|
PR RPR INCPLT/PRTL AV CANAL W/WO AV VALVE RPR
|
Professional
|
Both
|
$7,548.00
|
|
|
Service Code
|
HCPCS 33660
|
| Min. Negotiated Rate |
$1,104.62 |
| Max. Negotiated Rate |
$311,099.00 |
| Rate for Payer: Aetna Commercial |
$2,259.03
|
| Rate for Payer: Aetna Medicare |
$1,753.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,259.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,427.61
|
| Rate for Payer: BCBS Complete |
$1,159.85
|
| Rate for Payer: BCBS MAPPO |
$1,685.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,131.09
|
| Rate for Payer: BCN Commercial |
$2,516.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,685.84
|
| Rate for Payer: Cash Price |
$6,038.40
|
| Rate for Payer: Cash Price |
$6,038.40
|
| Rate for Payer: Cofinity Commercial |
$2,427.61
|
| Rate for Payer: Cofinity Commercial |
$2,259.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,685.84
|
| Rate for Payer: Healthscope Commercial |
$3,118.80
|
| Rate for Payer: Healthscope Commercial |
$2,697.34
|
| Rate for Payer: Mclaren Medicaid |
$1,104.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,770.13
|
| Rate for Payer: Meridian Medicaid |
$1,159.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311,099.00
|
| Rate for Payer: Nomi Health Commercial |
$2,023.01
|
| Rate for Payer: PACE SWMI |
$1,685.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,685.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,104.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,906.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,750.07
|
| Rate for Payer: Priority Health Medicare |
$1,685.84
|
| Rate for Payer: Priority Health Narrow Network |
$2,750.07
|
| Rate for Payer: Priority Health SBD |
$2,750.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,960.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,685.84
|
| Rate for Payer: UHC Exchange |
$2,960.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,685.84
|
| Rate for Payer: UHCCP Medicaid |
$1,104.62
|
|
|
PR RPR INGUN HERNIA SLIDING ANY AGE
|
Facility
|
IP
|
$1,636.00
|
|
|
Service Code
|
CPT 49525
|
| Hospital Charge Code |
49525
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,030.68 |
| Max. Negotiated Rate |
$1,472.40 |
| Rate for Payer: Aetna Commercial |
$1,390.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,063.40
|
| Rate for Payer: Cash Price |
$1,308.80
|
| Rate for Payer: Cofinity Commercial |
$1,145.20
|
| Rate for Payer: Cofinity Commercial |
$1,406.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,145.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,308.80
|
| Rate for Payer: Healthscope Commercial |
$1,472.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,390.60
|
| Rate for Payer: PHP Commercial |
$1,390.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,063.40
|
| Rate for Payer: Priority Health SBD |
$1,030.68
|
|
|
PR RPR INGUN HERNIA SLIDING ANY AGE
|
Facility
|
OP
|
$1,636.00
|
|
|
Service Code
|
CPT 49525
|
| Hospital Charge Code |
49525
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$618.74 |
| Max. Negotiated Rate |
$10,867.50 |
| Rate for Payer: Aetna Commercial |
$1,390.60
|
| Rate for Payer: Aetna Medicare |
$3,596.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,063.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,322.12
|
| Rate for Payer: BCBS Complete |
$1,945.99
|
| Rate for Payer: BCBS MAPPO |
$3,457.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,516.33
|
| Rate for Payer: BCN Commercial |
$1,516.33
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$1,308.80
|
| Rate for Payer: Cash Price |
$1,308.80
|
| Rate for Payer: Cash Price |
$1,308.80
|
| Rate for Payer: Cofinity Commercial |
$1,406.96
|
| Rate for Payer: Cofinity Commercial |
$1,145.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,145.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,308.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$1,472.40
|
| Rate for Payer: Mclaren Medicaid |
$1,853.33
|
| Rate for Payer: Mclaren Medicare |
$3,457.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,630.58
|
| Rate for Payer: Meridian Medicaid |
$1,945.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,976.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,390.60
|
| Rate for Payer: Nomi Health Commercial |
$7,261.17
|
| Rate for Payer: PACE Medicare |
$3,284.82
|
| Rate for Payer: PACE SWMI |
$3,457.70
|
| Rate for Payer: PHP Commercial |
$1,390.60
|
| Rate for Payer: PHP Medicare Advantage |
$3,457.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,853.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,063.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,867.50
|
| Rate for Payer: Priority Health Medicare |
$3,457.70
|
| Rate for Payer: Priority Health Narrow Network |
$8,694.00
|
| Rate for Payer: Priority Health SBD |
$1,030.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$618.74
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,457.70
|
| Rate for Payer: UHC Medicare Advantage |
$3,457.70
|
| Rate for Payer: UHCCP Medicaid |
$1,946.69
|
| Rate for Payer: VA VA |
$3,457.70
|
|
|
PR RPR INGUN HERNIA SLIDING ANY AGE
|
Professional
|
Both
|
$1,636.00
|
|
|
Service Code
|
HCPCS 49525
|
| Hospital Charge Code |
49525
|
| Min. Negotiated Rate |
$372.54 |
| Max. Negotiated Rate |
$102,852.00 |
| Rate for Payer: Aetna Commercial |
$750.51
|
| Rate for Payer: Aetna Medicare |
$582.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$750.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$806.52
|
| Rate for Payer: BCBS Complete |
$391.17
|
| Rate for Payer: BCBS MAPPO |
$560.08
|
| Rate for Payer: BCBS Trust/PPO |
$515.62
|
| Rate for Payer: BCN Commercial |
$842.48
|
| Rate for Payer: BCN Medicare Advantage |
$560.08
|
| Rate for Payer: Cash Price |
$1,308.80
|
| Rate for Payer: Cash Price |
$1,308.80
|
| Rate for Payer: Cofinity Commercial |
$806.52
|
| Rate for Payer: Cofinity Commercial |
$750.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$560.08
|
| Rate for Payer: Healthscope Commercial |
$896.13
|
| Rate for Payer: Healthscope Commercial |
$1,036.15
|
| Rate for Payer: Mclaren Medicaid |
$372.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$588.08
|
| Rate for Payer: Meridian Medicaid |
$391.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102,852.00
|
| Rate for Payer: Nomi Health Commercial |
$672.10
|
| Rate for Payer: PACE SWMI |
$560.08
|
| Rate for Payer: PHP Medicare Advantage |
$560.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$372.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,063.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,034.50
|
| Rate for Payer: Priority Health Medicare |
$560.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,034.50
|
| Rate for Payer: Priority Health SBD |
$1,034.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$665.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$560.08
|
| Rate for Payer: UHC Exchange |
$665.08
|
| Rate for Payer: UHC Medicare Advantage |
$560.08
|
| Rate for Payer: UHCCP Medicaid |
$372.54
|
|
|
PR RPR INGUN HERNIA SLIDING ANY AGE
|
Professional
|
Both
|
$1,636.00
|
|
|
Service Code
|
HCPCS 49525
|
| Min. Negotiated Rate |
$372.54 |
| Max. Negotiated Rate |
$102,852.00 |
| Rate for Payer: Aetna Commercial |
$750.51
|
| Rate for Payer: Aetna Medicare |
$582.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$750.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$806.52
|
| Rate for Payer: BCBS Complete |
$391.17
|
| Rate for Payer: BCBS MAPPO |
$560.08
|
| Rate for Payer: BCBS Trust/PPO |
$515.62
|
| Rate for Payer: BCN Commercial |
$842.48
|
| Rate for Payer: BCN Medicare Advantage |
$560.08
|
| Rate for Payer: Cash Price |
$1,308.80
|
| Rate for Payer: Cash Price |
$1,308.80
|
| Rate for Payer: Cofinity Commercial |
$806.52
|
| Rate for Payer: Cofinity Commercial |
$750.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$560.08
|
| Rate for Payer: Healthscope Commercial |
$896.13
|
| Rate for Payer: Healthscope Commercial |
$1,036.15
|
| Rate for Payer: Mclaren Medicaid |
$372.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$588.08
|
| Rate for Payer: Meridian Medicaid |
$391.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102,852.00
|
| Rate for Payer: Nomi Health Commercial |
$672.10
|
| Rate for Payer: PACE SWMI |
$560.08
|
| Rate for Payer: PHP Medicare Advantage |
$560.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$372.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,063.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,034.50
|
| Rate for Payer: Priority Health Medicare |
$560.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,034.50
|
| Rate for Payer: Priority Health SBD |
$1,034.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$665.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$560.08
|
| Rate for Payer: UHC Exchange |
$665.08
|
| Rate for Payer: UHC Medicare Advantage |
$560.08
|
| Rate for Payer: UHCCP Medicaid |
$372.54
|
|
|
PR RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM
|
Professional
|
Both
|
$928.00
|
|
|
Service Code
|
HCPCS 12046
|
| Min. Negotiated Rate |
$205.33 |
| Max. Negotiated Rate |
$56,156.00 |
| Rate for Payer: Aetna Commercial |
$409.73
|
| Rate for Payer: Aetna Medicare |
$318.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$409.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$440.31
|
| Rate for Payer: BCBS Complete |
$215.60
|
| Rate for Payer: BCBS MAPPO |
$305.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,305.00
|
| Rate for Payer: BCN Commercial |
$734.48
|
| Rate for Payer: BCN Medicare Advantage |
$305.77
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Cofinity Commercial |
$440.31
|
| Rate for Payer: Cofinity Commercial |
$409.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.77
|
| Rate for Payer: Healthscope Commercial |
$565.67
|
| Rate for Payer: Healthscope Commercial |
$489.23
|
| Rate for Payer: Mclaren Medicaid |
$205.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.06
|
| Rate for Payer: Meridian Medicaid |
$215.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56,156.00
|
| Rate for Payer: Nomi Health Commercial |
$366.92
|
| Rate for Payer: PACE SWMI |
$305.77
|
| Rate for Payer: PHP Medicare Advantage |
$305.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$603.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$432.55
|
| Rate for Payer: Priority Health Medicare |
$305.77
|
| Rate for Payer: Priority Health Narrow Network |
$432.55
|
| Rate for Payer: Priority Health SBD |
$432.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$446.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.77
|
| Rate for Payer: UHC Exchange |
$446.83
|
| Rate for Payer: UHC Medicare Advantage |
$305.77
|
| Rate for Payer: UHCCP Medicaid |
$205.33
|
|
|
PR RPR LAC 2.5 CM/< MOUTH&/ANT TWO-THIRDS TONG
|
Professional
|
Both
|
$216.00
|
|
|
Service Code
|
HCPCS 41250
|
| Min. Negotiated Rate |
$99.68 |
| Max. Negotiated Rate |
$27,054.00 |
| Rate for Payer: Aetna Commercial |
$196.79
|
| Rate for Payer: Aetna Medicare |
$152.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.48
|
| Rate for Payer: BCBS Complete |
$104.66
|
| Rate for Payer: BCBS MAPPO |
$146.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,744.97
|
| Rate for Payer: BCN Commercial |
$420.26
|
| Rate for Payer: BCN Medicare Advantage |
$146.86
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cofinity Commercial |
$211.48
|
| Rate for Payer: Cofinity Commercial |
$196.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.86
|
| Rate for Payer: Healthscope Commercial |
$271.69
|
| Rate for Payer: Healthscope Commercial |
$234.98
|
| Rate for Payer: Mclaren Medicaid |
$99.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.20
|
| Rate for Payer: Meridian Medicaid |
$104.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,054.00
|
| Rate for Payer: Nomi Health Commercial |
$176.23
|
| Rate for Payer: PACE SWMI |
$146.86
|
| Rate for Payer: PHP Medicare Advantage |
$146.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$276.81
|
| Rate for Payer: Priority Health Medicare |
$146.86
|
| Rate for Payer: Priority Health Narrow Network |
$276.81
|
| Rate for Payer: Priority Health SBD |
$276.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.86
|
| Rate for Payer: UHC Exchange |
$204.22
|
| Rate for Payer: UHC Medicare Advantage |
$146.86
|
| Rate for Payer: UHCCP Medicaid |
$99.68
|
|
|
PR RPR LAC TONGUE FLOOR MOUTH > 2.6 CM/CPLX
|
Professional
|
Both
|
$1,084.00
|
|
|
Service Code
|
HCPCS 41252
|
| Min. Negotiated Rate |
$134.83 |
| Max. Negotiated Rate |
$37,030.00 |
| Rate for Payer: Aetna Commercial |
$267.40
|
| Rate for Payer: Aetna Medicare |
$207.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$267.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.35
|
| Rate for Payer: BCBS Complete |
$141.57
|
| Rate for Payer: BCBS MAPPO |
$199.55
|
| Rate for Payer: BCBS Trust/PPO |
$370.34
|
| Rate for Payer: BCN Commercial |
$484.76
|
| Rate for Payer: BCN Medicare Advantage |
$199.55
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cofinity Commercial |
$287.35
|
| Rate for Payer: Cofinity Commercial |
$267.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.55
|
| Rate for Payer: Healthscope Commercial |
$369.17
|
| Rate for Payer: Healthscope Commercial |
$319.28
|
| Rate for Payer: Mclaren Medicaid |
$134.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.53
|
| Rate for Payer: Meridian Medicaid |
$141.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37,030.00
|
| Rate for Payer: Nomi Health Commercial |
$239.46
|
| Rate for Payer: PACE SWMI |
$199.55
|
| Rate for Payer: PHP Medicare Advantage |
$199.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$704.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$375.26
|
| Rate for Payer: Priority Health Medicare |
$199.55
|
| Rate for Payer: Priority Health Narrow Network |
$375.26
|
| Rate for Payer: Priority Health SBD |
$375.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$199.55
|
| Rate for Payer: UHC Exchange |
$293.27
|
| Rate for Payer: UHC Medicare Advantage |
$199.55
|
| Rate for Payer: UHCCP Medicaid |
$134.83
|
|
|
PR RPR LG OMPHALOCELE/GASTROSCHISIS RMVL PROSTH
|
Professional
|
Both
|
$3,409.00
|
|
|
Service Code
|
HCPCS 49606
|
| Min. Negotiated Rate |
$731.02 |
| Max. Negotiated Rate |
$203,760.00 |
| Rate for Payer: Aetna Commercial |
$1,483.55
|
| Rate for Payer: Aetna Medicare |
$1,151.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,483.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,594.27
|
| Rate for Payer: BCBS Complete |
$767.57
|
| Rate for Payer: BCBS MAPPO |
$1,107.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,106.86
|
| Rate for Payer: BCN Commercial |
$1,659.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,107.13
|
| Rate for Payer: Cash Price |
$2,727.20
|
| Rate for Payer: Cash Price |
$2,727.20
|
| Rate for Payer: Cofinity Commercial |
$1,594.27
|
| Rate for Payer: Cofinity Commercial |
$1,483.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,107.13
|
| Rate for Payer: Healthscope Commercial |
$2,048.19
|
| Rate for Payer: Healthscope Commercial |
$1,771.41
|
| Rate for Payer: Mclaren Medicaid |
$731.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,162.49
|
| Rate for Payer: Meridian Medicaid |
$767.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$203,760.00
|
| Rate for Payer: Nomi Health Commercial |
$1,328.56
|
| Rate for Payer: PACE SWMI |
$1,107.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,107.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$731.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,215.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,034.38
|
| Rate for Payer: Priority Health Medicare |
$1,107.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,034.38
|
| Rate for Payer: Priority Health SBD |
$2,034.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,296.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,107.13
|
| Rate for Payer: UHC Exchange |
$1,296.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,107.13
|
| Rate for Payer: UHCCP Medicaid |
$731.02
|
|
|
PR RPR LG OMPHALOCELE/GASTROSCHISIS W/WO PROSTH
|
Professional
|
Both
|
$9,119.00
|
|
|
Service Code
|
HCPCS 49605
|
| Min. Negotiated Rate |
$2,106.86 |
| Max. Negotiated Rate |
$881,631.00 |
| Rate for Payer: Aetna Commercial |
$6,405.13
|
| Rate for Payer: Aetna Medicare |
$4,971.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,405.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,883.13
|
| Rate for Payer: BCBS Complete |
$3,294.82
|
| Rate for Payer: BCBS MAPPO |
$4,779.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,106.86
|
| Rate for Payer: BCN Commercial |
$7,143.98
|
| Rate for Payer: BCN Medicare Advantage |
$4,779.95
|
| Rate for Payer: Cash Price |
$7,295.20
|
| Rate for Payer: Cash Price |
$7,295.20
|
| Rate for Payer: Cofinity Commercial |
$6,883.13
|
| Rate for Payer: Cofinity Commercial |
$6,405.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,779.95
|
| Rate for Payer: Healthscope Commercial |
$8,842.91
|
| Rate for Payer: Healthscope Commercial |
$7,647.92
|
| Rate for Payer: Mclaren Medicaid |
$3,137.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,018.95
|
| Rate for Payer: Meridian Medicaid |
$3,294.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$881,631.00
|
| Rate for Payer: Nomi Health Commercial |
$5,735.94
|
| Rate for Payer: PACE SWMI |
$4,779.95
|
| Rate for Payer: PHP Medicare Advantage |
$4,779.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,137.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,927.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,749.64
|
| Rate for Payer: Priority Health Medicare |
$4,779.95
|
| Rate for Payer: Priority Health Narrow Network |
$8,749.64
|
| Rate for Payer: Priority Health SBD |
$8,749.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,562.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,779.95
|
| Rate for Payer: UHC Exchange |
$4,562.27
|
| Rate for Payer: UHC Medicare Advantage |
$4,779.95
|
| Rate for Payer: UHCCP Medicaid |
$3,137.92
|
|
|
PR RPR LIP FTH OVER ONE-HALF VERT HEIGHT/COMPLEX
|
Professional
|
Both
|
$758.00
|
|
|
Service Code
|
HCPCS 40654
|
| Min. Negotiated Rate |
$277.54 |
| Max. Negotiated Rate |
$74,817.00 |
| Rate for Payer: Aetna Commercial |
$545.30
|
| Rate for Payer: Aetna Medicare |
$423.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$585.99
|
| Rate for Payer: BCBS Complete |
$291.42
|
| Rate for Payer: BCBS MAPPO |
$406.94
|
| Rate for Payer: BCBS Trust/PPO |
$842.64
|
| Rate for Payer: BCN Commercial |
$861.54
|
| Rate for Payer: BCN Medicare Advantage |
$406.94
|
| Rate for Payer: Cash Price |
$606.40
|
| Rate for Payer: Cash Price |
$606.40
|
| Rate for Payer: Cofinity Commercial |
$585.99
|
| Rate for Payer: Cofinity Commercial |
$545.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$406.94
|
| Rate for Payer: Healthscope Commercial |
$752.84
|
| Rate for Payer: Healthscope Commercial |
$651.10
|
| Rate for Payer: Mclaren Medicaid |
$277.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$427.29
|
| Rate for Payer: Meridian Medicaid |
$291.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74,817.00
|
| Rate for Payer: Nomi Health Commercial |
$488.33
|
| Rate for Payer: PACE SWMI |
$406.94
|
| Rate for Payer: PHP Medicare Advantage |
$406.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$492.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$770.79
|
| Rate for Payer: Priority Health Medicare |
$406.94
|
| Rate for Payer: Priority Health Narrow Network |
$770.79
|
| Rate for Payer: Priority Health SBD |
$770.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$635.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$406.94
|
| Rate for Payer: UHC Exchange |
$635.08
|
| Rate for Payer: UHC Medicare Advantage |
$406.94
|
| Rate for Payer: UHCCP Medicaid |
$277.54
|
|
|
PR RPR LW IMPERFORATE ANUS W/ANOPRNL FSTL CUT-BK
|
Professional
|
Both
|
$1,188.00
|
|
|
Service Code
|
HCPCS 46715
|
| Min. Negotiated Rate |
$231.40 |
| Max. Negotiated Rate |
$98,924.00 |
| Rate for Payer: Aetna Commercial |
$720.84
|
| Rate for Payer: Aetna Medicare |
$559.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$720.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$774.63
|
| Rate for Payer: BCBS Complete |
$379.09
|
| Rate for Payer: BCBS MAPPO |
$537.94
|
| Rate for Payer: BCBS Trust/PPO |
$231.40
|
| Rate for Payer: BCN Commercial |
$816.58
|
| Rate for Payer: BCN Medicare Advantage |
$537.94
|
| Rate for Payer: Cash Price |
$950.40
|
| Rate for Payer: Cash Price |
$950.40
|
| Rate for Payer: Cofinity Commercial |
$774.63
|
| Rate for Payer: Cofinity Commercial |
$720.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.94
|
| Rate for Payer: Healthscope Commercial |
$995.19
|
| Rate for Payer: Healthscope Commercial |
$860.70
|
| Rate for Payer: Mclaren Medicaid |
$361.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.84
|
| Rate for Payer: Meridian Medicaid |
$379.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98,924.00
|
| Rate for Payer: Nomi Health Commercial |
$645.53
|
| Rate for Payer: PACE SWMI |
$537.94
|
| Rate for Payer: PHP Medicare Advantage |
$537.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$361.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,001.08
|
| Rate for Payer: Priority Health Medicare |
$537.94
|
| Rate for Payer: Priority Health Narrow Network |
$1,001.08
|
| Rate for Payer: Priority Health SBD |
$1,001.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$537.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$537.94
|
| Rate for Payer: UHC Exchange |
$537.20
|
| Rate for Payer: UHC Medicare Advantage |
$537.94
|
| Rate for Payer: UHCCP Medicaid |
$361.04
|
|
|
PR RPR LW IMPERFORATE ANUS W/TRPOS FISTULA
|
Professional
|
Both
|
$2,992.00
|
|
|
Service Code
|
HCPCS 46716
|
| Min. Negotiated Rate |
$117.81 |
| Max. Negotiated Rate |
$219,487.00 |
| Rate for Payer: Aetna Commercial |
$1,604.03
|
| Rate for Payer: Aetna Medicare |
$1,244.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,604.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,723.74
|
| Rate for Payer: BCBS Complete |
$841.38
|
| Rate for Payer: BCBS MAPPO |
$1,197.04
|
| Rate for Payer: BCBS Trust/PPO |
$117.81
|
| Rate for Payer: BCN Commercial |
$1,807.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,197.04
|
| Rate for Payer: Cash Price |
$2,393.60
|
| Rate for Payer: Cash Price |
$2,393.60
|
| Rate for Payer: Cofinity Commercial |
$1,723.74
|
| Rate for Payer: Cofinity Commercial |
$1,604.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,197.04
|
| Rate for Payer: Healthscope Commercial |
$2,214.52
|
| Rate for Payer: Healthscope Commercial |
$1,915.26
|
| Rate for Payer: Mclaren Medicaid |
$801.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,256.89
|
| Rate for Payer: Meridian Medicaid |
$841.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219,487.00
|
| Rate for Payer: Nomi Health Commercial |
$1,436.45
|
| Rate for Payer: PACE SWMI |
$1,197.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,197.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$801.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,944.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,222.91
|
| Rate for Payer: Priority Health Medicare |
$1,197.04
|
| Rate for Payer: Priority Health Narrow Network |
$2,222.91
|
| Rate for Payer: Priority Health SBD |
$2,222.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$997.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,197.04
|
| Rate for Payer: UHC Exchange |
$997.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,197.04
|
| Rate for Payer: UHCCP Medicaid |
$801.31
|
|
|
PR RPR NEONATAL DIPHRG HERNIA W/WO CHEST TUBE INSJ
|
Professional
|
Both
|
$10,278.00
|
|
|
Service Code
|
HCPCS 39503
|
| Min. Negotiated Rate |
$516.15 |
| Max. Negotiated Rate |
$1,033,441.00 |
| Rate for Payer: Aetna Commercial |
$7,485.83
|
| Rate for Payer: Aetna Medicare |
$5,809.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,485.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,044.47
|
| Rate for Payer: BCBS Complete |
$3,830.67
|
| Rate for Payer: BCBS MAPPO |
$5,586.44
|
| Rate for Payer: BCBS Trust/PPO |
$516.15
|
| Rate for Payer: BCN Commercial |
$8,336.35
|
| Rate for Payer: BCN Medicare Advantage |
$5,586.44
|
| Rate for Payer: Cash Price |
$8,222.40
|
| Rate for Payer: Cash Price |
$8,222.40
|
| Rate for Payer: Cofinity Commercial |
$8,044.47
|
| Rate for Payer: Cofinity Commercial |
$7,485.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,586.44
|
| Rate for Payer: Healthscope Commercial |
$8,938.30
|
| Rate for Payer: Healthscope Commercial |
$10,334.91
|
| Rate for Payer: Mclaren Medicaid |
$3,648.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,865.76
|
| Rate for Payer: Meridian Medicaid |
$3,830.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,033,441.00
|
| Rate for Payer: Nomi Health Commercial |
$6,703.73
|
| Rate for Payer: PACE SWMI |
$5,586.44
|
| Rate for Payer: PHP Medicare Advantage |
$5,586.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,648.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,680.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,094.20
|
| Rate for Payer: Priority Health Medicare |
$5,586.44
|
| Rate for Payer: Priority Health Narrow Network |
$9,094.20
|
| Rate for Payer: Priority Health SBD |
$9,094.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,250.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,586.44
|
| Rate for Payer: UHC Exchange |
$5,250.76
|
| Rate for Payer: UHC Medicare Advantage |
$5,586.44
|
| Rate for Payer: UHCCP Medicaid |
$3,648.26
|
|
|
PR RPR NFLTBL URETHRAL/BLADDER NECK SPHINCTER
|
Professional
|
Both
|
$1,165.00
|
|
|
Service Code
|
HCPCS 53449
|
| Min. Negotiated Rate |
$319.62 |
| Max. Negotiated Rate |
$107,933.00 |
| Rate for Payer: Aetna Commercial |
$785.78
|
| Rate for Payer: Aetna Medicare |
$609.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$785.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$844.42
|
| Rate for Payer: BCBS Complete |
$413.75
|
| Rate for Payer: BCBS MAPPO |
$586.40
|
| Rate for Payer: BCBS Trust/PPO |
$319.62
|
| Rate for Payer: BCN Commercial |
$887.44
|
| Rate for Payer: BCN Medicare Advantage |
$586.40
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cash Price |
$932.00
|
| Rate for Payer: Cofinity Commercial |
$844.42
|
| Rate for Payer: Cofinity Commercial |
$785.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$586.40
|
| Rate for Payer: Healthscope Commercial |
$938.24
|
| Rate for Payer: Healthscope Commercial |
$1,084.84
|
| Rate for Payer: Mclaren Medicaid |
$394.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$615.72
|
| Rate for Payer: Meridian Medicaid |
$413.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107,933.00
|
| Rate for Payer: Nomi Health Commercial |
$703.68
|
| Rate for Payer: PACE SWMI |
$586.40
|
| Rate for Payer: PHP Medicare Advantage |
$586.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$394.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$977.86
|
| Rate for Payer: Priority Health Medicare |
$586.40
|
| Rate for Payer: Priority Health Narrow Network |
$977.86
|
| Rate for Payer: Priority Health SBD |
$977.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$769.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$586.40
|
| Rate for Payer: UHC Exchange |
$769.95
|
| Rate for Payer: UHC Medicare Advantage |
$586.40
|
| Rate for Payer: UHCCP Medicaid |
$394.05
|
|
|
PR RPR NON/MAL FEMUR DSTL H/N W/ILIAC/AUTOG BONE
|
Professional
|
Both
|
$3,865.00
|
|
|
Service Code
|
HCPCS 27472
|
| Min. Negotiated Rate |
$522.49 |
| Max. Negotiated Rate |
$224,374.00 |
| Rate for Payer: Aetna Commercial |
$1,632.56
|
| Rate for Payer: Aetna Medicare |
$1,267.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,632.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,754.40
|
| Rate for Payer: BCBS Complete |
$859.27
|
| Rate for Payer: BCBS MAPPO |
$1,218.33
|
| Rate for Payer: BCBS Trust/PPO |
$522.49
|
| Rate for Payer: BCN Commercial |
$1,850.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,218.33
|
| Rate for Payer: Cash Price |
$3,092.00
|
| Rate for Payer: Cash Price |
$3,092.00
|
| Rate for Payer: Cofinity Commercial |
$1,754.40
|
| Rate for Payer: Cofinity Commercial |
$1,632.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,218.33
|
| Rate for Payer: Healthscope Commercial |
$2,253.91
|
| Rate for Payer: Healthscope Commercial |
$1,949.33
|
| Rate for Payer: Mclaren Medicaid |
$818.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,279.25
|
| Rate for Payer: Meridian Medicaid |
$859.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224,374.00
|
| Rate for Payer: Nomi Health Commercial |
$1,462.00
|
| Rate for Payer: PACE SWMI |
$1,218.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,218.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$818.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,512.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,940.28
|
| Rate for Payer: Priority Health Medicare |
$1,218.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,940.28
|
| Rate for Payer: Priority Health SBD |
$1,940.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,781.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,218.33
|
| Rate for Payer: UHC Exchange |
$1,781.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,218.33
|
| Rate for Payer: UHCCP Medicaid |
$818.35
|
|
|
PR RPR NON/MAL FEMUR DSTL H/N W/O GRF
|
Professional
|
Both
|
$2,927.00
|
|
|
Service Code
|
HCPCS 27470
|
| Min. Negotiated Rate |
$266.79 |
| Max. Negotiated Rate |
$209,367.00 |
| Rate for Payer: Aetna Commercial |
$1,522.92
|
| Rate for Payer: Aetna Medicare |
$1,181.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,522.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,636.57
|
| Rate for Payer: BCBS Complete |
$802.68
|
| Rate for Payer: BCBS MAPPO |
$1,136.51
|
| Rate for Payer: BCBS Trust/PPO |
$266.79
|
| Rate for Payer: BCN Commercial |
$1,728.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,136.51
|
| Rate for Payer: Cash Price |
$2,341.60
|
| Rate for Payer: Cash Price |
$2,341.60
|
| Rate for Payer: Cofinity Commercial |
$1,636.57
|
| Rate for Payer: Cofinity Commercial |
$1,522.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,136.51
|
| Rate for Payer: Healthscope Commercial |
$2,102.54
|
| Rate for Payer: Healthscope Commercial |
$1,818.42
|
| Rate for Payer: Mclaren Medicaid |
$764.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,193.34
|
| Rate for Payer: Meridian Medicaid |
$802.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209,367.00
|
| Rate for Payer: Nomi Health Commercial |
$1,363.81
|
| Rate for Payer: PACE SWMI |
$1,136.51
|
| Rate for Payer: PHP Medicare Advantage |
$1,136.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$764.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,902.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,814.59
|
| Rate for Payer: Priority Health Medicare |
$1,136.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,814.59
|
| Rate for Payer: Priority Health SBD |
$1,814.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,643.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,136.51
|
| Rate for Payer: UHC Exchange |
$1,643.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,136.51
|
| Rate for Payer: UHCCP Medicaid |
$764.46
|
|
|
PR RPR NON/MAL TIBIA SYNOSTOSIS W/FIBULA ANY METH
|
Professional
|
Both
|
$5,421.00
|
|
|
Service Code
|
HCPCS 27725
|
| Min. Negotiated Rate |
$789.17 |
| Max. Negotiated Rate |
$215,343.00 |
| Rate for Payer: Aetna Commercial |
$1,570.35
|
| Rate for Payer: Aetna Medicare |
$1,218.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,570.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,687.54
|
| Rate for Payer: BCBS Complete |
$828.63
|
| Rate for Payer: BCBS MAPPO |
$1,171.90
|
| Rate for Payer: BCBS Trust/PPO |
$800.37
|
| Rate for Payer: BCN Commercial |
$1,779.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,171.90
|
| Rate for Payer: Cash Price |
$4,336.80
|
| Rate for Payer: Cash Price |
$4,336.80
|
| Rate for Payer: Cofinity Commercial |
$1,687.54
|
| Rate for Payer: Cofinity Commercial |
$1,570.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,171.90
|
| Rate for Payer: Healthscope Commercial |
$2,168.02
|
| Rate for Payer: Healthscope Commercial |
$1,875.04
|
| Rate for Payer: Mclaren Medicaid |
$789.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,230.50
|
| Rate for Payer: Meridian Medicaid |
$828.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215,343.00
|
| Rate for Payer: Nomi Health Commercial |
$1,406.28
|
| Rate for Payer: PACE SWMI |
$1,171.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,171.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$789.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,523.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,870.07
|
| Rate for Payer: Priority Health Medicare |
$1,171.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,870.07
|
| Rate for Payer: Priority Health SBD |
$1,870.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,353.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,171.90
|
| Rate for Payer: UHC Exchange |
$1,353.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,171.90
|
| Rate for Payer: UHCCP Medicaid |
$789.17
|
|
|
PR RPR NON/MAL TIBIA W/ILIAC/OTH AGRFT
|
Professional
|
Both
|
$4,771.00
|
|
|
Service Code
|
HCPCS 27724
|
| Min. Negotiated Rate |
$322.79 |
| Max. Negotiated Rate |
$222,980.00 |
| Rate for Payer: Aetna Commercial |
$1,619.16
|
| Rate for Payer: Aetna Medicare |
$1,256.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,619.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,740.00
|
| Rate for Payer: BCBS Complete |
$849.87
|
| Rate for Payer: BCBS MAPPO |
$1,208.33
|
| Rate for Payer: BCBS Trust/PPO |
$322.79
|
| Rate for Payer: BCN Commercial |
$1,834.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,208.33
|
| Rate for Payer: Cash Price |
$3,816.80
|
| Rate for Payer: Cash Price |
$3,816.80
|
| Rate for Payer: Cofinity Commercial |
$1,740.00
|
| Rate for Payer: Cofinity Commercial |
$1,619.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,208.33
|
| Rate for Payer: Healthscope Commercial |
$2,235.41
|
| Rate for Payer: Healthscope Commercial |
$1,933.33
|
| Rate for Payer: Mclaren Medicaid |
$809.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,268.75
|
| Rate for Payer: Meridian Medicaid |
$849.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222,980.00
|
| Rate for Payer: Nomi Health Commercial |
$1,450.00
|
| Rate for Payer: PACE SWMI |
$1,208.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,208.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$809.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,101.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,920.44
|
| Rate for Payer: Priority Health Medicare |
$1,208.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,920.44
|
| Rate for Payer: Priority Health SBD |
$1,920.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,496.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,208.33
|
| Rate for Payer: UHC Exchange |
$1,496.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,208.33
|
| Rate for Payer: UHCCP Medicaid |
$809.40
|
|
|
PR RPR NON/MALUNION METARSAL W/WO BONE GRAFT
|
Professional
|
Both
|
$1,316.00
|
|
|
Service Code
|
HCPCS 28322
|
| Min. Negotiated Rate |
$375.31 |
| Max. Negotiated Rate |
$102,274.00 |
| Rate for Payer: Aetna Commercial |
$743.19
|
| Rate for Payer: Aetna Medicare |
$576.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$743.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$798.65
|
| Rate for Payer: BCBS Complete |
$394.08
|
| Rate for Payer: BCBS MAPPO |
$554.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,539.54
|
| Rate for Payer: BCN Commercial |
$1,150.84
|
| Rate for Payer: BCN Medicare Advantage |
$554.62
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cofinity Commercial |
$798.65
|
| Rate for Payer: Cofinity Commercial |
$743.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$554.62
|
| Rate for Payer: Healthscope Commercial |
$887.39
|
| Rate for Payer: Healthscope Commercial |
$1,026.05
|
| Rate for Payer: Mclaren Medicaid |
$375.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$582.35
|
| Rate for Payer: Meridian Medicaid |
$394.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102,274.00
|
| Rate for Payer: Nomi Health Commercial |
$665.54
|
| Rate for Payer: PACE SWMI |
$554.62
|
| Rate for Payer: PHP Medicare Advantage |
$554.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$855.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$892.03
|
| Rate for Payer: Priority Health Medicare |
$554.62
|
| Rate for Payer: Priority Health Narrow Network |
$892.03
|
| Rate for Payer: Priority Health SBD |
$892.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$831.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$554.62
|
| Rate for Payer: UHC Exchange |
$831.51
|
| Rate for Payer: UHC Medicare Advantage |
$554.62
|
| Rate for Payer: UHCCP Medicaid |
$375.31
|
|
|
PR RPR NON-STRUCT PROSTC VALVE DYSFUNCTION W/BYPASS
|
Professional
|
Both
|
$7,025.00
|
|
|
Service Code
|
HCPCS 33496
|
| Min. Negotiated Rate |
$807.24 |
| Max. Negotiated Rate |
$294,014.00 |
| Rate for Payer: Aetna Commercial |
$2,132.54
|
| Rate for Payer: Aetna Medicare |
$1,655.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,132.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,291.69
|
| Rate for Payer: BCBS Complete |
$1,098.79
|
| Rate for Payer: BCBS MAPPO |
$1,591.45
|
| Rate for Payer: BCBS Trust/PPO |
$807.24
|
| Rate for Payer: BCN Commercial |
$2,383.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,591.45
|
| Rate for Payer: Cash Price |
$5,620.00
|
| Rate for Payer: Cash Price |
$5,620.00
|
| Rate for Payer: Cofinity Commercial |
$2,291.69
|
| Rate for Payer: Cofinity Commercial |
$2,132.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,591.45
|
| Rate for Payer: Healthscope Commercial |
$2,944.18
|
| Rate for Payer: Healthscope Commercial |
$2,546.32
|
| Rate for Payer: Mclaren Medicaid |
$1,046.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,671.02
|
| Rate for Payer: Meridian Medicaid |
$1,098.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294,014.00
|
| Rate for Payer: Nomi Health Commercial |
$1,909.74
|
| Rate for Payer: PACE SWMI |
$1,591.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,591.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,046.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,566.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,599.03
|
| Rate for Payer: Priority Health Medicare |
$1,591.45
|
| Rate for Payer: Priority Health Narrow Network |
$2,599.03
|
| Rate for Payer: Priority Health SBD |
$2,599.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,629.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,591.45
|
| Rate for Payer: UHC Exchange |
$3,629.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,591.45
|
| Rate for Payer: UHCCP Medicaid |
$1,046.47
|
|
|
PR RPR NONUNION/MALUNION RADIUS/ULNA W/AUTOGRAFT
|
Professional
|
Both
|
$3,241.00
|
|
|
Service Code
|
HCPCS 25405
|
| Min. Negotiated Rate |
$25.89 |
| Max. Negotiated Rate |
$183,926.00 |
| Rate for Payer: Aetna Commercial |
$1,341.03
|
| Rate for Payer: Aetna Medicare |
$1,040.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,341.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,441.11
|
| Rate for Payer: BCBS Complete |
$708.30
|
| Rate for Payer: BCBS MAPPO |
$1,000.77
|
| Rate for Payer: BCBS Trust/PPO |
$25.89
|
| Rate for Payer: BCN Commercial |
$1,520.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,000.77
|
| Rate for Payer: Cash Price |
$2,592.80
|
| Rate for Payer: Cash Price |
$2,592.80
|
| Rate for Payer: Cofinity Commercial |
$1,441.11
|
| Rate for Payer: Cofinity Commercial |
$1,341.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,000.77
|
| Rate for Payer: Healthscope Commercial |
$1,851.42
|
| Rate for Payer: Healthscope Commercial |
$1,601.23
|
| Rate for Payer: Mclaren Medicaid |
$674.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,050.81
|
| Rate for Payer: Meridian Medicaid |
$708.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183,926.00
|
| Rate for Payer: Nomi Health Commercial |
$1,200.92
|
| Rate for Payer: PACE SWMI |
$1,000.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,000.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$674.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,106.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,594.77
|
| Rate for Payer: Priority Health Medicare |
$1,000.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,594.77
|
| Rate for Payer: Priority Health SBD |
$1,594.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,427.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,000.77
|
| Rate for Payer: UHC Exchange |
$1,427.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,000.77
|
| Rate for Payer: UHCCP Medicaid |
$674.57
|
|
|
PR RPR NONUNION/MALUNION RADIUS&ULNA W/O AUTOGRAF
|
Professional
|
Both
|
$3,275.00
|
|
|
Service Code
|
HCPCS 25415
|
| Min. Negotiated Rate |
$272.95 |
| Max. Negotiated Rate |
$171,983.00 |
| Rate for Payer: Aetna Commercial |
$1,251.47
|
| Rate for Payer: Aetna Medicare |
$971.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,251.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,344.86
|
| Rate for Payer: BCBS Complete |
$660.66
|
| Rate for Payer: BCBS MAPPO |
$933.93
|
| Rate for Payer: BCBS Trust/PPO |
$272.95
|
| Rate for Payer: BCN Commercial |
$1,422.05
|
| Rate for Payer: BCN Medicare Advantage |
$933.93
|
| Rate for Payer: Cash Price |
$2,620.00
|
| Rate for Payer: Cash Price |
$2,620.00
|
| Rate for Payer: Cofinity Commercial |
$1,344.86
|
| Rate for Payer: Cofinity Commercial |
$1,251.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$933.93
|
| Rate for Payer: Healthscope Commercial |
$1,727.77
|
| Rate for Payer: Healthscope Commercial |
$1,494.29
|
| Rate for Payer: Mclaren Medicaid |
$629.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$980.63
|
| Rate for Payer: Meridian Medicaid |
$660.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171,983.00
|
| Rate for Payer: Nomi Health Commercial |
$1,120.72
|
| Rate for Payer: PACE SWMI |
$933.93
|
| Rate for Payer: PHP Medicare Advantage |
$933.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$629.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,128.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,491.48
|
| Rate for Payer: Priority Health Medicare |
$933.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,491.48
|
| Rate for Payer: Priority Health SBD |
$1,491.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,342.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$933.93
|
| Rate for Payer: UHC Exchange |
$1,342.73
|
| Rate for Payer: UHC Medicare Advantage |
$933.93
|
| Rate for Payer: UHCCP Medicaid |
$629.20
|
|
|
PR RPR NONUNION/MALUNION RADIUS/ULNA W/O AUTOGRAFT
|
Professional
|
Both
|
$2,633.00
|
|
|
Service Code
|
HCPCS 25400
|
| Min. Negotiated Rate |
$211.32 |
| Max. Negotiated Rate |
$142,763.00 |
| Rate for Payer: Aetna Commercial |
$1,038.00
|
| Rate for Payer: Aetna Medicare |
$805.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,038.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,115.47
|
| Rate for Payer: BCBS Complete |
$549.51
|
| Rate for Payer: BCBS MAPPO |
$774.63
|
| Rate for Payer: BCBS Trust/PPO |
$211.32
|
| Rate for Payer: BCN Commercial |
$1,182.60
|
| Rate for Payer: BCN Medicare Advantage |
$774.63
|
| Rate for Payer: Cash Price |
$2,106.40
|
| Rate for Payer: Cash Price |
$2,106.40
|
| Rate for Payer: Cofinity Commercial |
$1,115.47
|
| Rate for Payer: Cofinity Commercial |
$1,038.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.63
|
| Rate for Payer: Healthscope Commercial |
$1,433.07
|
| Rate for Payer: Healthscope Commercial |
$1,239.41
|
| Rate for Payer: Mclaren Medicaid |
$523.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$813.36
|
| Rate for Payer: Meridian Medicaid |
$549.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142,763.00
|
| Rate for Payer: Nomi Health Commercial |
$929.56
|
| Rate for Payer: PACE SWMI |
$774.63
|
| Rate for Payer: PHP Medicare Advantage |
$774.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$523.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,711.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,239.07
|
| Rate for Payer: Priority Health Medicare |
$774.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,239.07
|
| Rate for Payer: Priority Health SBD |
$1,239.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,182.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.63
|
| Rate for Payer: UHC Exchange |
$1,182.81
|
| Rate for Payer: UHC Medicare Advantage |
$774.63
|
| Rate for Payer: UHCCP Medicaid |
$523.34
|
|
|
PR RPR NON-UNION MTCRPL/PHALANX
|
Professional
|
Both
|
$2,109.00
|
|
|
Service Code
|
HCPCS 26546
|
| Min. Negotiated Rate |
$243.55 |
| Max. Negotiated Rate |
$182,887.00 |
| Rate for Payer: Aetna Commercial |
$1,317.86
|
| Rate for Payer: Aetna Medicare |
$1,022.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,317.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,416.21
|
| Rate for Payer: BCBS Complete |
$709.64
|
| Rate for Payer: BCBS MAPPO |
$983.48
|
| Rate for Payer: BCBS Trust/PPO |
$243.55
|
| Rate for Payer: BCN Commercial |
$1,538.85
|
| Rate for Payer: BCN Medicare Advantage |
$983.48
|
| Rate for Payer: Cash Price |
$1,687.20
|
| Rate for Payer: Cash Price |
$1,687.20
|
| Rate for Payer: Cofinity Commercial |
$1,416.21
|
| Rate for Payer: Cofinity Commercial |
$1,317.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$983.48
|
| Rate for Payer: Healthscope Commercial |
$1,819.44
|
| Rate for Payer: Healthscope Commercial |
$1,573.57
|
| Rate for Payer: Mclaren Medicaid |
$675.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,032.65
|
| Rate for Payer: Meridian Medicaid |
$709.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182,887.00
|
| Rate for Payer: Nomi Health Commercial |
$1,180.18
|
| Rate for Payer: PACE SWMI |
$983.48
|
| Rate for Payer: PHP Medicare Advantage |
$983.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$675.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,370.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,603.93
|
| Rate for Payer: Priority Health Medicare |
$983.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,603.93
|
| Rate for Payer: Priority Health SBD |
$1,603.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,008.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$983.48
|
| Rate for Payer: UHC Exchange |
$1,008.44
|
| Rate for Payer: UHC Medicare Advantage |
$983.48
|
| Rate for Payer: UHCCP Medicaid |
$675.85
|
|
