
| Rate for Payer: Aetna Commercial |
$36.13
|
| Rate for Payer: Aetna Medicare |
$28.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.13
|
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: BCBS MAPPO |
$26.96
|
| Rate for Payer: BCN Medicare Advantage |
$26.96
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cofinity Commercial |
$38.82
|
| Rate for Payer: Cofinity Commercial |
$36.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.96
|
| Rate for Payer: Healthscope Commercial |
$43.14
|
| Rate for Payer: Healthscope Commercial |
$49.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.55
|
| Rate for Payer: Nomi Health Commercial |
$32.35
|
| Rate for Payer: PACE SWMI |
$26.96
|
| Rate for Payer: PHP Medicare Advantage |
$26.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.55
|
| Rate for Payer: Priority Health Medicare |
$26.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.96
|
| Rate for Payer: UHC Medicare Advantage |
$26.96
|
|
|
PR PARTIAL EXCISION BONE CLAVICLE
|
Professional
|
Both
|
$1,421.00
|
|
|
Service Code
|
HCPCS 23180
|
| Min. Negotiated Rate |
$568.40 |
| Max. Negotiated Rate |
$1,234.08 |
| Rate for Payer: Aetna Commercial |
$893.87
|
| Rate for Payer: Aetna Medicare |
$693.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$960.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$893.87
|
| Rate for Payer: BCBS Complete |
$568.40
|
| Rate for Payer: BCBS MAPPO |
$667.07
|
| Rate for Payer: BCN Medicare Advantage |
$667.07
|
| Rate for Payer: Cash Price |
$1,136.80
|
| Rate for Payer: Cash Price |
$1,136.80
|
| Rate for Payer: Cofinity Commercial |
$960.58
|
| Rate for Payer: Cofinity Commercial |
$893.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$667.07
|
| Rate for Payer: Healthscope Commercial |
$1,234.08
|
| Rate for Payer: Healthscope Commercial |
$1,067.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$700.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$923.65
|
| Rate for Payer: Nomi Health Commercial |
$800.48
|
| Rate for Payer: PACE SWMI |
$667.07
|
| Rate for Payer: PHP Medicare Advantage |
$667.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$923.65
|
| Rate for Payer: Priority Health Medicare |
$667.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$667.07
|
| Rate for Payer: UHC Medicare Advantage |
$667.07
|
|
|
PR PARTIAL EXCISION BONE FIBULA
|
Professional
|
Both
|
$2,385.00
|
|
|
Service Code
|
HCPCS 27641
|
| Min. Negotiated Rate |
$632.08 |
| Max. Negotiated Rate |
$1,550.25 |
| Rate for Payer: Aetna Commercial |
$846.99
|
| Rate for Payer: Aetna Medicare |
$657.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$910.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$846.99
|
| Rate for Payer: BCBS Complete |
$954.00
|
| Rate for Payer: BCBS MAPPO |
$632.08
|
| Rate for Payer: BCN Medicare Advantage |
$632.08
|
| Rate for Payer: Cash Price |
$1,908.00
|
| Rate for Payer: Cash Price |
$1,908.00
|
| Rate for Payer: Cofinity Commercial |
$910.20
|
| Rate for Payer: Cofinity Commercial |
$846.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$632.08
|
| Rate for Payer: Healthscope Commercial |
$1,011.33
|
| Rate for Payer: Healthscope Commercial |
$1,169.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$663.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,550.25
|
| Rate for Payer: Nomi Health Commercial |
$758.50
|
| Rate for Payer: PACE SWMI |
$632.08
|
| Rate for Payer: PHP Medicare Advantage |
$632.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,550.25
|
| Rate for Payer: Priority Health Medicare |
$632.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$632.08
|
| Rate for Payer: UHC Medicare Advantage |
$632.08
|
|
|
PR PARTIAL EXCISION BONE HUMERUS
|
Professional
|
Both
|
$1,429.00
|
|
|
Service Code
|
HCPCS 24140
|
| Min. Negotiated Rate |
$571.60 |
| Max. Negotiated Rate |
$1,259.04 |
| Rate for Payer: Aetna Commercial |
$911.95
|
| Rate for Payer: Aetna Medicare |
$707.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$980.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$911.95
|
| Rate for Payer: BCBS Complete |
$571.60
|
| Rate for Payer: BCBS MAPPO |
$680.56
|
| Rate for Payer: BCN Medicare Advantage |
$680.56
|
| Rate for Payer: Cash Price |
$1,143.20
|
| Rate for Payer: Cash Price |
$1,143.20
|
| Rate for Payer: Cofinity Commercial |
$980.01
|
| Rate for Payer: Cofinity Commercial |
$911.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.56
|
| Rate for Payer: Healthscope Commercial |
$1,259.04
|
| Rate for Payer: Healthscope Commercial |
$1,088.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$714.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.85
|
| Rate for Payer: Nomi Health Commercial |
$816.67
|
| Rate for Payer: PACE SWMI |
$680.56
|
| Rate for Payer: PHP Medicare Advantage |
$680.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$928.85
|
| Rate for Payer: Priority Health Medicare |
$680.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$680.56
|
| Rate for Payer: UHC Medicare Advantage |
$680.56
|
|
|
PR PARTIAL EXCISION BONE METACARPAL
|
Professional
|
Both
|
$1,454.00
|
|
|
Service Code
|
HCPCS 26230
|
| Min. Negotiated Rate |
$485.21 |
| Max. Negotiated Rate |
$945.10 |
| Rate for Payer: Aetna Commercial |
$650.18
|
| Rate for Payer: Aetna Medicare |
$504.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$698.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$650.18
|
| Rate for Payer: BCBS Complete |
$581.60
|
| Rate for Payer: BCBS MAPPO |
$485.21
|
| Rate for Payer: BCN Medicare Advantage |
$485.21
|
| Rate for Payer: Cash Price |
$1,163.20
|
| Rate for Payer: Cash Price |
$1,163.20
|
| Rate for Payer: Cofinity Commercial |
$698.70
|
| Rate for Payer: Cofinity Commercial |
$650.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$485.21
|
| Rate for Payer: Healthscope Commercial |
$776.34
|
| Rate for Payer: Healthscope Commercial |
$897.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$509.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$945.10
|
| Rate for Payer: Nomi Health Commercial |
$582.25
|
| Rate for Payer: PACE SWMI |
$485.21
|
| Rate for Payer: PHP Medicare Advantage |
$485.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$945.10
|
| Rate for Payer: Priority Health Medicare |
$485.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$485.21
|
| Rate for Payer: UHC Medicare Advantage |
$485.21
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Facility
|
OP
|
$1,482.00
|
|
|
Service Code
|
CPT 24147
|
| Hospital Charge Code |
24147
|
| Min. Negotiated Rate |
$933.66 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna Commercial |
$1,259.70
|
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cofinity Commercial |
$1,037.40
|
| Rate for Payer: Cofinity Commercial |
$1,274.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,037.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,185.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$1,333.80
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,259.70
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$1,259.70
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$963.30
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health SBD |
$933.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,907.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,781.56
|
| Rate for Payer: VA VA |
$3,164.40
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Facility
|
IP
|
$1,482.00
|
|
|
Service Code
|
CPT 24147
|
| Hospital Charge Code |
24147
|
| Min. Negotiated Rate |
$933.66 |
| Max. Negotiated Rate |
$1,333.80 |
| Rate for Payer: Aetna Commercial |
$1,259.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.30
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cofinity Commercial |
$1,037.40
|
| Rate for Payer: Cofinity Commercial |
$1,274.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,037.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,185.60
|
| Rate for Payer: Healthscope Commercial |
$1,333.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,259.70
|
| Rate for Payer: PHP Commercial |
$1,259.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$963.30
|
| Rate for Payer: Priority Health SBD |
$933.66
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Professional
|
Both
|
$1,482.00
|
|
|
Service Code
|
HCPCS 24147
|
| Hospital Charge Code |
24147
|
| Min. Negotiated Rate |
$592.80 |
| Max. Negotiated Rate |
$1,122.78 |
| Rate for Payer: Aetna Commercial |
$813.26
|
| Rate for Payer: Aetna Medicare |
$631.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$873.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$813.26
|
| Rate for Payer: BCBS Complete |
$592.80
|
| Rate for Payer: BCBS MAPPO |
$606.91
|
| Rate for Payer: BCN Medicare Advantage |
$606.91
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cofinity Commercial |
$873.95
|
| Rate for Payer: Cofinity Commercial |
$813.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.91
|
| Rate for Payer: Healthscope Commercial |
$1,122.78
|
| Rate for Payer: Healthscope Commercial |
$971.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$637.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$963.30
|
| Rate for Payer: Nomi Health Commercial |
$728.29
|
| Rate for Payer: PACE SWMI |
$606.91
|
| Rate for Payer: PHP Medicare Advantage |
$606.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$963.30
|
| Rate for Payer: Priority Health Medicare |
$606.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$606.91
|
| Rate for Payer: UHC Medicare Advantage |
$606.91
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Professional
|
Both
|
$1,482.00
|
|
|
Service Code
|
HCPCS 24147
|
| Min. Negotiated Rate |
$592.80 |
| Max. Negotiated Rate |
$1,122.78 |
| Rate for Payer: Aetna Commercial |
$813.26
|
| Rate for Payer: Aetna Medicare |
$631.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$873.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$813.26
|
| Rate for Payer: BCBS Complete |
$592.80
|
| Rate for Payer: BCBS MAPPO |
$606.91
|
| Rate for Payer: BCN Medicare Advantage |
$606.91
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cofinity Commercial |
$873.95
|
| Rate for Payer: Cofinity Commercial |
$813.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.91
|
| Rate for Payer: Healthscope Commercial |
$971.06
|
| Rate for Payer: Healthscope Commercial |
$1,122.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$637.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$963.30
|
| Rate for Payer: Nomi Health Commercial |
$728.29
|
| Rate for Payer: PACE SWMI |
$606.91
|
| Rate for Payer: PHP Medicare Advantage |
$606.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$963.30
|
| Rate for Payer: Priority Health Medicare |
$606.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$606.91
|
| Rate for Payer: UHC Medicare Advantage |
$606.91
|
|
|
PR PARTIAL EXCISION BONE PROXIMAL HUMERUS
|
Professional
|
Both
|
$1,664.00
|
|
|
Service Code
|
HCPCS 23184
|
| Min. Negotiated Rate |
$665.60 |
| Max. Negotiated Rate |
$1,321.58 |
| Rate for Payer: Aetna Commercial |
$957.26
|
| Rate for Payer: Aetna Medicare |
$742.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$957.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,028.69
|
| Rate for Payer: BCBS Complete |
$665.60
|
| Rate for Payer: BCBS MAPPO |
$714.37
|
| Rate for Payer: BCN Medicare Advantage |
$714.37
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cofinity Commercial |
$957.26
|
| Rate for Payer: Cofinity Commercial |
$1,028.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$714.37
|
| Rate for Payer: Healthscope Commercial |
$1,142.99
|
| Rate for Payer: Healthscope Commercial |
$1,321.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$750.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,081.60
|
| Rate for Payer: Nomi Health Commercial |
$857.24
|
| Rate for Payer: PACE SWMI |
$714.37
|
| Rate for Payer: PHP Medicare Advantage |
$714.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,081.60
|
| Rate for Payer: Priority Health Medicare |
$714.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$714.37
|
| Rate for Payer: UHC Medicare Advantage |
$714.37
|
|
|
PR PARTIAL EXCISION BONE RADIUS
|
Professional
|
Both
|
$2,289.00
|
|
|
Service Code
|
HCPCS 25151
|
| Min. Negotiated Rate |
$566.75 |
| Max. Negotiated Rate |
$1,487.85 |
| Rate for Payer: Aetna Commercial |
$759.45
|
| Rate for Payer: Aetna Medicare |
$589.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$816.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.45
|
| Rate for Payer: BCBS Complete |
$915.60
|
| Rate for Payer: BCBS MAPPO |
$566.75
|
| Rate for Payer: BCN Medicare Advantage |
$566.75
|
| Rate for Payer: Cash Price |
$1,831.20
|
| Rate for Payer: Cash Price |
$1,831.20
|
| Rate for Payer: Cofinity Commercial |
$816.12
|
| Rate for Payer: Cofinity Commercial |
$759.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.75
|
| Rate for Payer: Healthscope Commercial |
$906.80
|
| Rate for Payer: Healthscope Commercial |
$1,048.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$595.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,487.85
|
| Rate for Payer: Nomi Health Commercial |
$680.10
|
| Rate for Payer: PACE SWMI |
$566.75
|
| Rate for Payer: PHP Medicare Advantage |
$566.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,487.85
|
| Rate for Payer: Priority Health Medicare |
$566.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$566.75
|
| Rate for Payer: UHC Medicare Advantage |
$566.75
|
|
|
PR PARTIAL EXCISION BONE SCAPULA
|
Professional
|
Both
|
$1,265.00
|
|
|
Service Code
|
HCPCS 23182
|
| Min. Negotiated Rate |
$506.00 |
| Max. Negotiated Rate |
$1,202.61 |
| Rate for Payer: Aetna Commercial |
$871.08
|
| Rate for Payer: Aetna Medicare |
$676.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$936.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$871.08
|
| Rate for Payer: BCBS Complete |
$506.00
|
| Rate for Payer: BCBS MAPPO |
$650.06
|
| Rate for Payer: BCN Medicare Advantage |
$650.06
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cofinity Commercial |
$936.09
|
| Rate for Payer: Cofinity Commercial |
$871.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$650.06
|
| Rate for Payer: Healthscope Commercial |
$1,040.10
|
| Rate for Payer: Healthscope Commercial |
$1,202.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$682.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$822.25
|
| Rate for Payer: Nomi Health Commercial |
$780.07
|
| Rate for Payer: PACE SWMI |
$650.06
|
| Rate for Payer: PHP Medicare Advantage |
$650.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$822.25
|
| Rate for Payer: Priority Health Medicare |
$650.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$650.06
|
| Rate for Payer: UHC Medicare Advantage |
$650.06
|
|
|
PR PARTIAL EXCISION BONE TALUS/CALCANEUS
|
Professional
|
Both
|
$1,274.00
|
|
|
Service Code
|
HCPCS 28120
|
| Min. Negotiated Rate |
$473.72 |
| Max. Negotiated Rate |
$876.38 |
| Rate for Payer: Aetna Commercial |
$634.78
|
| Rate for Payer: Aetna Medicare |
$492.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$682.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$634.78
|
| Rate for Payer: BCBS Complete |
$509.60
|
| Rate for Payer: BCBS MAPPO |
$473.72
|
| Rate for Payer: BCN Medicare Advantage |
$473.72
|
| Rate for Payer: Cash Price |
$1,019.20
|
| Rate for Payer: Cash Price |
$1,019.20
|
| Rate for Payer: Cofinity Commercial |
$682.16
|
| Rate for Payer: Cofinity Commercial |
$634.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$473.72
|
| Rate for Payer: Healthscope Commercial |
$876.38
|
| Rate for Payer: Healthscope Commercial |
$757.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$497.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$828.10
|
| Rate for Payer: Nomi Health Commercial |
$568.46
|
| Rate for Payer: PACE SWMI |
$473.72
|
| Rate for Payer: PHP Medicare Advantage |
$473.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$828.10
|
| Rate for Payer: Priority Health Medicare |
$473.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$473.72
|
| Rate for Payer: UHC Medicare Advantage |
$473.72
|
|
|
PR PARTIAL EXCISION BONE TIBIA
|
Professional
|
Both
|
$2,763.00
|
|
|
Service Code
|
HCPCS 27640
|
| Min. Negotiated Rate |
$796.25 |
| Max. Negotiated Rate |
$1,795.95 |
| Rate for Payer: Aetna Commercial |
$1,066.97
|
| Rate for Payer: Aetna Medicare |
$828.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,146.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,066.97
|
| Rate for Payer: BCBS Complete |
$1,105.20
|
| Rate for Payer: BCBS MAPPO |
$796.25
|
| Rate for Payer: BCN Medicare Advantage |
$796.25
|
| Rate for Payer: Cash Price |
$2,210.40
|
| Rate for Payer: Cash Price |
$2,210.40
|
| Rate for Payer: Cofinity Commercial |
$1,146.60
|
| Rate for Payer: Cofinity Commercial |
$1,066.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$796.25
|
| Rate for Payer: Healthscope Commercial |
$1,274.00
|
| Rate for Payer: Healthscope Commercial |
$1,473.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$836.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,795.95
|
| Rate for Payer: Nomi Health Commercial |
$955.50
|
| Rate for Payer: PACE SWMI |
$796.25
|
| Rate for Payer: PHP Medicare Advantage |
$796.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,795.95
|
| Rate for Payer: Priority Health Medicare |
$796.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$796.25
|
| Rate for Payer: UHC Medicare Advantage |
$796.25
|
|
|
PR PARTIAL EXCISION BONE ULNA
|
Professional
|
Both
|
$1,179.00
|
|
|
Service Code
|
HCPCS 25150
|
| Min. Negotiated Rate |
$471.60 |
| Max. Negotiated Rate |
$1,018.78 |
| Rate for Payer: Aetna Commercial |
$737.92
|
| Rate for Payer: Aetna Medicare |
$572.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$792.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$737.92
|
| Rate for Payer: BCBS Complete |
$471.60
|
| Rate for Payer: BCBS MAPPO |
$550.69
|
| Rate for Payer: BCN Medicare Advantage |
$550.69
|
| Rate for Payer: Cash Price |
$943.20
|
| Rate for Payer: Cash Price |
$943.20
|
| Rate for Payer: Cofinity Commercial |
$792.99
|
| Rate for Payer: Cofinity Commercial |
$737.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.69
|
| Rate for Payer: Healthscope Commercial |
$881.10
|
| Rate for Payer: Healthscope Commercial |
$1,018.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$578.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$766.35
|
| Rate for Payer: Nomi Health Commercial |
$660.83
|
| Rate for Payer: PACE SWMI |
$550.69
|
| Rate for Payer: PHP Medicare Advantage |
$550.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$766.35
|
| Rate for Payer: Priority Health Medicare |
$550.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$550.69
|
| Rate for Payer: UHC Medicare Advantage |
$550.69
|
|
|
PR PARTIAL EXCISION DEEP PELVIS
|
Professional
|
Both
|
$3,227.00
|
|
|
Service Code
|
HCPCS 27071
|
| Min. Negotiated Rate |
$923.04 |
| Max. Negotiated Rate |
$2,097.55 |
| Rate for Payer: Aetna Commercial |
$1,236.87
|
| Rate for Payer: Aetna Medicare |
$959.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,329.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.87
|
| Rate for Payer: BCBS Complete |
$1,290.80
|
| Rate for Payer: BCBS MAPPO |
$923.04
|
| Rate for Payer: BCN Medicare Advantage |
$923.04
|
| Rate for Payer: Cash Price |
$2,581.60
|
| Rate for Payer: Cash Price |
$2,581.60
|
| Rate for Payer: Cofinity Commercial |
$1,329.18
|
| Rate for Payer: Cofinity Commercial |
$1,236.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$923.04
|
| Rate for Payer: Healthscope Commercial |
$1,476.86
|
| Rate for Payer: Healthscope Commercial |
$1,707.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$969.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,097.55
|
| Rate for Payer: Nomi Health Commercial |
$1,107.65
|
| Rate for Payer: PACE SWMI |
$923.04
|
| Rate for Payer: PHP Medicare Advantage |
$923.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,097.55
|
| Rate for Payer: Priority Health Medicare |
$923.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$923.04
|
| Rate for Payer: UHC Medicare Advantage |
$923.04
|
|
|
PR PARTIAL EXCISION DISTAL PHALANX FINGER
|
Professional
|
Both
|
$1,272.00
|
|
|
Service Code
|
HCPCS 26236
|
| Min. Negotiated Rate |
$428.45 |
| Max. Negotiated Rate |
$826.80 |
| Rate for Payer: Aetna Commercial |
$574.12
|
| Rate for Payer: Aetna Medicare |
$445.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$574.12
|
| Rate for Payer: BCBS Complete |
$508.80
|
| Rate for Payer: BCBS MAPPO |
$428.45
|
| Rate for Payer: BCN Medicare Advantage |
$428.45
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cofinity Commercial |
$616.97
|
| Rate for Payer: Cofinity Commercial |
$574.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$428.45
|
| Rate for Payer: Healthscope Commercial |
$792.63
|
| Rate for Payer: Healthscope Commercial |
$685.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$826.80
|
| Rate for Payer: Nomi Health Commercial |
$514.14
|
| Rate for Payer: PACE SWMI |
$428.45
|
| Rate for Payer: PHP Medicare Advantage |
$428.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.80
|
| Rate for Payer: Priority Health Medicare |
$428.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$428.45
|
| Rate for Payer: UHC Medicare Advantage |
$428.45
|
|
|
PR PARTIAL EXCISION PROXIMAL/MIDDLE PHALANX FINGER
|
Professional
|
Both
|
$1,363.00
|
|
|
Service Code
|
HCPCS 26235
|
| Min. Negotiated Rate |
$477.52 |
| Max. Negotiated Rate |
$885.95 |
| Rate for Payer: Aetna Commercial |
$639.88
|
| Rate for Payer: Aetna Medicare |
$496.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$687.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$639.88
|
| Rate for Payer: BCBS Complete |
$545.20
|
| Rate for Payer: BCBS MAPPO |
$477.52
|
| Rate for Payer: BCN Medicare Advantage |
$477.52
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cofinity Commercial |
$687.63
|
| Rate for Payer: Cofinity Commercial |
$639.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$477.52
|
| Rate for Payer: Healthscope Commercial |
$764.03
|
| Rate for Payer: Healthscope Commercial |
$883.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$501.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$885.95
|
| Rate for Payer: Nomi Health Commercial |
$573.02
|
| Rate for Payer: PACE SWMI |
$477.52
|
| Rate for Payer: PHP Medicare Advantage |
$477.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.95
|
| Rate for Payer: Priority Health Medicare |
$477.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$477.52
|
| Rate for Payer: UHC Medicare Advantage |
$477.52
|
|
|
PR PARTIAL EXCISION SUPERFICIAL PELVIS
|
Professional
|
Both
|
$1,528.00
|
|
|
Service Code
|
HCPCS 27070
|
| Min. Negotiated Rate |
$611.20 |
| Max. Negotiated Rate |
$1,548.58 |
| Rate for Payer: Aetna Commercial |
$1,121.67
|
| Rate for Payer: Aetna Medicare |
$870.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,205.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,121.67
|
| Rate for Payer: BCBS Complete |
$611.20
|
| Rate for Payer: BCBS MAPPO |
$837.07
|
| Rate for Payer: BCN Medicare Advantage |
$837.07
|
| Rate for Payer: Cash Price |
$1,222.40
|
| Rate for Payer: Cash Price |
$1,222.40
|
| Rate for Payer: Cofinity Commercial |
$1,205.38
|
| Rate for Payer: Cofinity Commercial |
$1,121.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$837.07
|
| Rate for Payer: Healthscope Commercial |
$1,548.58
|
| Rate for Payer: Healthscope Commercial |
$1,339.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$878.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$993.20
|
| Rate for Payer: Nomi Health Commercial |
$1,004.48
|
| Rate for Payer: PACE SWMI |
$837.07
|
| Rate for Payer: PHP Medicare Advantage |
$837.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$993.20
|
| Rate for Payer: Priority Health Medicare |
$837.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$837.07
|
| Rate for Payer: UHC Medicare Advantage |
$837.07
|
|
|
PR PARTIAL HYMENECTOMY OR REVISION HYMENAL RING
|
Professional
|
Both
|
$657.00
|
|
|
Service Code
|
HCPCS 56700
|
| Min. Negotiated Rate |
$193.26 |
| Max. Negotiated Rate |
$427.05 |
| Rate for Payer: Aetna Commercial |
$258.97
|
| Rate for Payer: Aetna Medicare |
$200.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.97
|
| Rate for Payer: BCBS Complete |
$262.80
|
| Rate for Payer: BCBS MAPPO |
$193.26
|
| Rate for Payer: BCN Medicare Advantage |
$193.26
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cofinity Commercial |
$278.29
|
| Rate for Payer: Cofinity Commercial |
$258.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.26
|
| Rate for Payer: Healthscope Commercial |
$309.22
|
| Rate for Payer: Healthscope Commercial |
$357.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$202.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$427.05
|
| Rate for Payer: Nomi Health Commercial |
$231.91
|
| Rate for Payer: PACE SWMI |
$193.26
|
| Rate for Payer: PHP Medicare Advantage |
$193.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.05
|
| Rate for Payer: Priority Health Medicare |
$193.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.26
|
| Rate for Payer: UHC Medicare Advantage |
$193.26
|
|
|
PR PARTICAL EXCISION BONE PHALANX TOE
|
Professional
|
Both
|
$914.00
|
|
|
Service Code
|
HCPCS 28124
|
| Min. Negotiated Rate |
$320.80 |
| Max. Negotiated Rate |
$594.10 |
| Rate for Payer: Aetna Commercial |
$429.87
|
| Rate for Payer: Aetna Medicare |
$333.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.87
|
| Rate for Payer: BCBS Complete |
$365.60
|
| Rate for Payer: BCBS MAPPO |
$320.80
|
| Rate for Payer: BCN Medicare Advantage |
$320.80
|
| Rate for Payer: Cash Price |
$731.20
|
| Rate for Payer: Cash Price |
$731.20
|
| Rate for Payer: Cofinity Commercial |
$461.95
|
| Rate for Payer: Cofinity Commercial |
$429.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.80
|
| Rate for Payer: Healthscope Commercial |
$593.48
|
| Rate for Payer: Healthscope Commercial |
$513.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$594.10
|
| Rate for Payer: Nomi Health Commercial |
$384.96
|
| Rate for Payer: PACE SWMI |
$320.80
|
| Rate for Payer: PHP Medicare Advantage |
$320.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$594.10
|
| Rate for Payer: Priority Health Medicare |
$320.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.80
|
| Rate for Payer: UHC Medicare Advantage |
$320.80
|
|
|
PR PATELLECTOMY/HEMIPATELLECTOMY
|
Professional
|
Both
|
$2,101.00
|
|
|
Service Code
|
HCPCS 27350
|
| Min. Negotiated Rate |
$632.86 |
| Max. Negotiated Rate |
$1,365.65 |
| Rate for Payer: Aetna Commercial |
$848.03
|
| Rate for Payer: Aetna Medicare |
$658.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$911.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$848.03
|
| Rate for Payer: BCBS Complete |
$840.40
|
| Rate for Payer: BCBS MAPPO |
$632.86
|
| Rate for Payer: BCN Medicare Advantage |
$632.86
|
| Rate for Payer: Cash Price |
$1,680.80
|
| Rate for Payer: Cash Price |
$1,680.80
|
| Rate for Payer: Cofinity Commercial |
$911.32
|
| Rate for Payer: Cofinity Commercial |
$848.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$632.86
|
| Rate for Payer: Healthscope Commercial |
$1,012.58
|
| Rate for Payer: Healthscope Commercial |
$1,170.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$664.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,365.65
|
| Rate for Payer: Nomi Health Commercial |
$759.43
|
| Rate for Payer: PACE SWMI |
$632.86
|
| Rate for Payer: PHP Medicare Advantage |
$632.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,365.65
|
| Rate for Payer: Priority Health Medicare |
$632.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$632.86
|
| Rate for Payer: UHC Medicare Advantage |
$632.86
|
|
|
PR PATIENT-INITIATED SPIROMETRIC RECORDING
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 94015
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$52.48 |
| Rate for Payer: Aetna Commercial |
$38.02
|
| Rate for Payer: Aetna Medicare |
$29.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.02
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS MAPPO |
$28.37
|
| Rate for Payer: BCN Medicare Advantage |
$28.37
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$40.85
|
| Rate for Payer: Cofinity Commercial |
$38.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.37
|
| Rate for Payer: Healthscope Commercial |
$52.48
|
| Rate for Payer: Healthscope Commercial |
$45.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.15
|
| Rate for Payer: Nomi Health Commercial |
$34.04
|
| Rate for Payer: PACE SWMI |
$28.37
|
| Rate for Payer: PHP Medicare Advantage |
$28.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health Medicare |
$28.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.37
|
| Rate for Payer: UHC Medicare Advantage |
$28.37
|
|
|
PR PCV13 VACCINE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$290.00
|
|
|
Service Code
|
HCPCS 90670
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$477.28 |
| Rate for Payer: Aetna Commercial |
$345.71
|
| Rate for Payer: Aetna Medicare |
$268.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$371.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.71
|
| Rate for Payer: BCBS Complete |
$116.00
|
| Rate for Payer: BCBS MAPPO |
$257.99
|
| Rate for Payer: BCN Medicare Advantage |
$257.99
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cofinity Commercial |
$371.51
|
| Rate for Payer: Cofinity Commercial |
$345.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.99
|
| Rate for Payer: Healthscope Commercial |
$412.78
|
| Rate for Payer: Healthscope Commercial |
$477.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.50
|
| Rate for Payer: Nomi Health Commercial |
$309.59
|
| Rate for Payer: PACE SWMI |
$257.99
|
| Rate for Payer: PHP Medicare Advantage |
$257.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.50
|
| Rate for Payer: Priority Health Medicare |
$257.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.99
|
| Rate for Payer: UHC Medicare Advantage |
$257.99
|
|
