|
PR RCNSTJ MNDBL XTRORAL W/TRANSOSTEAL BONE PLATE
|
Professional
|
Both
|
$3,509.00
|
|
|
Service Code
|
HCPCS 21244
|
| Min. Negotiated Rate |
$110.96 |
| Max. Negotiated Rate |
$176,850.00 |
| Rate for Payer: Aetna Commercial |
$1,267.45
|
| Rate for Payer: Aetna Medicare |
$983.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,267.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,362.04
|
| Rate for Payer: BCBS Complete |
$676.55
|
| Rate for Payer: BCBS MAPPO |
$945.86
|
| Rate for Payer: BCBS Trust/PPO |
$110.96
|
| Rate for Payer: BCN Commercial |
$1,474.83
|
| Rate for Payer: BCN Medicare Advantage |
$945.86
|
| Rate for Payer: Cash Price |
$2,807.20
|
| Rate for Payer: Cash Price |
$2,807.20
|
| Rate for Payer: Cofinity Commercial |
$1,362.04
|
| Rate for Payer: Cofinity Commercial |
$1,267.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$945.86
|
| Rate for Payer: Healthscope Commercial |
$1,749.84
|
| Rate for Payer: Healthscope Commercial |
$1,513.38
|
| Rate for Payer: Mclaren Medicaid |
$644.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$993.15
|
| Rate for Payer: Meridian Medicaid |
$676.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176,850.00
|
| Rate for Payer: Nomi Health Commercial |
$1,135.03
|
| Rate for Payer: PACE SWMI |
$945.86
|
| Rate for Payer: PHP Medicare Advantage |
$945.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$644.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,280.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,537.78
|
| Rate for Payer: Priority Health Medicare |
$945.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,537.78
|
| Rate for Payer: Priority Health SBD |
$1,537.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$999.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$945.86
|
| Rate for Payer: UHC Exchange |
$999.79
|
| Rate for Payer: UHC Medicare Advantage |
$945.86
|
| Rate for Payer: UHCCP Medicaid |
$644.33
|
|
|
PR RCNSTJ POLYDACTYLOUS DIGIT SOFT TISSUE & BONE
|
Professional
|
Both
|
$1,739.00
|
|
|
Service Code
|
HCPCS 26587
|
| Min. Negotiated Rate |
$57.06 |
| Max. Negotiated Rate |
$185,173.00 |
| Rate for Payer: Aetna Commercial |
$1,350.59
|
| Rate for Payer: Aetna Medicare |
$1,048.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,350.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,451.38
|
| Rate for Payer: BCBS Complete |
$714.12
|
| Rate for Payer: BCBS MAPPO |
$1,007.90
|
| Rate for Payer: BCBS Trust/PPO |
$57.06
|
| Rate for Payer: BCN Commercial |
$1,533.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,007.90
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cofinity Commercial |
$1,451.38
|
| Rate for Payer: Cofinity Commercial |
$1,350.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,007.90
|
| Rate for Payer: Healthscope Commercial |
$1,864.62
|
| Rate for Payer: Healthscope Commercial |
$1,612.64
|
| Rate for Payer: Mclaren Medicaid |
$680.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,058.30
|
| Rate for Payer: Meridian Medicaid |
$714.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185,173.00
|
| Rate for Payer: Nomi Health Commercial |
$1,209.48
|
| Rate for Payer: PACE SWMI |
$1,007.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,007.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$680.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,130.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,610.04
|
| Rate for Payer: Priority Health Medicare |
$1,007.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,610.04
|
| Rate for Payer: Priority Health SBD |
$1,610.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$966.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,007.90
|
| Rate for Payer: UHC Exchange |
$966.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,007.90
|
| Rate for Payer: UHCCP Medicaid |
$680.11
|
|
|
PR RCNSTJ PST TIBL TDN W/EXC ACCESSORY TARSL NAVCLR
|
Professional
|
Both
|
$1,482.00
|
|
|
Service Code
|
HCPCS 28238
|
| Min. Negotiated Rate |
$314.18 |
| Max. Negotiated Rate |
$86,681.00 |
| Rate for Payer: Aetna Commercial |
$622.67
|
| Rate for Payer: Aetna Medicare |
$483.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$622.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$669.14
|
| Rate for Payer: BCBS Complete |
$329.89
|
| Rate for Payer: BCBS MAPPO |
$464.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,785.20
|
| Rate for Payer: BCN Commercial |
$981.75
|
| Rate for Payer: BCN Medicare Advantage |
$464.68
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cofinity Commercial |
$669.14
|
| Rate for Payer: Cofinity Commercial |
$622.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$464.68
|
| Rate for Payer: Healthscope Commercial |
$859.66
|
| Rate for Payer: Healthscope Commercial |
$743.49
|
| Rate for Payer: Mclaren Medicaid |
$314.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$487.91
|
| Rate for Payer: Meridian Medicaid |
$329.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86,681.00
|
| Rate for Payer: Nomi Health Commercial |
$557.62
|
| Rate for Payer: PACE SWMI |
$464.68
|
| Rate for Payer: PHP Medicare Advantage |
$464.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$314.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$963.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$752.60
|
| Rate for Payer: Priority Health Medicare |
$464.68
|
| Rate for Payer: Priority Health Narrow Network |
$752.60
|
| Rate for Payer: Priority Health SBD |
$752.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$743.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$464.68
|
| Rate for Payer: UHC Exchange |
$743.76
|
| Rate for Payer: UHC Medicare Advantage |
$464.68
|
| Rate for Payer: UHCCP Medicaid |
$314.18
|
|
|
PR RCNSTJ STABLJ DSTL U/DSTL JT 2 SOFT TISS STABLJ
|
Professional
|
Both
|
$3,444.00
|
|
|
Service Code
|
HCPCS 25337
|
| Min. Negotiated Rate |
$336.53 |
| Max. Negotiated Rate |
$157,232.00 |
| Rate for Payer: Aetna Commercial |
$1,149.17
|
| Rate for Payer: Aetna Medicare |
$891.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,149.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,234.93
|
| Rate for Payer: BCBS Complete |
$611.24
|
| Rate for Payer: BCBS MAPPO |
$857.59
|
| Rate for Payer: BCBS Trust/PPO |
$336.53
|
| Rate for Payer: BCN Commercial |
$1,307.70
|
| Rate for Payer: BCN Medicare Advantage |
$857.59
|
| Rate for Payer: Cash Price |
$2,755.20
|
| Rate for Payer: Cash Price |
$2,755.20
|
| Rate for Payer: Cofinity Commercial |
$1,234.93
|
| Rate for Payer: Cofinity Commercial |
$1,149.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$857.59
|
| Rate for Payer: Healthscope Commercial |
$1,586.54
|
| Rate for Payer: Healthscope Commercial |
$1,372.14
|
| Rate for Payer: Mclaren Medicaid |
$582.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$900.47
|
| Rate for Payer: Meridian Medicaid |
$611.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157,232.00
|
| Rate for Payer: Nomi Health Commercial |
$1,029.11
|
| Rate for Payer: PACE SWMI |
$857.59
|
| Rate for Payer: PHP Medicare Advantage |
$857.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$582.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,238.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,374.94
|
| Rate for Payer: Priority Health Medicare |
$857.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,374.94
|
| Rate for Payer: Priority Health SBD |
$1,374.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$982.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$857.59
|
| Rate for Payer: UHC Exchange |
$982.19
|
| Rate for Payer: UHC Medicare Advantage |
$857.59
|
| Rate for Payer: UHCCP Medicaid |
$582.13
|
|
|
PR RCNSTJ SUPERIOR-LATERAL ORBITAL RIM & LOWER FHD
|
Professional
|
Both
|
$4,478.00
|
|
|
Service Code
|
HCPCS 21172
|
| Min. Negotiated Rate |
$580.95 |
| Max. Negotiated Rate |
$381,929.00 |
| Rate for Payer: Aetna Commercial |
$2,781.48
|
| Rate for Payer: Aetna Medicare |
$2,158.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,781.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,989.05
|
| Rate for Payer: BCBS Complete |
$1,439.19
|
| Rate for Payer: BCBS MAPPO |
$2,075.73
|
| Rate for Payer: BCBS Trust/PPO |
$580.95
|
| Rate for Payer: BCN Commercial |
$3,123.14
|
| Rate for Payer: BCN Medicare Advantage |
$2,075.73
|
| Rate for Payer: Cash Price |
$3,582.40
|
| Rate for Payer: Cash Price |
$3,582.40
|
| Rate for Payer: Cofinity Commercial |
$2,989.05
|
| Rate for Payer: Cofinity Commercial |
$2,781.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,075.73
|
| Rate for Payer: Healthscope Commercial |
$3,840.10
|
| Rate for Payer: Healthscope Commercial |
$3,321.17
|
| Rate for Payer: Mclaren Medicaid |
$1,370.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,179.52
|
| Rate for Payer: Meridian Medicaid |
$1,439.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$381,929.00
|
| Rate for Payer: Nomi Health Commercial |
$2,490.88
|
| Rate for Payer: PACE SWMI |
$2,075.73
|
| Rate for Payer: PHP Medicare Advantage |
$2,075.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,370.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,910.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,274.52
|
| Rate for Payer: Priority Health Medicare |
$2,075.73
|
| Rate for Payer: Priority Health Narrow Network |
$3,274.52
|
| Rate for Payer: Priority Health SBD |
$3,274.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,000.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,075.73
|
| Rate for Payer: UHC Exchange |
$2,000.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,075.73
|
| Rate for Payer: UHCCP Medicaid |
$1,370.66
|
|
|
PR RCNSTJ TDN PULLEY EA TDN W/TDN/FSCAL GRF SPX
|
Professional
|
Both
|
$1,434.00
|
|
|
Service Code
|
HCPCS 26502
|
| Min. Negotiated Rate |
$487.56 |
| Max. Negotiated Rate |
$133,321.00 |
| Rate for Payer: Aetna Commercial |
$949.08
|
| Rate for Payer: Aetna Medicare |
$736.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,019.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$949.08
|
| Rate for Payer: BCBS Complete |
$511.94
|
| Rate for Payer: BCBS MAPPO |
$708.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,792.59
|
| Rate for Payer: BCN Commercial |
$1,124.45
|
| Rate for Payer: BCN Medicare Advantage |
$708.27
|
| Rate for Payer: Cash Price |
$1,147.20
|
| Rate for Payer: Cash Price |
$1,147.20
|
| Rate for Payer: Cofinity Commercial |
$949.08
|
| Rate for Payer: Cofinity Commercial |
$1,019.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$708.27
|
| Rate for Payer: Healthscope Commercial |
$1,310.30
|
| Rate for Payer: Healthscope Commercial |
$1,133.23
|
| Rate for Payer: Mclaren Medicaid |
$487.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$743.68
|
| Rate for Payer: Meridian Medicaid |
$511.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133,321.00
|
| Rate for Payer: Nomi Health Commercial |
$849.92
|
| Rate for Payer: PACE SWMI |
$708.27
|
| Rate for Payer: PHP Medicare Advantage |
$708.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$932.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,170.38
|
| Rate for Payer: Priority Health Medicare |
$708.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,170.38
|
| Rate for Payer: Priority Health SBD |
$1,170.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$889.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$708.27
|
| Rate for Payer: UHC Exchange |
$889.37
|
| Rate for Payer: UHC Medicare Advantage |
$708.27
|
| Rate for Payer: UHCCP Medicaid |
$487.56
|
|
|
PR RCNSTJ TENDON PULLEY EACH W/LOCAL TISSUES SPX
|
Professional
|
Both
|
$1,388.00
|
|
|
Service Code
|
HCPCS 26500
|
| Min. Negotiated Rate |
$444.11 |
| Max. Negotiated Rate |
$116,714.00 |
| Rate for Payer: Aetna Commercial |
$861.26
|
| Rate for Payer: Aetna Medicare |
$668.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$861.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$925.53
|
| Rate for Payer: BCBS Complete |
$466.32
|
| Rate for Payer: BCBS MAPPO |
$642.73
|
| Rate for Payer: BCBS Trust/PPO |
$5,862.74
|
| Rate for Payer: BCN Commercial |
$987.13
|
| Rate for Payer: BCN Medicare Advantage |
$642.73
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cofinity Commercial |
$925.53
|
| Rate for Payer: Cofinity Commercial |
$861.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$642.73
|
| Rate for Payer: Healthscope Commercial |
$1,189.05
|
| Rate for Payer: Healthscope Commercial |
$1,028.37
|
| Rate for Payer: Mclaren Medicaid |
$444.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$674.87
|
| Rate for Payer: Meridian Medicaid |
$466.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116,714.00
|
| Rate for Payer: Nomi Health Commercial |
$771.28
|
| Rate for Payer: PACE SWMI |
$642.73
|
| Rate for Payer: PHP Medicare Advantage |
$642.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$902.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,066.06
|
| Rate for Payer: Priority Health Medicare |
$642.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,066.06
|
| Rate for Payer: Priority Health SBD |
$1,066.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$820.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$642.73
|
| Rate for Payer: UHC Exchange |
$820.03
|
| Rate for Payer: UHC Medicare Advantage |
$642.73
|
| Rate for Payer: UHCCP Medicaid |
$444.11
|
|
|
PR RDCTJ PROCIDENTIA UNDER ANES SEPARATE PROCEDURE
|
Professional
|
Both
|
$387.00
|
|
|
Service Code
|
HCPCS 45900
|
| Min. Negotiated Rate |
$137.81 |
| Max. Negotiated Rate |
$37,831.00 |
| Rate for Payer: Aetna Commercial |
$275.64
|
| Rate for Payer: Aetna Medicare |
$213.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$296.21
|
| Rate for Payer: BCBS Complete |
$144.70
|
| Rate for Payer: BCBS MAPPO |
$205.70
|
| Rate for Payer: BCBS Trust/PPO |
$771.85
|
| Rate for Payer: BCN Commercial |
$311.78
|
| Rate for Payer: BCN Medicare Advantage |
$205.70
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Cash Price |
$309.60
|
| Rate for Payer: Cofinity Commercial |
$296.21
|
| Rate for Payer: Cofinity Commercial |
$275.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$205.70
|
| Rate for Payer: Healthscope Commercial |
$380.54
|
| Rate for Payer: Healthscope Commercial |
$329.12
|
| Rate for Payer: Mclaren Medicaid |
$137.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$215.98
|
| Rate for Payer: Meridian Medicaid |
$144.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37,831.00
|
| Rate for Payer: Nomi Health Commercial |
$246.84
|
| Rate for Payer: PACE SWMI |
$205.70
|
| Rate for Payer: PHP Medicare Advantage |
$205.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$137.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$383.02
|
| Rate for Payer: Priority Health Medicare |
$205.70
|
| Rate for Payer: Priority Health Narrow Network |
$383.02
|
| Rate for Payer: Priority Health SBD |
$383.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$205.70
|
| Rate for Payer: UHC Exchange |
$171.76
|
| Rate for Payer: UHC Medicare Advantage |
$205.70
|
| Rate for Payer: UHCCP Medicaid |
$137.81
|
|
|
PR RDCTJ TORSION TSTIS W/WO FIXJ CLAT TESTIS
|
Professional
|
Both
|
$817.00
|
|
|
Service Code
|
HCPCS 54600
|
| Min. Negotiated Rate |
$291.81 |
| Max. Negotiated Rate |
$79,580.00 |
| Rate for Payer: Aetna Commercial |
$580.77
|
| Rate for Payer: Aetna Medicare |
$450.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.11
|
| Rate for Payer: BCBS Complete |
$306.40
|
| Rate for Payer: BCBS MAPPO |
$433.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,890.86
|
| Rate for Payer: BCN Commercial |
$655.32
|
| Rate for Payer: BCN Medicare Advantage |
$433.41
|
| Rate for Payer: Cash Price |
$653.60
|
| Rate for Payer: Cash Price |
$653.60
|
| Rate for Payer: Cofinity Commercial |
$624.11
|
| Rate for Payer: Cofinity Commercial |
$580.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.41
|
| Rate for Payer: Healthscope Commercial |
$801.81
|
| Rate for Payer: Healthscope Commercial |
$693.46
|
| Rate for Payer: Mclaren Medicaid |
$291.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.08
|
| Rate for Payer: Meridian Medicaid |
$306.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79,580.00
|
| Rate for Payer: Nomi Health Commercial |
$520.09
|
| Rate for Payer: PACE SWMI |
$433.41
|
| Rate for Payer: PHP Medicare Advantage |
$433.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$291.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$531.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$725.41
|
| Rate for Payer: Priority Health Medicare |
$433.41
|
| Rate for Payer: Priority Health Narrow Network |
$725.41
|
| Rate for Payer: Priority Health SBD |
$725.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$556.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.41
|
| Rate for Payer: UHC Exchange |
$556.15
|
| Rate for Payer: UHC Medicare Advantage |
$433.41
|
| Rate for Payer: UHCCP Medicaid |
$291.81
|
|
|
PR RDCTJ VOLVULUS INTUSSUSCEPTION INT HRNA LAPT
|
Professional
|
Both
|
$2,376.00
|
|
|
Service Code
|
HCPCS 44050
|
| Min. Negotiated Rate |
$602.36 |
| Max. Negotiated Rate |
$167,548.00 |
| Rate for Payer: Aetna Commercial |
$1,219.48
|
| Rate for Payer: Aetna Medicare |
$946.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,219.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,310.49
|
| Rate for Payer: BCBS Complete |
$632.48
|
| Rate for Payer: BCBS MAPPO |
$910.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,793.65
|
| Rate for Payer: BCN Commercial |
$1,366.35
|
| Rate for Payer: BCN Medicare Advantage |
$910.06
|
| Rate for Payer: Cash Price |
$1,900.80
|
| Rate for Payer: Cash Price |
$1,900.80
|
| Rate for Payer: Cofinity Commercial |
$1,310.49
|
| Rate for Payer: Cofinity Commercial |
$1,219.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$910.06
|
| Rate for Payer: Healthscope Commercial |
$1,683.61
|
| Rate for Payer: Healthscope Commercial |
$1,456.10
|
| Rate for Payer: Mclaren Medicaid |
$602.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$955.56
|
| Rate for Payer: Meridian Medicaid |
$632.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167,548.00
|
| Rate for Payer: Nomi Health Commercial |
$1,092.07
|
| Rate for Payer: PACE SWMI |
$910.06
|
| Rate for Payer: PHP Medicare Advantage |
$910.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$602.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,544.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,677.61
|
| Rate for Payer: Priority Health Medicare |
$910.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,677.61
|
| Rate for Payer: Priority Health SBD |
$1,677.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$946.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$910.06
|
| Rate for Payer: UHC Exchange |
$946.15
|
| Rate for Payer: UHC Medicare Advantage |
$910.06
|
| Rate for Payer: UHCCP Medicaid |
$602.36
|
|
|
PR REALIGNMENT EXTENSOR TENDON HAND EACH TENDON
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26437
|
| Min. Negotiated Rate |
$147.92 |
| Max. Negotiated Rate |
$117,405.00 |
| Rate for Payer: Aetna Commercial |
$834.75
|
| Rate for Payer: Aetna Medicare |
$647.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$834.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$897.05
|
| Rate for Payer: BCBS Complete |
$452.44
|
| Rate for Payer: BCBS MAPPO |
$622.95
|
| Rate for Payer: BCBS Trust/PPO |
$147.92
|
| Rate for Payer: BCN Commercial |
$993.97
|
| Rate for Payer: BCN Medicare Advantage |
$622.95
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$897.05
|
| Rate for Payer: Cofinity Commercial |
$834.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$622.95
|
| Rate for Payer: Healthscope Commercial |
$996.72
|
| Rate for Payer: Healthscope Commercial |
$1,152.46
|
| Rate for Payer: Mclaren Medicaid |
$430.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$654.10
|
| Rate for Payer: Meridian Medicaid |
$452.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117,405.00
|
| Rate for Payer: Nomi Health Commercial |
$747.54
|
| Rate for Payer: PACE SWMI |
$622.95
|
| Rate for Payer: PHP Medicare Advantage |
$622.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$430.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,030.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,032.99
|
| Rate for Payer: Priority Health Medicare |
$622.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,032.99
|
| Rate for Payer: Priority Health SBD |
$1,032.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$798.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$622.95
|
| Rate for Payer: UHC Exchange |
$798.28
|
| Rate for Payer: UHC Medicare Advantage |
$622.95
|
| Rate for Payer: UHCCP Medicaid |
$430.90
|
|
|
PR REAORT VALV W CP BYPASS
|
Professional
|
Both
|
$8,044.00
|
|
|
Service Code
|
HCPCS 33400
|
| Min. Negotiated Rate |
$3,217.60 |
| Max. Negotiated Rate |
$5,228.60 |
| Rate for Payer: Aetna Medicare |
$4,022.00
|
| Rate for Payer: BCBS Complete |
$3,217.60
|
| Rate for Payer: Cash Price |
$6,435.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,228.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,228.60
|
|
|
PR RECMPL WND LID,NOS,EAR <1 CM
|
Professional
|
Both
|
$603.00
|
|
|
Service Code
|
HCPCS 13150
|
| Min. Negotiated Rate |
$241.20 |
| Max. Negotiated Rate |
$391.95 |
| Rate for Payer: Aetna Medicare |
$301.50
|
| Rate for Payer: BCBS Complete |
$241.20
|
| Rate for Payer: Cash Price |
$482.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$391.95
|
|
|
PR RECONSTRUCTION EXTERNAL AUDITORY CANAL SPX
|
Professional
|
Both
|
$3,465.00
|
|
|
Service Code
|
HCPCS 69310
|
| Min. Negotiated Rate |
$714.19 |
| Max. Negotiated Rate |
$195,563.00 |
| Rate for Payer: Aetna Commercial |
$1,385.04
|
| Rate for Payer: Aetna Medicare |
$1,074.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,385.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,488.40
|
| Rate for Payer: BCBS Complete |
$749.90
|
| Rate for Payer: BCBS MAPPO |
$1,033.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,074.63
|
| Rate for Payer: BCN Commercial |
$1,653.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,033.61
|
| Rate for Payer: Cash Price |
$2,772.00
|
| Rate for Payer: Cash Price |
$2,772.00
|
| Rate for Payer: Cofinity Commercial |
$1,385.04
|
| Rate for Payer: Cofinity Commercial |
$1,488.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,033.61
|
| Rate for Payer: Healthscope Commercial |
$1,653.78
|
| Rate for Payer: Healthscope Commercial |
$1,912.18
|
| Rate for Payer: Mclaren Medicaid |
$714.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,085.29
|
| Rate for Payer: Meridian Medicaid |
$749.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195,563.00
|
| Rate for Payer: Nomi Health Commercial |
$1,240.33
|
| Rate for Payer: PACE SWMI |
$1,033.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,033.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$714.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,252.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,636.16
|
| Rate for Payer: Priority Health Medicare |
$1,033.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,636.16
|
| Rate for Payer: Priority Health SBD |
$1,636.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,024.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,033.61
|
| Rate for Payer: UHC Exchange |
$1,024.91
|
| Rate for Payer: UHC Medicare Advantage |
$1,033.61
|
| Rate for Payer: UHCCP Medicaid |
$714.19
|
|
|
PR RECONSTRUCTION NAIL BED W/GRAFT
|
Professional
|
Both
|
$447.00
|
|
|
Service Code
|
HCPCS 11762
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$32,749.00 |
| Rate for Payer: Aetna Commercial |
$239.89
|
| Rate for Payer: Aetna Medicare |
$186.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.79
|
| Rate for Payer: BCBS Complete |
$127.26
|
| Rate for Payer: BCBS MAPPO |
$179.02
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$421.24
|
| Rate for Payer: BCN Medicare Advantage |
$179.02
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Cofinity Commercial |
$257.79
|
| Rate for Payer: Cofinity Commercial |
$239.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.02
|
| Rate for Payer: Healthscope Commercial |
$331.19
|
| Rate for Payer: Healthscope Commercial |
$286.43
|
| Rate for Payer: Mclaren Medicaid |
$121.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$187.97
|
| Rate for Payer: Meridian Medicaid |
$127.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32,749.00
|
| Rate for Payer: Nomi Health Commercial |
$214.82
|
| Rate for Payer: PACE SWMI |
$179.02
|
| Rate for Payer: PHP Medicare Advantage |
$179.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$253.30
|
| Rate for Payer: Priority Health Medicare |
$179.02
|
| Rate for Payer: Priority Health Narrow Network |
$253.30
|
| Rate for Payer: Priority Health SBD |
$253.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.02
|
| Rate for Payer: UHC Exchange |
$268.17
|
| Rate for Payer: UHC Medicare Advantage |
$179.02
|
| Rate for Payer: UHCCP Medicaid |
$121.20
|
|
|
PR RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC
|
Professional
|
Both
|
$3,986.00
|
|
|
Service Code
|
HCPCS 23420
|
| Hospital Charge Code |
23420
|
| Min. Negotiated Rate |
$120.13 |
| Max. Negotiated Rate |
$172,838.00 |
| Rate for Payer: Aetna Commercial |
$1,260.56
|
| Rate for Payer: Aetna Medicare |
$978.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,260.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,354.64
|
| Rate for Payer: BCBS Complete |
$666.70
|
| Rate for Payer: BCBS MAPPO |
$940.72
|
| Rate for Payer: BCBS Trust/PPO |
$120.13
|
| Rate for Payer: BCN Commercial |
$1,576.02
|
| Rate for Payer: BCN Medicare Advantage |
$940.72
|
| Rate for Payer: Cash Price |
$3,188.80
|
| Rate for Payer: Cash Price |
$3,188.80
|
| Rate for Payer: Cofinity Commercial |
$1,354.64
|
| Rate for Payer: Cofinity Commercial |
$1,260.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$940.72
|
| Rate for Payer: Healthscope Commercial |
$1,740.33
|
| Rate for Payer: Healthscope Commercial |
$1,505.15
|
| Rate for Payer: Mclaren Medicaid |
$634.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$987.76
|
| Rate for Payer: Meridian Medicaid |
$666.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172,838.00
|
| Rate for Payer: Nomi Health Commercial |
$1,128.86
|
| Rate for Payer: PACE SWMI |
$940.72
|
| Rate for Payer: PHP Medicare Advantage |
$940.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$634.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,590.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,502.67
|
| Rate for Payer: Priority Health Medicare |
$940.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,502.67
|
| Rate for Payer: Priority Health SBD |
$1,502.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,633.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$940.72
|
| Rate for Payer: UHC Exchange |
$1,633.56
|
| Rate for Payer: UHC Medicare Advantage |
$940.72
|
| Rate for Payer: UHCCP Medicaid |
$634.95
|
|
|
PR RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC
|
Facility
|
OP
|
$3,986.00
|
|
|
Service Code
|
CPT 23420
|
| Hospital Charge Code |
23420
|
| Min. Negotiated Rate |
$1,038.42 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna Commercial |
$3,388.10
|
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,590.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,763.16
|
| Rate for Payer: BCN Commercial |
$2,763.16
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$3,188.80
|
| Rate for Payer: Cash Price |
$3,188.80
|
| Rate for Payer: Cash Price |
$3,188.80
|
| Rate for Payer: Cofinity Commercial |
$3,427.96
|
| Rate for Payer: Cofinity Commercial |
$2,790.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,790.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,188.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$3,587.40
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,388.10
|
| Rate for Payer: Nomi Health Commercial |
$14,698.49
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Commercial |
$3,388.10
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,590.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,998.64
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$17,598.91
|
| Rate for Payer: Priority Health SBD |
$2,511.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,038.42
|
| Rate for Payer: UHC Core |
$6,837.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,940.59
|
| Rate for Payer: VA VA |
$6,999.28
|
|
|
PR RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC
|
Professional
|
Both
|
$3,986.00
|
|
|
Service Code
|
HCPCS 23420
|
| Min. Negotiated Rate |
$120.13 |
| Max. Negotiated Rate |
$172,838.00 |
| Rate for Payer: Aetna Commercial |
$1,260.56
|
| Rate for Payer: Aetna Medicare |
$978.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,260.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,354.64
|
| Rate for Payer: BCBS Complete |
$666.70
|
| Rate for Payer: BCBS MAPPO |
$940.72
|
| Rate for Payer: BCBS Trust/PPO |
$120.13
|
| Rate for Payer: BCN Commercial |
$1,576.02
|
| Rate for Payer: BCN Medicare Advantage |
$940.72
|
| Rate for Payer: Cash Price |
$3,188.80
|
| Rate for Payer: Cash Price |
$3,188.80
|
| Rate for Payer: Cofinity Commercial |
$1,354.64
|
| Rate for Payer: Cofinity Commercial |
$1,260.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$940.72
|
| Rate for Payer: Healthscope Commercial |
$1,740.33
|
| Rate for Payer: Healthscope Commercial |
$1,505.15
|
| Rate for Payer: Mclaren Medicaid |
$634.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$987.76
|
| Rate for Payer: Meridian Medicaid |
$666.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172,838.00
|
| Rate for Payer: Nomi Health Commercial |
$1,128.86
|
| Rate for Payer: PACE SWMI |
$940.72
|
| Rate for Payer: PHP Medicare Advantage |
$940.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$634.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,590.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,502.67
|
| Rate for Payer: Priority Health Medicare |
$940.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,502.67
|
| Rate for Payer: Priority Health SBD |
$1,502.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,633.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$940.72
|
| Rate for Payer: UHC Exchange |
$1,633.56
|
| Rate for Payer: UHC Medicare Advantage |
$940.72
|
| Rate for Payer: UHCCP Medicaid |
$634.95
|
|
|
PR RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC
|
Facility
|
IP
|
$3,986.00
|
|
|
Service Code
|
CPT 23420
|
| Hospital Charge Code |
23420
|
| Min. Negotiated Rate |
$2,511.18 |
| Max. Negotiated Rate |
$3,587.40 |
| Rate for Payer: Aetna Commercial |
$3,388.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,590.90
|
| Rate for Payer: Cash Price |
$3,188.80
|
| Rate for Payer: Cofinity Commercial |
$2,790.20
|
| Rate for Payer: Cofinity Commercial |
$3,427.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,790.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,188.80
|
| Rate for Payer: Healthscope Commercial |
$3,587.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,388.10
|
| Rate for Payer: PHP Commercial |
$3,388.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,590.90
|
| Rate for Payer: Priority Health SBD |
$2,511.18
|
|
|
PR RECONSTRUCTION TOE POLYDACTYLY
|
Professional
|
Both
|
$825.00
|
|
|
Service Code
|
HCPCS 28344
|
| Min. Negotiated Rate |
$181.69 |
| Max. Negotiated Rate |
$48,863.00 |
| Rate for Payer: Aetna Commercial |
$357.77
|
| Rate for Payer: Aetna Medicare |
$277.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$357.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$384.47
|
| Rate for Payer: BCBS Complete |
$190.77
|
| Rate for Payer: BCBS MAPPO |
$266.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,741.35
|
| Rate for Payer: BCN Commercial |
$607.43
|
| Rate for Payer: BCN Medicare Advantage |
$266.99
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cofinity Commercial |
$384.47
|
| Rate for Payer: Cofinity Commercial |
$357.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$266.99
|
| Rate for Payer: Healthscope Commercial |
$493.93
|
| Rate for Payer: Healthscope Commercial |
$427.18
|
| Rate for Payer: Mclaren Medicaid |
$181.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$280.34
|
| Rate for Payer: Meridian Medicaid |
$190.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48,863.00
|
| Rate for Payer: Nomi Health Commercial |
$320.39
|
| Rate for Payer: PACE SWMI |
$266.99
|
| Rate for Payer: PHP Medicare Advantage |
$266.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$430.49
|
| Rate for Payer: Priority Health Medicare |
$266.99
|
| Rate for Payer: Priority Health Narrow Network |
$430.49
|
| Rate for Payer: Priority Health SBD |
$430.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$524.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$266.99
|
| Rate for Payer: UHC Exchange |
$524.95
|
| Rate for Payer: UHC Medicare Advantage |
$266.99
|
| Rate for Payer: UHCCP Medicaid |
$181.69
|
|
|
PR RECONSTRUCTION VENA CAVA ANY METHOD
|
Professional
|
Both
|
$2,399.00
|
|
|
Service Code
|
HCPCS 34502
|
| Min. Negotiated Rate |
$972.77 |
| Max. Negotiated Rate |
$271,606.00 |
| Rate for Payer: Aetna Commercial |
$1,982.96
|
| Rate for Payer: Aetna Medicare |
$1,539.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,982.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,130.94
|
| Rate for Payer: BCBS Complete |
$1,021.41
|
| Rate for Payer: BCBS MAPPO |
$1,479.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,399.01
|
| Rate for Payer: BCN Commercial |
$2,200.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,479.82
|
| Rate for Payer: Cash Price |
$1,919.20
|
| Rate for Payer: Cash Price |
$1,919.20
|
| Rate for Payer: Cofinity Commercial |
$2,130.94
|
| Rate for Payer: Cofinity Commercial |
$1,982.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,479.82
|
| Rate for Payer: Healthscope Commercial |
$2,737.67
|
| Rate for Payer: Healthscope Commercial |
$2,367.71
|
| Rate for Payer: Mclaren Medicaid |
$972.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,553.81
|
| Rate for Payer: Meridian Medicaid |
$1,021.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271,606.00
|
| Rate for Payer: Nomi Health Commercial |
$1,775.78
|
| Rate for Payer: PACE SWMI |
$1,479.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,479.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$972.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,559.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,424.05
|
| Rate for Payer: Priority Health Medicare |
$1,479.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,424.05
|
| Rate for Payer: Priority Health SBD |
$2,424.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,002.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,479.82
|
| Rate for Payer: UHC Exchange |
$2,002.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,479.82
|
| Rate for Payer: UHCCP Medicaid |
$972.77
|
|
|
PR RECTAL SESATION TONE & COMPLIANCE TEST
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 91120
|
| Min. Negotiated Rate |
$30.25 |
| Max. Negotiated Rate |
$71,423.00 |
| Rate for Payer: Aetna Commercial |
$569.75
|
| Rate for Payer: Aetna Commercial |
$569.75
|
| Rate for Payer: Aetna Medicare |
$442.20
|
| Rate for Payer: Aetna Medicare |
$442.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$569.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$569.75
|
| Rate for Payer: BCBS Complete |
$31.76
|
| Rate for Payer: BCBS Complete |
$31.76
|
| Rate for Payer: BCBS MAPPO |
$425.19
|
| Rate for Payer: BCBS MAPPO |
$425.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.77
|
| Rate for Payer: BCN Commercial |
$748.66
|
| Rate for Payer: BCN Commercial |
$748.66
|
| Rate for Payer: BCN Medicare Advantage |
$425.19
|
| Rate for Payer: BCN Medicare Advantage |
$425.19
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cofinity Commercial |
$612.27
|
| Rate for Payer: Cofinity Commercial |
$569.75
|
| Rate for Payer: Cofinity Commercial |
$569.75
|
| Rate for Payer: Cofinity Commercial |
$612.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$425.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$425.19
|
| Rate for Payer: Healthscope Commercial |
$680.30
|
| Rate for Payer: Healthscope Commercial |
$786.60
|
| Rate for Payer: Healthscope Commercial |
$680.30
|
| Rate for Payer: Healthscope Commercial |
$786.60
|
| Rate for Payer: Mclaren Medicaid |
$30.25
|
| Rate for Payer: Mclaren Medicaid |
$30.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$446.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$446.45
|
| Rate for Payer: Meridian Medicaid |
$31.76
|
| Rate for Payer: Meridian Medicaid |
$31.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71,423.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71,423.00
|
| Rate for Payer: Nomi Health Commercial |
$510.23
|
| Rate for Payer: Nomi Health Commercial |
$510.23
|
| Rate for Payer: PACE SWMI |
$425.19
|
| Rate for Payer: PACE SWMI |
$425.19
|
| Rate for Payer: PHP Medicare Advantage |
$425.19
|
| Rate for Payer: PHP Medicare Advantage |
$425.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$461.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$678.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$678.47
|
| Rate for Payer: Priority Health Medicare |
$425.19
|
| Rate for Payer: Priority Health Medicare |
$425.19
|
| Rate for Payer: Priority Health Narrow Network |
$678.47
|
| Rate for Payer: Priority Health Narrow Network |
$678.47
|
| Rate for Payer: Priority Health SBD |
$64.23
|
| Rate for Payer: Priority Health SBD |
$64.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$455.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$455.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$425.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$425.19
|
| Rate for Payer: UHC Exchange |
$455.44
|
| Rate for Payer: UHC Exchange |
$455.44
|
| Rate for Payer: UHC Medicare Advantage |
$425.19
|
| Rate for Payer: UHC Medicare Advantage |
$425.19
|
| Rate for Payer: UHCCP Medicaid |
$30.25
|
| Rate for Payer: UHCCP Medicaid |
$30.25
|
|
|
PR RECTAL TUMOR EXCISION TRANSANAL ENDOSCOPIC
|
Professional
|
Both
|
$1,793.00
|
|
|
Service Code
|
HCPCS 0184T
|
| Min. Negotiated Rate |
$25.64 |
| Max. Negotiated Rate |
$147,217.00 |
| Rate for Payer: Aetna Commercial |
$771.30
|
| Rate for Payer: Aetna Medicare |
$896.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$771.30
|
| Rate for Payer: BCBS Complete |
$717.20
|
| Rate for Payer: BCBS Trust/PPO |
$25.64
|
| Rate for Payer: BCN Commercial |
$4,847.67
|
| Rate for Payer: Cash Price |
$1,434.40
|
| Rate for Payer: Cash Price |
$1,434.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147,217.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,165.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,238.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,238.26
|
| Rate for Payer: Priority Health SBD |
$1,238.26
|
|
|
PR REGION IV LOCAL ANESTH,UPPER/LOWER EXT
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS 01995
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.25 |
| Rate for Payer: Aetna Medicare |
$2.50
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.25
|
|
|
PR REIMPLANTATION ANOMALOUS PULMONARY ARTERY
|
Professional
|
Both
|
$6,703.00
|
|
|
Service Code
|
HCPCS 33788
|
| Min. Negotiated Rate |
$965.96 |
| Max. Negotiated Rate |
$271,798.00 |
| Rate for Payer: Aetna Commercial |
$1,972.69
|
| Rate for Payer: Aetna Medicare |
$1,531.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,972.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,119.91
|
| Rate for Payer: BCBS Complete |
$1,014.26
|
| Rate for Payer: BCBS MAPPO |
$1,472.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,462.33
|
| Rate for Payer: BCN Commercial |
$2,201.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,472.16
|
| Rate for Payer: Cash Price |
$5,362.40
|
| Rate for Payer: Cash Price |
$5,362.40
|
| Rate for Payer: Cofinity Commercial |
$2,119.91
|
| Rate for Payer: Cofinity Commercial |
$1,972.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,472.16
|
| Rate for Payer: Healthscope Commercial |
$2,723.50
|
| Rate for Payer: Healthscope Commercial |
$2,355.46
|
| Rate for Payer: Mclaren Medicaid |
$965.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,545.77
|
| Rate for Payer: Meridian Medicaid |
$1,014.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271,798.00
|
| Rate for Payer: Nomi Health Commercial |
$1,766.59
|
| Rate for Payer: PACE SWMI |
$1,472.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,472.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$965.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,356.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,404.91
|
| Rate for Payer: Priority Health Medicare |
$1,472.16
|
| Rate for Payer: Priority Health Narrow Network |
$2,404.91
|
| Rate for Payer: Priority Health SBD |
$2,404.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,913.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,472.16
|
| Rate for Payer: UHC Exchange |
$2,913.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,472.16
|
| Rate for Payer: UHCCP Medicaid |
$965.96
|
|
