|
PR SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ
|
Professional
|
Both
|
$2,412.00
|
|
|
Service Code
|
HCPCS 27386
|
| Min. Negotiated Rate |
$514.82 |
| Max. Negotiated Rate |
$1,809.00 |
| Rate for Payer: Aetna Commercial |
$1,051.38
|
| Rate for Payer: Aetna Medicare |
$815.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,051.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,129.84
|
| Rate for Payer: BCBS Complete |
$540.56
|
| Rate for Payer: BCBS MAPPO |
$784.61
|
| Rate for Payer: BCN Commercial |
$1,302.22
|
| Rate for Payer: BCN Medicare Advantage |
$784.61
|
| Rate for Payer: Cash Price |
$1,929.60
|
| Rate for Payer: Cash Price |
$1,929.60
|
| Rate for Payer: Cofinity Commercial |
$1,129.84
|
| Rate for Payer: Cofinity Commercial |
$1,051.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$784.61
|
| Rate for Payer: Healthscope Commercial |
$1,451.53
|
| Rate for Payer: Healthscope Commercial |
$1,255.38
|
| Rate for Payer: Mclaren Medicaid |
$514.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$823.84
|
| Rate for Payer: Meridian Medicaid |
$540.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$863.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,516.37
|
| Rate for Payer: Nomi Health Commercial |
$941.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,809.00
|
| Rate for Payer: PACE SWMI |
$784.61
|
| Rate for Payer: PHP Medicare Advantage |
$784.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$514.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,392.04
|
| Rate for Payer: Priority Health Medicare |
$784.61
|
| Rate for Payer: Priority Health SBD |
$1,392.04
|
| Rate for Payer: Priority Health Tiered Network |
$1,392.04
|
| Rate for Payer: Railroad Medicare Medicare |
$784.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,472.21
|
| Rate for Payer: UHC Core |
$1,472.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$784.61
|
| Rate for Payer: UHC Exchange |
$1,472.21
|
| Rate for Payer: UHC Medicaid |
$514.82
|
| Rate for Payer: UHCCP Medicaid |
$514.82
|
|
|
PR SUTR RPR AORTA/GRT VSL W/O SHUNT/CARD BYP
|
Professional
|
Both
|
$2,269.00
|
|
|
Service Code
|
HCPCS 33320
|
| Min. Negotiated Rate |
$648.80 |
| Max. Negotiated Rate |
$1,895.47 |
| Rate for Payer: Aetna Commercial |
$1,359.08
|
| Rate for Payer: Aetna Medicare |
$1,054.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,359.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,460.51
|
| Rate for Payer: BCBS Complete |
$681.24
|
| Rate for Payer: BCBS MAPPO |
$1,014.24
|
| Rate for Payer: BCN Commercial |
$1,581.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,014.24
|
| Rate for Payer: Cash Price |
$1,815.20
|
| Rate for Payer: Cash Price |
$1,815.20
|
| Rate for Payer: Cofinity Commercial |
$1,460.51
|
| Rate for Payer: Cofinity Commercial |
$1,359.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,014.24
|
| Rate for Payer: Healthscope Commercial |
$1,876.34
|
| Rate for Payer: Healthscope Commercial |
$1,622.78
|
| Rate for Payer: Mclaren Medicaid |
$648.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,064.95
|
| Rate for Payer: Meridian Medicaid |
$681.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,115.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,895.47
|
| Rate for Payer: Nomi Health Commercial |
$1,217.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,701.75
|
| Rate for Payer: PACE SWMI |
$1,014.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,014.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$648.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,700.26
|
| Rate for Payer: Priority Health Medicare |
$1,014.24
|
| Rate for Payer: Priority Health SBD |
$1,700.26
|
| Rate for Payer: Priority Health Tiered Network |
$1,700.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,014.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,870.50
|
| Rate for Payer: UHC Core |
$1,870.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,014.24
|
| Rate for Payer: UHC Exchange |
$1,870.50
|
| Rate for Payer: UHC Medicaid |
$648.80
|
| Rate for Payer: UHCCP Medicaid |
$648.80
|
|
|
PR SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK
|
Professional
|
Both
|
$1,186.00
|
|
|
Service Code
|
HCPCS 67935
|
| Min. Negotiated Rate |
$234.94 |
| Max. Negotiated Rate |
$889.50 |
| Rate for Payer: Aetna Commercial |
$480.38
|
| Rate for Payer: Aetna Medicare |
$372.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$480.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$516.23
|
| Rate for Payer: BCBS Complete |
$246.69
|
| Rate for Payer: BCBS MAPPO |
$358.49
|
| Rate for Payer: BCN Commercial |
$648.38
|
| Rate for Payer: BCN Medicare Advantage |
$358.49
|
| Rate for Payer: Cash Price |
$948.80
|
| Rate for Payer: Cash Price |
$948.80
|
| Rate for Payer: Cofinity Commercial |
$516.23
|
| Rate for Payer: Cofinity Commercial |
$480.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$358.49
|
| Rate for Payer: Healthscope Commercial |
$663.21
|
| Rate for Payer: Healthscope Commercial |
$573.58
|
| Rate for Payer: Mclaren Medicaid |
$234.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$376.41
|
| Rate for Payer: Meridian Medicaid |
$246.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$394.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$757.55
|
| Rate for Payer: Nomi Health Commercial |
$430.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$889.50
|
| Rate for Payer: PACE SWMI |
$358.49
|
| Rate for Payer: PHP Medicare Advantage |
$358.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$759.46
|
| Rate for Payer: Priority Health Medicare |
$358.49
|
| Rate for Payer: Priority Health SBD |
$759.46
|
| Rate for Payer: Priority Health Tiered Network |
$759.46
|
| Rate for Payer: Railroad Medicare Medicare |
$358.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$756.17
|
| Rate for Payer: UHC Core |
$756.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$358.49
|
| Rate for Payer: UHC Exchange |
$756.17
|
| Rate for Payer: UHC Medicaid |
$234.94
|
| Rate for Payer: UHCCP Medicaid |
$234.94
|
|
|
PR SUTR WND EYELID/MARGIN/TARSUS/CONJUNC PRTL THICK
|
Professional
|
Both
|
$788.00
|
|
|
Service Code
|
HCPCS 67930
|
| Min. Negotiated Rate |
$125.46 |
| Max. Negotiated Rate |
$591.00 |
| Rate for Payer: Aetna Commercial |
$257.74
|
| Rate for Payer: Aetna Medicare |
$200.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.97
|
| Rate for Payer: BCBS Complete |
$131.73
|
| Rate for Payer: BCBS MAPPO |
$192.34
|
| Rate for Payer: BCN Commercial |
$348.59
|
| Rate for Payer: BCN Medicare Advantage |
$192.34
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Cofinity Commercial |
$276.97
|
| Rate for Payer: Cofinity Commercial |
$257.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.34
|
| Rate for Payer: Healthscope Commercial |
$355.83
|
| Rate for Payer: Healthscope Commercial |
$307.74
|
| Rate for Payer: Mclaren Medicaid |
$125.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.96
|
| Rate for Payer: Meridian Medicaid |
$131.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$211.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$407.92
|
| Rate for Payer: Nomi Health Commercial |
$230.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$591.00
|
| Rate for Payer: PACE SWMI |
$192.34
|
| Rate for Payer: PHP Medicare Advantage |
$192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$408.32
|
| Rate for Payer: Priority Health Medicare |
$192.34
|
| Rate for Payer: Priority Health SBD |
$408.32
|
| Rate for Payer: Priority Health Tiered Network |
$408.32
|
| Rate for Payer: Railroad Medicare Medicare |
$192.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$410.52
|
| Rate for Payer: UHC Core |
$410.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$192.34
|
| Rate for Payer: UHC Exchange |
$410.52
|
| Rate for Payer: UHC Medicaid |
$125.46
|
| Rate for Payer: UHCCP Medicaid |
$125.46
|
|
|
PR SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE
|
Professional
|
Both
|
$2,215.00
|
|
|
Service Code
|
HCPCS 64834
|
| Min. Negotiated Rate |
$421.31 |
| Max. Negotiated Rate |
$1,661.25 |
| Rate for Payer: Priority Health SBD |
$1,317.01
|
| Rate for Payer: Aetna Commercial |
$866.62
|
| Rate for Payer: Aetna Medicare |
$672.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$866.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$931.29
|
| Rate for Payer: BCBS Complete |
$442.38
|
| Rate for Payer: BCBS MAPPO |
$646.73
|
| Rate for Payer: BCN Commercial |
$1,133.90
|
| Rate for Payer: BCN Medicare Advantage |
$646.73
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cofinity Commercial |
$931.29
|
| Rate for Payer: Cofinity Commercial |
$866.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$646.73
|
| Rate for Payer: Healthscope Commercial |
$1,196.45
|
| Rate for Payer: Healthscope Commercial |
$1,034.77
|
| Rate for Payer: Mclaren Medicaid |
$421.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$679.07
|
| Rate for Payer: Meridian Medicaid |
$442.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$711.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,303.49
|
| Rate for Payer: Nomi Health Commercial |
$776.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,661.25
|
| Rate for Payer: PACE SWMI |
$646.73
|
| Rate for Payer: PHP Medicare Advantage |
$646.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$421.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,317.01
|
| Rate for Payer: Priority Health Medicare |
$646.73
|
| Rate for Payer: Priority Health Tiered Network |
$1,317.01
|
| Rate for Payer: Railroad Medicare Medicare |
$646.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,296.28
|
| Rate for Payer: UHC Core |
$1,296.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$646.73
|
| Rate for Payer: UHC Exchange |
$1,296.28
|
| Rate for Payer: UHC Medicaid |
$421.31
|
| Rate for Payer: UHCCP Medicaid |
$421.31
|
|
|
PR SUTURE 1 NERVE MEDIAN MOTOR THENAR
|
Professional
|
Both
|
$2,356.00
|
|
|
Service Code
|
HCPCS 64835
|
| Min. Negotiated Rate |
$481.59 |
| Max. Negotiated Rate |
$1,767.00 |
| Rate for Payer: Aetna Commercial |
$992.06
|
| Rate for Payer: Aetna Medicare |
$769.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,066.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$992.06
|
| Rate for Payer: BCBS Complete |
$505.67
|
| Rate for Payer: BCBS MAPPO |
$740.34
|
| Rate for Payer: BCN Commercial |
$1,239.47
|
| Rate for Payer: BCN Medicare Advantage |
$740.34
|
| Rate for Payer: Cash Price |
$1,884.80
|
| Rate for Payer: Cash Price |
$1,884.80
|
| Rate for Payer: Cofinity Commercial |
$992.06
|
| Rate for Payer: Cofinity Commercial |
$1,066.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$740.34
|
| Rate for Payer: Healthscope Commercial |
$1,369.63
|
| Rate for Payer: Healthscope Commercial |
$1,184.54
|
| Rate for Payer: Mclaren Medicaid |
$481.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$777.36
|
| Rate for Payer: Meridian Medicaid |
$505.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$814.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,448.86
|
| Rate for Payer: Nomi Health Commercial |
$888.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,767.00
|
| Rate for Payer: PACE SWMI |
$740.34
|
| Rate for Payer: PHP Medicare Advantage |
$740.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,439.62
|
| Rate for Payer: Priority Health Medicare |
$740.34
|
| Rate for Payer: Priority Health SBD |
$1,439.62
|
| Rate for Payer: Priority Health Tiered Network |
$1,439.62
|
| Rate for Payer: Railroad Medicare Medicare |
$740.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,430.40
|
| Rate for Payer: UHC Core |
$1,430.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$740.34
|
| Rate for Payer: UHC Exchange |
$1,430.40
|
| Rate for Payer: UHC Medicaid |
$481.59
|
| Rate for Payer: UHCCP Medicaid |
$481.59
|
|
|
PR SUTURE 1 NERVE ULNAR MOTOR
|
Professional
|
Both
|
$1,859.00
|
|
|
Service Code
|
HCPCS 64836
|
| Min. Negotiated Rate |
$481.59 |
| Max. Negotiated Rate |
$1,448.86 |
| Rate for Payer: Aetna Commercial |
$992.06
|
| Rate for Payer: Aetna Medicare |
$769.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,066.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$992.06
|
| Rate for Payer: BCBS Complete |
$505.67
|
| Rate for Payer: BCBS MAPPO |
$740.34
|
| Rate for Payer: BCN Commercial |
$1,239.47
|
| Rate for Payer: BCN Medicare Advantage |
$740.34
|
| Rate for Payer: Cash Price |
$1,487.20
|
| Rate for Payer: Cash Price |
$1,487.20
|
| Rate for Payer: Cofinity Commercial |
$992.06
|
| Rate for Payer: Cofinity Commercial |
$1,066.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$740.34
|
| Rate for Payer: Healthscope Commercial |
$1,369.63
|
| Rate for Payer: Healthscope Commercial |
$1,184.54
|
| Rate for Payer: Mclaren Medicaid |
$481.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$777.36
|
| Rate for Payer: Meridian Medicaid |
$505.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$814.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,448.86
|
| Rate for Payer: Nomi Health Commercial |
$888.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,394.25
|
| Rate for Payer: PACE SWMI |
$740.34
|
| Rate for Payer: PHP Medicare Advantage |
$740.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,439.62
|
| Rate for Payer: Priority Health Medicare |
$740.34
|
| Rate for Payer: Priority Health SBD |
$1,439.62
|
| Rate for Payer: Priority Health Tiered Network |
$1,439.62
|
| Rate for Payer: Railroad Medicare Medicare |
$740.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,430.40
|
| Rate for Payer: UHC Core |
$1,430.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$740.34
|
| Rate for Payer: UHC Exchange |
$1,430.40
|
| Rate for Payer: UHC Medicaid |
$481.59
|
| Rate for Payer: UHCCP Medicaid |
$481.59
|
|
|
PR SUTURE BRACHIAL PLEXUS
|
Professional
|
Both
|
$3,816.00
|
|
|
Service Code
|
HCPCS 64861
|
| Min. Negotiated Rate |
$964.25 |
| Max. Negotiated Rate |
$2,862.00 |
| Rate for Payer: Aetna Commercial |
$2,012.25
|
| Rate for Payer: Aetna Medicare |
$1,561.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,012.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,162.42
|
| Rate for Payer: BCBS Complete |
$1,012.46
|
| Rate for Payer: BCBS MAPPO |
$1,501.68
|
| Rate for Payer: BCN Commercial |
$2,327.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,501.68
|
| Rate for Payer: Cash Price |
$3,052.80
|
| Rate for Payer: Cash Price |
$3,052.80
|
| Rate for Payer: Cofinity Commercial |
$2,162.42
|
| Rate for Payer: Cofinity Commercial |
$2,012.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,501.68
|
| Rate for Payer: Healthscope Commercial |
$2,778.11
|
| Rate for Payer: Healthscope Commercial |
$2,402.69
|
| Rate for Payer: Mclaren Medicaid |
$964.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,576.76
|
| Rate for Payer: Meridian Medicaid |
$1,012.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,651.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,758.12
|
| Rate for Payer: Nomi Health Commercial |
$1,802.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,862.00
|
| Rate for Payer: PACE SWMI |
$1,501.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,501.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$964.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,703.43
|
| Rate for Payer: Priority Health Medicare |
$1,501.68
|
| Rate for Payer: Priority Health SBD |
$2,703.43
|
| Rate for Payer: Priority Health Tiered Network |
$2,703.43
|
| Rate for Payer: Railroad Medicare Medicare |
$1,501.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,664.72
|
| Rate for Payer: UHC Core |
$2,664.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,501.68
|
| Rate for Payer: UHC Exchange |
$2,664.72
|
| Rate for Payer: UHC Medicaid |
$964.25
|
| Rate for Payer: UHCCP Medicaid |
$964.25
|
|
|
PR SUTURE DIGITAL NERVE HAND/FOOT 1 NERVE
|
Professional
|
Both
|
$2,045.00
|
|
|
Service Code
|
HCPCS 64831
|
| Min. Negotiated Rate |
$410.45 |
| Max. Negotiated Rate |
$1,533.75 |
| Rate for Payer: Aetna Commercial |
$838.64
|
| Rate for Payer: Aetna Medicare |
$650.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$901.22
|
| Rate for Payer: BCBS Complete |
$430.97
|
| Rate for Payer: BCBS MAPPO |
$625.85
|
| Rate for Payer: BCN Commercial |
$1,060.21
|
| Rate for Payer: BCN Medicare Advantage |
$625.85
|
| Rate for Payer: Cash Price |
$1,636.00
|
| Rate for Payer: Cash Price |
$1,636.00
|
| Rate for Payer: Cofinity Commercial |
$901.22
|
| Rate for Payer: Cofinity Commercial |
$838.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.85
|
| Rate for Payer: Healthscope Commercial |
$1,157.82
|
| Rate for Payer: Healthscope Commercial |
$1,001.36
|
| Rate for Payer: Mclaren Medicaid |
$410.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$657.14
|
| Rate for Payer: Meridian Medicaid |
$430.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$688.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,226.25
|
| Rate for Payer: Nomi Health Commercial |
$751.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,533.75
|
| Rate for Payer: PACE SWMI |
$625.85
|
| Rate for Payer: PHP Medicare Advantage |
$625.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,231.41
|
| Rate for Payer: Priority Health Medicare |
$625.85
|
| Rate for Payer: Priority Health SBD |
$1,231.41
|
| Rate for Payer: Priority Health Tiered Network |
$1,231.41
|
| Rate for Payer: Railroad Medicare Medicare |
$625.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,198.62
|
| Rate for Payer: UHC Core |
$1,198.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.85
|
| Rate for Payer: UHC Exchange |
$1,198.62
|
| Rate for Payer: UHC Medicaid |
$410.45
|
| Rate for Payer: UHCCP Medicaid |
$410.45
|
|
|
PR SUTURE EACH ADDITIONAL NERVE HAND/FOOT
|
Professional
|
Both
|
$1,350.00
|
|
|
Service Code
|
HCPCS 64837
|
| Min. Negotiated Rate |
$198.73 |
| Max. Negotiated Rate |
$1,012.50 |
| Rate for Payer: Aetna Commercial |
$417.53
|
| Rate for Payer: Aetna Medicare |
$324.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$417.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$448.69
|
| Rate for Payer: BCBS Complete |
$208.67
|
| Rate for Payer: BCBS MAPPO |
$311.59
|
| Rate for Payer: BCN Commercial |
$539.81
|
| Rate for Payer: BCN Medicare Advantage |
$311.59
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cofinity Commercial |
$448.69
|
| Rate for Payer: Cofinity Commercial |
$417.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.59
|
| Rate for Payer: Healthscope Commercial |
$576.44
|
| Rate for Payer: Healthscope Commercial |
$498.54
|
| Rate for Payer: Mclaren Medicaid |
$198.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$327.17
|
| Rate for Payer: Meridian Medicaid |
$208.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$342.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$643.97
|
| Rate for Payer: Nomi Health Commercial |
$373.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,012.50
|
| Rate for Payer: PACE SWMI |
$311.59
|
| Rate for Payer: PHP Medicare Advantage |
$311.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$626.99
|
| Rate for Payer: Priority Health Medicare |
$311.59
|
| Rate for Payer: Priority Health SBD |
$626.99
|
| Rate for Payer: Priority Health Tiered Network |
$626.99
|
| Rate for Payer: Railroad Medicare Medicare |
$311.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$651.32
|
| Rate for Payer: UHC Core |
$651.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$311.59
|
| Rate for Payer: UHC Exchange |
$651.32
|
| Rate for Payer: UHC Medicaid |
$198.73
|
| Rate for Payer: UHCCP Medicaid |
$198.73
|
|
|
PR SUTURE EACH ADDITIONAL PERIPHERAL NERVE
|
Professional
|
Both
|
$1,682.00
|
|
|
Service Code
|
HCPCS 64859
|
| Min. Negotiated Rate |
$135.26 |
| Max. Negotiated Rate |
$1,261.50 |
| Rate for Payer: Aetna Commercial |
$284.20
|
| Rate for Payer: Aetna Medicare |
$220.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.41
|
| Rate for Payer: BCBS Complete |
$142.02
|
| Rate for Payer: BCBS MAPPO |
$212.09
|
| Rate for Payer: BCN Commercial |
$366.51
|
| Rate for Payer: BCN Medicare Advantage |
$212.09
|
| Rate for Payer: Cash Price |
$1,345.60
|
| Rate for Payer: Cash Price |
$1,345.60
|
| Rate for Payer: Cofinity Commercial |
$305.41
|
| Rate for Payer: Cofinity Commercial |
$284.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$212.09
|
| Rate for Payer: Healthscope Commercial |
$392.37
|
| Rate for Payer: Healthscope Commercial |
$339.34
|
| Rate for Payer: Mclaren Medicaid |
$135.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$222.69
|
| Rate for Payer: Meridian Medicaid |
$142.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$233.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$437.83
|
| Rate for Payer: Nomi Health Commercial |
$254.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,261.50
|
| Rate for Payer: PACE SWMI |
$212.09
|
| Rate for Payer: PHP Medicare Advantage |
$212.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$135.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$425.70
|
| Rate for Payer: Priority Health Medicare |
$212.09
|
| Rate for Payer: Priority Health SBD |
$425.70
|
| Rate for Payer: Priority Health Tiered Network |
$425.70
|
| Rate for Payer: Railroad Medicare Medicare |
$212.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$442.59
|
| Rate for Payer: UHC Core |
$442.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$212.09
|
| Rate for Payer: UHC Exchange |
$442.59
|
| Rate for Payer: UHC Medicaid |
$135.26
|
| Rate for Payer: UHCCP Medicaid |
$135.26
|
|
|
PR SUTURE EXTRAHEPATIC BILE DUCT PRE-EXIST INJURY
|
Professional
|
Both
|
$3,139.00
|
|
|
Service Code
|
HCPCS 47900
|
| Min. Negotiated Rate |
$827.72 |
| Max. Negotiated Rate |
$2,524.10 |
| Rate for Payer: Priority Health SBD |
$2,524.10
|
| Rate for Payer: Aetna Commercial |
$1,729.70
|
| Rate for Payer: Aetna Medicare |
$1,342.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,729.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,858.78
|
| Rate for Payer: BCBS Complete |
$869.11
|
| Rate for Payer: BCBS MAPPO |
$1,290.82
|
| Rate for Payer: BCN Commercial |
$2,071.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,290.82
|
| Rate for Payer: Cash Price |
$2,511.20
|
| Rate for Payer: Cash Price |
$2,511.20
|
| Rate for Payer: Cofinity Commercial |
$1,858.78
|
| Rate for Payer: Cofinity Commercial |
$1,729.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,290.82
|
| Rate for Payer: Healthscope Commercial |
$2,388.02
|
| Rate for Payer: Healthscope Commercial |
$2,065.31
|
| Rate for Payer: Mclaren Medicaid |
$827.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,355.36
|
| Rate for Payer: Meridian Medicaid |
$869.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,419.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,470.68
|
| Rate for Payer: Nomi Health Commercial |
$1,548.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,354.25
|
| Rate for Payer: PACE SWMI |
$1,290.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,290.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$827.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,524.10
|
| Rate for Payer: Priority Health Medicare |
$1,290.82
|
| Rate for Payer: Priority Health Tiered Network |
$2,524.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,290.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,433.48
|
| Rate for Payer: UHC Core |
$2,433.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,290.82
|
| Rate for Payer: UHC Exchange |
$2,433.48
|
| Rate for Payer: UHC Medicaid |
$827.72
|
| Rate for Payer: UHCCP Medicaid |
$827.72
|
|
|
PR SUTURE FACIAL NERVE EXTRACRANIAL
|
Professional
|
Both
|
$2,502.00
|
|
|
Service Code
|
HCPCS 64864
|
| Min. Negotiated Rate |
$481.59 |
| Max. Negotiated Rate |
$1,876.50 |
| Rate for Payer: Aetna Commercial |
$995.98
|
| Rate for Payer: Aetna Medicare |
$773.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,070.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$995.98
|
| Rate for Payer: BCBS Complete |
$505.67
|
| Rate for Payer: BCBS MAPPO |
$743.27
|
| Rate for Payer: BCN Commercial |
$1,294.26
|
| Rate for Payer: BCN Medicare Advantage |
$743.27
|
| Rate for Payer: Cash Price |
$2,001.60
|
| Rate for Payer: Cash Price |
$2,001.60
|
| Rate for Payer: Cofinity Commercial |
$995.98
|
| Rate for Payer: Cofinity Commercial |
$1,070.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$743.27
|
| Rate for Payer: Healthscope Commercial |
$1,375.05
|
| Rate for Payer: Healthscope Commercial |
$1,189.23
|
| Rate for Payer: Mclaren Medicaid |
$481.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$780.43
|
| Rate for Payer: Meridian Medicaid |
$505.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$817.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,528.09
|
| Rate for Payer: Nomi Health Commercial |
$891.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,876.50
|
| Rate for Payer: PACE SWMI |
$743.27
|
| Rate for Payer: PHP Medicare Advantage |
$743.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,503.26
|
| Rate for Payer: Priority Health Medicare |
$743.27
|
| Rate for Payer: Priority Health SBD |
$1,503.26
|
| Rate for Payer: Priority Health Tiered Network |
$1,503.26
|
| Rate for Payer: Railroad Medicare Medicare |
$743.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,508.93
|
| Rate for Payer: UHC Core |
$1,508.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$743.27
|
| Rate for Payer: UHC Exchange |
$1,508.93
|
| Rate for Payer: UHC Medicaid |
$481.59
|
| Rate for Payer: UHCCP Medicaid |
$481.59
|
|
|
PR SUTURE FACIAL NERVE INFRATEMPORAL W/WO GRAFT
|
Professional
|
Both
|
$3,128.00
|
|
|
Service Code
|
HCPCS 64865
|
| Min. Negotiated Rate |
$604.49 |
| Max. Negotiated Rate |
$2,346.00 |
| Rate for Payer: Aetna Commercial |
$1,243.04
|
| Rate for Payer: Aetna Medicare |
$964.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,243.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,335.80
|
| Rate for Payer: BCBS Complete |
$634.71
|
| Rate for Payer: BCBS MAPPO |
$927.64
|
| Rate for Payer: BCN Commercial |
$1,618.44
|
| Rate for Payer: BCN Medicare Advantage |
$927.64
|
| Rate for Payer: Cash Price |
$2,502.40
|
| Rate for Payer: Cash Price |
$2,502.40
|
| Rate for Payer: Cofinity Commercial |
$1,335.80
|
| Rate for Payer: Cofinity Commercial |
$1,243.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$927.64
|
| Rate for Payer: Healthscope Commercial |
$1,716.13
|
| Rate for Payer: Healthscope Commercial |
$1,484.22
|
| Rate for Payer: Mclaren Medicaid |
$604.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$974.02
|
| Rate for Payer: Meridian Medicaid |
$634.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,020.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,920.82
|
| Rate for Payer: Nomi Health Commercial |
$1,113.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,346.00
|
| Rate for Payer: PACE SWMI |
$927.64
|
| Rate for Payer: PHP Medicare Advantage |
$927.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$604.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,879.78
|
| Rate for Payer: Priority Health Medicare |
$927.64
|
| Rate for Payer: Priority Health SBD |
$1,879.78
|
| Rate for Payer: Priority Health Tiered Network |
$1,879.78
|
| Rate for Payer: Railroad Medicare Medicare |
$927.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,895.36
|
| Rate for Payer: UHC Core |
$1,895.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$927.64
|
| Rate for Payer: UHC Exchange |
$1,895.36
|
| Rate for Payer: UHC Medicaid |
$604.49
|
| Rate for Payer: UHCCP Medicaid |
$604.49
|
|
|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Professional
|
Both
|
$1,598.00
|
|
|
Service Code
|
HCPCS 27380
|
| Min. Negotiated Rate |
$381.27 |
| Max. Negotiated Rate |
$1,198.50 |
| Rate for Payer: Aetna Commercial |
$774.23
|
| Rate for Payer: Aetna Medicare |
$600.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$774.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$832.00
|
| Rate for Payer: BCBS Complete |
$400.33
|
| Rate for Payer: BCBS MAPPO |
$577.78
|
| Rate for Payer: BCN Commercial |
$948.65
|
| Rate for Payer: BCN Medicare Advantage |
$577.78
|
| Rate for Payer: Cash Price |
$1,278.40
|
| Rate for Payer: Cash Price |
$1,278.40
|
| Rate for Payer: Cofinity Commercial |
$832.00
|
| Rate for Payer: Cofinity Commercial |
$774.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$577.78
|
| Rate for Payer: Healthscope Commercial |
$924.45
|
| Rate for Payer: Healthscope Commercial |
$1,068.89
|
| Rate for Payer: Mclaren Medicaid |
$381.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$606.67
|
| Rate for Payer: Meridian Medicaid |
$400.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$635.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,105.02
|
| Rate for Payer: Nomi Health Commercial |
$693.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,198.50
|
| Rate for Payer: PACE SWMI |
$577.78
|
| Rate for Payer: PHP Medicare Advantage |
$577.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$381.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,014.08
|
| Rate for Payer: Priority Health Medicare |
$577.78
|
| Rate for Payer: Priority Health SBD |
$1,014.08
|
| Rate for Payer: Priority Health Tiered Network |
$1,014.08
|
| Rate for Payer: Railroad Medicare Medicare |
$577.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,054.60
|
| Rate for Payer: UHC Core |
$1,054.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$577.78
|
| Rate for Payer: UHC Exchange |
$1,054.60
|
| Rate for Payer: UHC Medicaid |
$381.27
|
| Rate for Payer: UHCCP Medicaid |
$381.27
|
|
|
PR SUTURE MESENTERY SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,038.00
|
|
|
Service Code
|
HCPCS 44850
|
| Min. Negotiated Rate |
$452.41 |
| Max. Negotiated Rate |
$1,528.50 |
| Rate for Payer: Aetna Commercial |
$942.06
|
| Rate for Payer: Aetna Medicare |
$731.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,012.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$942.06
|
| Rate for Payer: BCBS Complete |
$475.03
|
| Rate for Payer: BCBS MAPPO |
$703.03
|
| Rate for Payer: BCN Commercial |
$1,127.93
|
| Rate for Payer: BCN Medicare Advantage |
$703.03
|
| Rate for Payer: Cash Price |
$1,630.40
|
| Rate for Payer: Cash Price |
$1,630.40
|
| Rate for Payer: Cofinity Commercial |
$942.06
|
| Rate for Payer: Cofinity Commercial |
$1,012.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.03
|
| Rate for Payer: Healthscope Commercial |
$1,300.61
|
| Rate for Payer: Healthscope Commercial |
$1,124.85
|
| Rate for Payer: Mclaren Medicaid |
$452.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.18
|
| Rate for Payer: Meridian Medicaid |
$475.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,334.41
|
| Rate for Payer: Nomi Health Commercial |
$843.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,528.50
|
| Rate for Payer: PACE SWMI |
$703.03
|
| Rate for Payer: PHP Medicare Advantage |
$703.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$452.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,374.31
|
| Rate for Payer: Priority Health Medicare |
$703.03
|
| Rate for Payer: Priority Health SBD |
$1,374.31
|
| Rate for Payer: Priority Health Tiered Network |
$1,374.31
|
| Rate for Payer: Railroad Medicare Medicare |
$703.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,324.78
|
| Rate for Payer: UHC Core |
$1,324.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.03
|
| Rate for Payer: UHC Exchange |
$1,324.78
|
| Rate for Payer: UHC Medicaid |
$452.41
|
| Rate for Payer: UHCCP Medicaid |
$452.41
|
|
|
PR SUTURE NERVE REQ SECONDARY/DELAYED SUTURE
|
Professional
|
Both
|
$208.00
|
|
|
Service Code
|
HCPCS 64872
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$207.51 |
| Rate for Payer: Aetna Commercial |
$133.38
|
| Rate for Payer: Aetna Medicare |
$103.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.34
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCBS MAPPO |
$99.54
|
| Rate for Payer: BCN Commercial |
$171.81
|
| Rate for Payer: BCN Medicare Advantage |
$99.54
|
| Rate for Payer: Cash Price |
$166.40
|
| Rate for Payer: Cash Price |
$166.40
|
| Rate for Payer: Cofinity Commercial |
$143.34
|
| Rate for Payer: Cofinity Commercial |
$133.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.54
|
| Rate for Payer: Healthscope Commercial |
$184.15
|
| Rate for Payer: Healthscope Commercial |
$159.26
|
| Rate for Payer: Mclaren Medicaid |
$63.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.52
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$109.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.88
|
| Rate for Payer: Nomi Health Commercial |
$119.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.00
|
| Rate for Payer: PACE SWMI |
$99.54
|
| Rate for Payer: PHP Medicare Advantage |
$99.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$199.55
|
| Rate for Payer: Priority Health Medicare |
$99.54
|
| Rate for Payer: Priority Health SBD |
$199.55
|
| Rate for Payer: Priority Health Tiered Network |
$199.55
|
| Rate for Payer: Railroad Medicare Medicare |
$99.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.51
|
| Rate for Payer: UHC Core |
$207.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$99.54
|
| Rate for Payer: UHC Exchange |
$207.51
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
|
|
PR SUTURE NERVE REQ XTNSV MOBIL/TRPOS NERVE
|
Professional
|
Both
|
$319.00
|
|
|
Service Code
|
HCPCS 64874
|
| Min. Negotiated Rate |
$94.79 |
| Max. Negotiated Rate |
$309.13 |
| Rate for Payer: Aetna Commercial |
$199.07
|
| Rate for Payer: Aetna Medicare |
$154.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.93
|
| Rate for Payer: BCBS Complete |
$99.53
|
| Rate for Payer: BCBS MAPPO |
$148.56
|
| Rate for Payer: BCN Commercial |
$256.96
|
| Rate for Payer: BCN Medicare Advantage |
$148.56
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cofinity Commercial |
$213.93
|
| Rate for Payer: Cofinity Commercial |
$199.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.56
|
| Rate for Payer: Healthscope Commercial |
$274.84
|
| Rate for Payer: Healthscope Commercial |
$237.70
|
| Rate for Payer: Mclaren Medicaid |
$94.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$155.99
|
| Rate for Payer: Meridian Medicaid |
$99.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$163.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.07
|
| Rate for Payer: Nomi Health Commercial |
$178.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$239.25
|
| Rate for Payer: PACE SWMI |
$148.56
|
| Rate for Payer: PHP Medicare Advantage |
$148.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$298.46
|
| Rate for Payer: Priority Health Medicare |
$148.56
|
| Rate for Payer: Priority Health SBD |
$298.46
|
| Rate for Payer: Priority Health Tiered Network |
$298.46
|
| Rate for Payer: Railroad Medicare Medicare |
$148.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.13
|
| Rate for Payer: UHC Core |
$309.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$148.56
|
| Rate for Payer: UHC Exchange |
$309.13
|
| Rate for Payer: UHC Medicaid |
$94.79
|
| Rate for Payer: UHCCP Medicaid |
$94.79
|
|
|
PR SUTURE PHARYNX WOUND/INJURY
|
Professional
|
Both
|
$642.00
|
|
|
Service Code
|
HCPCS 42900
|
| Min. Negotiated Rate |
$184.25 |
| Max. Negotiated Rate |
$608.59 |
| Rate for Payer: Priority Health SBD |
$608.59
|
| Rate for Payer: Aetna Commercial |
$380.91
|
| Rate for Payer: Aetna Medicare |
$295.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$380.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$409.33
|
| Rate for Payer: BCBS Complete |
$193.46
|
| Rate for Payer: BCBS MAPPO |
$284.26
|
| Rate for Payer: BCN Commercial |
$499.48
|
| Rate for Payer: BCN Medicare Advantage |
$284.26
|
| Rate for Payer: Cash Price |
$513.60
|
| Rate for Payer: Cash Price |
$513.60
|
| Rate for Payer: Cofinity Commercial |
$409.33
|
| Rate for Payer: Cofinity Commercial |
$380.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$284.26
|
| Rate for Payer: Healthscope Commercial |
$525.88
|
| Rate for Payer: Healthscope Commercial |
$454.82
|
| Rate for Payer: Mclaren Medicaid |
$184.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$298.47
|
| Rate for Payer: Meridian Medicaid |
$193.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$312.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$588.62
|
| Rate for Payer: Nomi Health Commercial |
$341.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$481.50
|
| Rate for Payer: PACE SWMI |
$284.26
|
| Rate for Payer: PHP Medicare Advantage |
$284.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$184.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$608.59
|
| Rate for Payer: Priority Health Medicare |
$284.26
|
| Rate for Payer: Priority Health Tiered Network |
$608.59
|
| Rate for Payer: Railroad Medicare Medicare |
$284.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$581.33
|
| Rate for Payer: UHC Core |
$581.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$284.26
|
| Rate for Payer: UHC Exchange |
$581.33
|
| Rate for Payer: UHC Medicaid |
$184.25
|
| Rate for Payer: UHCCP Medicaid |
$184.25
|
|
|
PR SUTURE POSTERIOR TIBIAL NERVE
|
Professional
|
Both
|
$2,038.00
|
|
|
Service Code
|
HCPCS 64840
|
| Min. Negotiated Rate |
$564.24 |
| Max. Negotiated Rate |
$1,707.17 |
| Rate for Payer: Aetna Commercial |
$1,163.83
|
| Rate for Payer: Aetna Medicare |
$903.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,163.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,250.68
|
| Rate for Payer: BCBS Complete |
$592.45
|
| Rate for Payer: BCBS MAPPO |
$868.53
|
| Rate for Payer: BCN Commercial |
$1,459.09
|
| Rate for Payer: BCN Medicare Advantage |
$868.53
|
| Rate for Payer: Cash Price |
$1,630.40
|
| Rate for Payer: Cash Price |
$1,630.40
|
| Rate for Payer: Cofinity Commercial |
$1,250.68
|
| Rate for Payer: Cofinity Commercial |
$1,163.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$868.53
|
| Rate for Payer: Healthscope Commercial |
$1,606.78
|
| Rate for Payer: Healthscope Commercial |
$1,389.65
|
| Rate for Payer: Mclaren Medicaid |
$564.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$911.96
|
| Rate for Payer: Meridian Medicaid |
$592.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$955.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,707.17
|
| Rate for Payer: Nomi Health Commercial |
$1,042.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,528.50
|
| Rate for Payer: PACE SWMI |
$868.53
|
| Rate for Payer: PHP Medicare Advantage |
$868.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$564.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,694.69
|
| Rate for Payer: Priority Health Medicare |
$868.53
|
| Rate for Payer: Priority Health SBD |
$1,694.69
|
| Rate for Payer: Priority Health Tiered Network |
$1,694.69
|
| Rate for Payer: Railroad Medicare Medicare |
$868.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,686.84
|
| Rate for Payer: UHC Core |
$1,686.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$868.53
|
| Rate for Payer: UHC Exchange |
$1,686.84
|
| Rate for Payer: UHC Medicaid |
$564.24
|
| Rate for Payer: UHCCP Medicaid |
$564.24
|
|
|
PR SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY
|
Professional
|
Both
|
$1,960.00
|
|
|
Service Code
|
HCPCS 27385
|
| Min. Negotiated Rate |
$375.31 |
| Max. Negotiated Rate |
$1,470.00 |
| Rate for Payer: Aetna Commercial |
$759.58
|
| Rate for Payer: Aetna Medicare |
$589.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$816.26
|
| Rate for Payer: BCBS Complete |
$394.08
|
| Rate for Payer: BCBS MAPPO |
$566.85
|
| Rate for Payer: BCN Commercial |
$925.74
|
| Rate for Payer: BCN Medicare Advantage |
$566.85
|
| Rate for Payer: Cash Price |
$1,568.00
|
| Rate for Payer: Cash Price |
$1,568.00
|
| Rate for Payer: Cofinity Commercial |
$816.26
|
| Rate for Payer: Cofinity Commercial |
$759.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.85
|
| Rate for Payer: Healthscope Commercial |
$906.96
|
| Rate for Payer: Healthscope Commercial |
$1,048.67
|
| Rate for Payer: Mclaren Medicaid |
$375.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$595.19
|
| Rate for Payer: Meridian Medicaid |
$394.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$623.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,073.02
|
| Rate for Payer: Nomi Health Commercial |
$680.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,470.00
|
| Rate for Payer: PACE SWMI |
$566.85
|
| Rate for Payer: PHP Medicare Advantage |
$566.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$989.59
|
| Rate for Payer: Priority Health Medicare |
$566.85
|
| Rate for Payer: Priority Health SBD |
$989.59
|
| Rate for Payer: Priority Health Tiered Network |
$989.59
|
| Rate for Payer: Railroad Medicare Medicare |
$566.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,019.59
|
| Rate for Payer: UHC Core |
$1,019.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$566.85
|
| Rate for Payer: UHC Exchange |
$1,019.59
|
| Rate for Payer: UHC Medicaid |
$375.31
|
| Rate for Payer: UHCCP Medicaid |
$375.31
|
|
|
PR SUTURE REPAIR AORTA/GREAT VESSEL W/BYPASS
|
Professional
|
Both
|
$5,859.00
|
|
|
Service Code
|
HCPCS 33322
|
| Min. Negotiated Rate |
$847.10 |
| Max. Negotiated Rate |
$4,394.25 |
| Rate for Payer: Aetna Commercial |
$1,775.18
|
| Rate for Payer: Aetna Medicare |
$1,377.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,775.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,907.65
|
| Rate for Payer: BCBS Complete |
$889.46
|
| Rate for Payer: BCBS MAPPO |
$1,324.76
|
| Rate for Payer: BCN Commercial |
$2,046.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,324.76
|
| Rate for Payer: Cash Price |
$4,687.20
|
| Rate for Payer: Cash Price |
$4,687.20
|
| Rate for Payer: Cofinity Commercial |
$1,907.65
|
| Rate for Payer: Cofinity Commercial |
$1,775.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,324.76
|
| Rate for Payer: Healthscope Commercial |
$2,450.81
|
| Rate for Payer: Healthscope Commercial |
$2,119.62
|
| Rate for Payer: Mclaren Medicaid |
$847.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,391.00
|
| Rate for Payer: Meridian Medicaid |
$889.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,457.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,451.73
|
| Rate for Payer: Nomi Health Commercial |
$1,589.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,394.25
|
| Rate for Payer: PACE SWMI |
$1,324.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,324.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$847.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,200.97
|
| Rate for Payer: Priority Health Medicare |
$1,324.76
|
| Rate for Payer: Priority Health SBD |
$2,200.97
|
| Rate for Payer: Priority Health Tiered Network |
$2,200.97
|
| Rate for Payer: Railroad Medicare Medicare |
$1,324.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,469.70
|
| Rate for Payer: UHC Core |
$2,469.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,324.76
|
| Rate for Payer: UHC Exchange |
$2,469.70
|
| Rate for Payer: UHC Medicaid |
$847.10
|
| Rate for Payer: UHCCP Medicaid |
$847.10
|
|
|
PR SUTURE/REPAIR TESTICULAR INJURY
|
Professional
|
Both
|
$1,294.00
|
|
|
Service Code
|
HCPCS 54670
|
| Min. Negotiated Rate |
$241.54 |
| Max. Negotiated Rate |
$970.50 |
| Rate for Payer: Aetna Commercial |
$496.74
|
| Rate for Payer: Aetna Medicare |
$385.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$496.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.81
|
| Rate for Payer: BCBS Complete |
$253.62
|
| Rate for Payer: BCBS MAPPO |
$370.70
|
| Rate for Payer: BCN Commercial |
$617.49
|
| Rate for Payer: BCN Medicare Advantage |
$370.70
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cofinity Commercial |
$533.81
|
| Rate for Payer: Cofinity Commercial |
$496.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$370.70
|
| Rate for Payer: Healthscope Commercial |
$685.79
|
| Rate for Payer: Healthscope Commercial |
$593.12
|
| Rate for Payer: Mclaren Medicaid |
$241.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$389.24
|
| Rate for Payer: Meridian Medicaid |
$253.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$407.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$718.65
|
| Rate for Payer: Nomi Health Commercial |
$444.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$970.50
|
| Rate for Payer: PACE SWMI |
$370.70
|
| Rate for Payer: PHP Medicare Advantage |
$370.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$672.66
|
| Rate for Payer: Priority Health Medicare |
$370.70
|
| Rate for Payer: Priority Health SBD |
$672.66
|
| Rate for Payer: Priority Health Tiered Network |
$672.66
|
| Rate for Payer: Railroad Medicare Medicare |
$370.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$714.69
|
| Rate for Payer: UHC Core |
$714.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$370.70
|
| Rate for Payer: UHC Exchange |
$714.69
|
| Rate for Payer: UHC Medicaid |
$241.54
|
| Rate for Payer: UHCCP Medicaid |
$241.54
|
|
|
PR SUTURE SCIATIC NERVE
|
Professional
|
Both
|
$2,575.00
|
|
|
Service Code
|
HCPCS 64858
|
| Min. Negotiated Rate |
$678.41 |
| Max. Negotiated Rate |
$2,083.77 |
| Rate for Payer: Aetna Commercial |
$1,404.91
|
| Rate for Payer: Aetna Medicare |
$1,090.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,404.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,509.75
|
| Rate for Payer: BCBS Complete |
$712.33
|
| Rate for Payer: BCBS MAPPO |
$1,048.44
|
| Rate for Payer: BCN Commercial |
$1,772.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.44
|
| Rate for Payer: Cash Price |
$2,060.00
|
| Rate for Payer: Cash Price |
$2,060.00
|
| Rate for Payer: Cofinity Commercial |
$1,509.75
|
| Rate for Payer: Cofinity Commercial |
$1,404.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.44
|
| Rate for Payer: Healthscope Commercial |
$1,939.61
|
| Rate for Payer: Healthscope Commercial |
$1,677.50
|
| Rate for Payer: Mclaren Medicaid |
$678.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,100.86
|
| Rate for Payer: Meridian Medicaid |
$712.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,153.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,083.77
|
| Rate for Payer: Nomi Health Commercial |
$1,258.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,931.25
|
| Rate for Payer: PACE SWMI |
$1,048.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$678.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,059.10
|
| Rate for Payer: Priority Health Medicare |
$1,048.44
|
| Rate for Payer: Priority Health SBD |
$2,059.10
|
| Rate for Payer: Priority Health Tiered Network |
$2,059.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,069.03
|
| Rate for Payer: UHC Core |
$2,069.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,048.44
|
| Rate for Payer: UHC Exchange |
$2,069.03
|
| Rate for Payer: UHC Medicaid |
$678.41
|
| Rate for Payer: UHCCP Medicaid |
$678.41
|
|
|
PR SUTURE TRACHEAL WOUND/INJURY CERVICAL
|
Professional
|
Both
|
$1,637.00
|
|
|
Service Code
|
HCPCS 31800
|
| Min. Negotiated Rate |
$411.09 |
| Max. Negotiated Rate |
$1,244.79 |
| Rate for Payer: Aetna Commercial |
$831.04
|
| Rate for Payer: Aetna Medicare |
$644.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$831.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$893.06
|
| Rate for Payer: BCBS Complete |
$431.64
|
| Rate for Payer: BCBS MAPPO |
$620.18
|
| Rate for Payer: BCN Commercial |
$1,055.72
|
| Rate for Payer: BCN Medicare Advantage |
$620.18
|
| Rate for Payer: Cash Price |
$1,309.60
|
| Rate for Payer: Cash Price |
$1,309.60
|
| Rate for Payer: Cofinity Commercial |
$893.06
|
| Rate for Payer: Cofinity Commercial |
$831.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$620.18
|
| Rate for Payer: Healthscope Commercial |
$992.29
|
| Rate for Payer: Healthscope Commercial |
$1,147.33
|
| Rate for Payer: Mclaren Medicaid |
$411.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$651.19
|
| Rate for Payer: Meridian Medicaid |
$431.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$682.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,244.79
|
| Rate for Payer: Nomi Health Commercial |
$744.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,227.75
|
| Rate for Payer: PACE SWMI |
$620.18
|
| Rate for Payer: PHP Medicare Advantage |
$620.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$411.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$994.18
|
| Rate for Payer: Priority Health Medicare |
$620.18
|
| Rate for Payer: Priority Health SBD |
$994.18
|
| Rate for Payer: Priority Health Tiered Network |
$994.18
|
| Rate for Payer: Railroad Medicare Medicare |
$620.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,219.43
|
| Rate for Payer: UHC Core |
$1,219.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$620.18
|
| Rate for Payer: UHC Exchange |
$1,219.43
|
| Rate for Payer: UHC Medicaid |
$411.09
|
| Rate for Payer: UHCCP Medicaid |
$411.09
|
|
