|
PR RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE
|
Facility
|
OP
|
$1,721.00
|
|
|
Service Code
|
CPT 49520
|
| Hospital Charge Code |
49520
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$683.94 |
| Max. Negotiated Rate |
$10,867.50 |
| Rate for Payer: Aetna Commercial |
$1,462.85
|
| Rate for Payer: Aetna Medicare |
$3,596.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,118.65
|
| 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 |
$2,168.33
|
| Rate for Payer: BCN Commercial |
$2,168.33
|
| Rate for Payer: BCN Medicare Advantage |
$3,457.70
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cash Price |
$1,376.80
|
| Rate for Payer: Cofinity Commercial |
$1,480.06
|
| Rate for Payer: Cofinity Commercial |
$1,204.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,204.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,376.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,457.70
|
| Rate for Payer: Healthscope Commercial |
$1,548.90
|
| 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 |
$1,462.85
|
| 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 |
$1,462.85
|
| 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 |
$1,118.65
|
| 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 |
$1,084.23
|
| Rate for Payer: Railroad Medicare Medicare |
$3,457.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$683.94
|
| 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 RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Professional
|
Both
|
$2,092.00
|
|
|
Service Code
|
HCPCS 49521
|
| Hospital Charge Code |
49521
|
| Min. Negotiated Rate |
$134.72 |
| Max. Negotiated Rate |
$128,542.00 |
| Rate for Payer: Aetna Commercial |
$937.69
|
| Rate for Payer: Aetna Medicare |
$727.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,007.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$937.69
|
| Rate for Payer: BCBS Complete |
$487.56
|
| Rate for Payer: BCBS MAPPO |
$699.77
|
| Rate for Payer: BCBS Trust/PPO |
$134.72
|
| Rate for Payer: BCN Commercial |
$1,050.66
|
| Rate for Payer: BCN Medicare Advantage |
$699.77
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cofinity Commercial |
$937.69
|
| Rate for Payer: Cofinity Commercial |
$1,007.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.77
|
| Rate for Payer: Healthscope Commercial |
$1,294.57
|
| Rate for Payer: Healthscope Commercial |
$1,119.63
|
| Rate for Payer: Mclaren Medicaid |
$464.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$734.76
|
| Rate for Payer: Meridian Medicaid |
$487.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128,542.00
|
| Rate for Payer: Nomi Health Commercial |
$839.72
|
| Rate for Payer: PACE SWMI |
$699.77
|
| Rate for Payer: PHP Medicare Advantage |
$699.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,289.84
|
| Rate for Payer: Priority Health Medicare |
$699.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,289.84
|
| Rate for Payer: Priority Health SBD |
$1,289.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$879.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$699.77
|
| Rate for Payer: UHC Exchange |
$879.45
|
| Rate for Payer: UHC Medicare Advantage |
$699.77
|
| Rate for Payer: UHCCP Medicaid |
$464.34
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Professional
|
Both
|
$2,092.00
|
|
|
Service Code
|
HCPCS 49521
|
| Min. Negotiated Rate |
$134.72 |
| Max. Negotiated Rate |
$128,542.00 |
| Rate for Payer: Aetna Commercial |
$937.69
|
| Rate for Payer: Aetna Medicare |
$727.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,007.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$937.69
|
| Rate for Payer: BCBS Complete |
$487.56
|
| Rate for Payer: BCBS MAPPO |
$699.77
|
| Rate for Payer: BCBS Trust/PPO |
$134.72
|
| Rate for Payer: BCN Commercial |
$1,050.66
|
| Rate for Payer: BCN Medicare Advantage |
$699.77
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cofinity Commercial |
$937.69
|
| Rate for Payer: Cofinity Commercial |
$1,007.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.77
|
| Rate for Payer: Healthscope Commercial |
$1,294.57
|
| Rate for Payer: Healthscope Commercial |
$1,119.63
|
| Rate for Payer: Mclaren Medicaid |
$464.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$734.76
|
| Rate for Payer: Meridian Medicaid |
$487.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128,542.00
|
| Rate for Payer: Nomi Health Commercial |
$839.72
|
| Rate for Payer: PACE SWMI |
$699.77
|
| Rate for Payer: PHP Medicare Advantage |
$699.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,289.84
|
| Rate for Payer: Priority Health Medicare |
$699.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,289.84
|
| Rate for Payer: Priority Health SBD |
$1,289.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$879.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$699.77
|
| Rate for Payer: UHC Exchange |
$879.45
|
| Rate for Payer: UHC Medicare Advantage |
$699.77
|
| Rate for Payer: UHCCP Medicaid |
$464.34
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Facility
|
IP
|
$2,092.00
|
|
|
Service Code
|
CPT 49521
|
| Hospital Charge Code |
49521
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,317.96 |
| Max. Negotiated Rate |
$1,882.80 |
| Rate for Payer: Aetna Commercial |
$1,778.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,359.80
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cofinity Commercial |
$1,464.40
|
| Rate for Payer: Cofinity Commercial |
$1,799.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,464.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,673.60
|
| Rate for Payer: Healthscope Commercial |
$1,882.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,778.20
|
| Rate for Payer: PHP Commercial |
$1,778.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.80
|
| Rate for Payer: Priority Health SBD |
$1,317.96
|
|
|
PR RPR RECRT INGUN HERNIA ANY AGE INCARCERATED
|
Facility
|
OP
|
$2,092.00
|
|
|
Service Code
|
CPT 49521
|
| Hospital Charge Code |
49521
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$773.40 |
| Max. Negotiated Rate |
$19,214.90 |
| Rate for Payer: Aetna Commercial |
$1,778.20
|
| Rate for Payer: Aetna Medicare |
$6,358.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,359.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,641.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,641.98
|
| Rate for Payer: BCBS Complete |
$3,440.72
|
| Rate for Payer: BCBS MAPPO |
$6,113.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,516.33
|
| Rate for Payer: BCN Commercial |
$1,516.33
|
| Rate for Payer: BCN Medicare Advantage |
$6,113.58
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cofinity Commercial |
$1,799.12
|
| Rate for Payer: Cofinity Commercial |
$1,464.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,464.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,673.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,113.58
|
| Rate for Payer: Healthscope Commercial |
$1,882.80
|
| Rate for Payer: Mclaren Medicaid |
$3,276.88
|
| Rate for Payer: Mclaren Medicare |
$6,113.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,419.26
|
| Rate for Payer: Meridian Medicaid |
$3,440.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,030.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,778.20
|
| Rate for Payer: Nomi Health Commercial |
$12,838.52
|
| Rate for Payer: PACE Medicare |
$5,807.90
|
| Rate for Payer: PACE SWMI |
$6,113.58
|
| Rate for Payer: PHP Commercial |
$1,778.20
|
| Rate for Payer: PHP Medicare Advantage |
$6,113.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,276.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,214.90
|
| Rate for Payer: Priority Health Medicare |
$6,113.58
|
| Rate for Payer: Priority Health Narrow Network |
$15,371.92
|
| Rate for Payer: Priority Health SBD |
$1,317.96
|
| Rate for Payer: Railroad Medicare Medicare |
$6,113.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$773.40
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,113.58
|
| Rate for Payer: UHC Medicare Advantage |
$6,113.58
|
| Rate for Payer: UHCCP Medicaid |
$3,441.95
|
| Rate for Payer: VA VA |
$6,113.58
|
|
|
PR RPR RPTD SPLEEN SPLENORRHAPHY W/WO PRTL SPLENECT
|
Professional
|
Both
|
$4,469.00
|
|
|
Service Code
|
HCPCS 38115
|
| Min. Negotiated Rate |
$710.04 |
| Max. Negotiated Rate |
$231,462.00 |
| Rate for Payer: Aetna Commercial |
$1,683.92
|
| Rate for Payer: Aetna Medicare |
$1,306.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,683.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,809.59
|
| Rate for Payer: BCBS Complete |
$870.00
|
| Rate for Payer: BCBS MAPPO |
$1,256.66
|
| Rate for Payer: BCBS Trust/PPO |
$710.04
|
| Rate for Payer: BCN Commercial |
$1,882.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,256.66
|
| Rate for Payer: Cash Price |
$3,575.20
|
| Rate for Payer: Cash Price |
$3,575.20
|
| Rate for Payer: Cofinity Commercial |
$1,809.59
|
| Rate for Payer: Cofinity Commercial |
$1,683.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,256.66
|
| Rate for Payer: Healthscope Commercial |
$2,324.82
|
| Rate for Payer: Healthscope Commercial |
$2,010.66
|
| Rate for Payer: Mclaren Medicaid |
$828.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,319.49
|
| Rate for Payer: Meridian Medicaid |
$870.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231,462.00
|
| Rate for Payer: Nomi Health Commercial |
$1,507.99
|
| Rate for Payer: PACE SWMI |
$1,256.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,256.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$828.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,904.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,575.78
|
| Rate for Payer: Priority Health Medicare |
$1,256.66
|
| Rate for Payer: Priority Health Narrow Network |
$2,575.78
|
| Rate for Payer: Priority Health SBD |
$2,575.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,050.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,256.66
|
| Rate for Payer: UHC Exchange |
$1,050.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,256.66
|
| Rate for Payer: UHCCP Medicaid |
$828.57
|
|
|
PR RPR SINUS VALSALVA FISTULA
|
Professional
|
Both
|
$3,229.00
|
|
|
Service Code
|
HCPCS 33702
|
| Min. Negotiated Rate |
$977.88 |
| Max. Negotiated Rate |
$274,280.00 |
| Rate for Payer: Aetna Commercial |
$1,993.77
|
| Rate for Payer: Aetna Medicare |
$1,547.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,993.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,142.56
|
| Rate for Payer: BCBS Complete |
$1,026.77
|
| Rate for Payer: BCBS MAPPO |
$1,487.89
|
| Rate for Payer: BCN Commercial |
$2,223.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,487.89
|
| Rate for Payer: Cash Price |
$2,583.20
|
| Rate for Payer: Cash Price |
$2,583.20
|
| Rate for Payer: Cofinity Commercial |
$2,142.56
|
| Rate for Payer: Cofinity Commercial |
$1,993.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,487.89
|
| Rate for Payer: Healthscope Commercial |
$2,752.60
|
| Rate for Payer: Healthscope Commercial |
$2,380.62
|
| Rate for Payer: Mclaren Medicaid |
$977.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,562.28
|
| Rate for Payer: Meridian Medicaid |
$1,026.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274,280.00
|
| Rate for Payer: Nomi Health Commercial |
$1,785.47
|
| Rate for Payer: PACE SWMI |
$1,487.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,487.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$977.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,098.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,432.04
|
| Rate for Payer: Priority Health Medicare |
$1,487.89
|
| Rate for Payer: Priority Health Narrow Network |
$2,432.04
|
| Rate for Payer: Priority Health SBD |
$2,432.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,964.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,487.89
|
| Rate for Payer: UHC Exchange |
$2,964.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,487.89
|
| Rate for Payer: UHCCP Medicaid |
$977.88
|
|
|
PR RPR SMALL OMPHALOCELE W/PRIMARY CLOSURE
|
Professional
|
Both
|
$1,971.00
|
|
|
Service Code
|
HCPCS 49600
|
| Min. Negotiated Rate |
$475.63 |
| Max. Negotiated Rate |
$131,706.00 |
| Rate for Payer: Aetna Commercial |
$959.68
|
| Rate for Payer: Aetna Medicare |
$744.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$959.68
|
| Rate for Payer: BCBS Complete |
$499.41
|
| Rate for Payer: BCBS MAPPO |
$716.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,035.01
|
| Rate for Payer: BCN Commercial |
$1,077.53
|
| Rate for Payer: BCN Medicare Advantage |
$716.18
|
| Rate for Payer: Cash Price |
$1,576.80
|
| Rate for Payer: Cash Price |
$1,576.80
|
| Rate for Payer: Cofinity Commercial |
$959.68
|
| Rate for Payer: Cofinity Commercial |
$1,031.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$716.18
|
| Rate for Payer: Healthscope Commercial |
$1,324.93
|
| Rate for Payer: Healthscope Commercial |
$1,145.89
|
| Rate for Payer: Mclaren Medicaid |
$475.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$751.99
|
| Rate for Payer: Meridian Medicaid |
$499.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131,706.00
|
| Rate for Payer: Nomi Health Commercial |
$859.42
|
| Rate for Payer: PACE SWMI |
$716.18
|
| Rate for Payer: PHP Medicare Advantage |
$716.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$475.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,281.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,323.25
|
| Rate for Payer: Priority Health Medicare |
$716.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,323.25
|
| Rate for Payer: Priority Health SBD |
$1,323.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$778.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$716.18
|
| Rate for Payer: UHC Exchange |
$778.22
|
| Rate for Payer: UHC Medicare Advantage |
$716.18
|
| Rate for Payer: UHCCP Medicaid |
$475.63
|
|
|
PR RPR SPIGELIAN HERNIA
|
Professional
|
Both
|
$1,626.00
|
|
|
Service Code
|
HCPCS 49590
|
| Min. Negotiated Rate |
$650.40 |
| Max. Negotiated Rate |
$1,056.90 |
| Rate for Payer: Aetna Medicare |
$813.00
|
| Rate for Payer: BCBS Complete |
$650.40
|
| Rate for Payer: Cash Price |
$1,300.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,056.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,056.90
|
|
|
PR RPR TABDL LMPHADEC EXTNSV W/PEL AORTIC&RNL
|
Professional
|
Both
|
$7,886.00
|
|
|
Service Code
|
HCPCS 38780
|
| Min. Negotiated Rate |
$678.62 |
| Max. Negotiated Rate |
$184,824.00 |
| Rate for Payer: Aetna Commercial |
$1,365.39
|
| Rate for Payer: Aetna Medicare |
$1,059.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,365.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,467.29
|
| Rate for Payer: BCBS Complete |
$712.55
|
| Rate for Payer: BCBS MAPPO |
$1,018.95
|
| Rate for Payer: BCBS Trust/PPO |
$957.28
|
| Rate for Payer: BCN Commercial |
$1,513.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,018.95
|
| Rate for Payer: Cash Price |
$6,308.80
|
| Rate for Payer: Cash Price |
$6,308.80
|
| Rate for Payer: Cofinity Commercial |
$1,467.29
|
| Rate for Payer: Cofinity Commercial |
$1,365.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,018.95
|
| Rate for Payer: Healthscope Commercial |
$1,885.06
|
| Rate for Payer: Healthscope Commercial |
$1,630.32
|
| Rate for Payer: Mclaren Medicaid |
$678.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,069.90
|
| Rate for Payer: Meridian Medicaid |
$712.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184,824.00
|
| Rate for Payer: Nomi Health Commercial |
$1,222.74
|
| Rate for Payer: PACE SWMI |
$1,018.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,018.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$678.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,125.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,100.44
|
| Rate for Payer: Priority Health Medicare |
$1,018.95
|
| Rate for Payer: Priority Health Narrow Network |
$2,100.44
|
| Rate for Payer: Priority Health SBD |
$2,100.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,429.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,018.95
|
| Rate for Payer: UHC Exchange |
$1,429.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,018.95
|
| Rate for Payer: UHCCP Medicaid |
$678.62
|
|
|
PR RPR TDN FLXR FOOT 1/2 W/O FREE GRAFG EACH TENDON
|
Professional
|
Both
|
$1,253.00
|
|
|
Service Code
|
HCPCS 28200
|
| Min. Negotiated Rate |
$213.00 |
| Max. Negotiated Rate |
$57,407.00 |
| Rate for Payer: Aetna Commercial |
$419.29
|
| Rate for Payer: Aetna Medicare |
$325.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$450.58
|
| Rate for Payer: BCBS Complete |
$223.65
|
| Rate for Payer: BCBS MAPPO |
$312.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,084.07
|
| Rate for Payer: BCN Commercial |
$719.83
|
| Rate for Payer: BCN Medicare Advantage |
$312.90
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cash Price |
$1,002.40
|
| Rate for Payer: Cofinity Commercial |
$450.58
|
| Rate for Payer: Cofinity Commercial |
$419.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.90
|
| Rate for Payer: Healthscope Commercial |
$578.86
|
| Rate for Payer: Healthscope Commercial |
$500.64
|
| Rate for Payer: Mclaren Medicaid |
$213.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.54
|
| Rate for Payer: Meridian Medicaid |
$223.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57,407.00
|
| Rate for Payer: Nomi Health Commercial |
$375.48
|
| Rate for Payer: PACE SWMI |
$312.90
|
| Rate for Payer: PHP Medicare Advantage |
$312.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$814.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$504.28
|
| Rate for Payer: Priority Health Medicare |
$312.90
|
| Rate for Payer: Priority Health Narrow Network |
$504.28
|
| Rate for Payer: Priority Health SBD |
$504.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$522.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$312.90
|
| Rate for Payer: UHC Exchange |
$522.57
|
| Rate for Payer: UHC Medicare Advantage |
$312.90
|
| Rate for Payer: UHCCP Medicaid |
$213.00
|
|
|
PR RPR TDN/MUSC FLXR F/ARM&/WRIST SEC 1 EA TDN/MUS
|
Professional
|
Both
|
$1,254.00
|
|
|
Service Code
|
HCPCS 25263
|
| Min. Negotiated Rate |
$417.05 |
| Max. Negotiated Rate |
$112,676.00 |
| Rate for Payer: Aetna Commercial |
$822.79
|
| Rate for Payer: Aetna Medicare |
$638.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$822.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$884.19
|
| Rate for Payer: BCBS Complete |
$437.90
|
| Rate for Payer: BCBS MAPPO |
$614.02
|
| Rate for Payer: BCBS Trust/PPO |
$3,601.42
|
| Rate for Payer: BCN Commercial |
$938.26
|
| Rate for Payer: BCN Medicare Advantage |
$614.02
|
| Rate for Payer: Cash Price |
$1,003.20
|
| Rate for Payer: Cash Price |
$1,003.20
|
| Rate for Payer: Cofinity Commercial |
$884.19
|
| Rate for Payer: Cofinity Commercial |
$822.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.02
|
| Rate for Payer: Healthscope Commercial |
$982.43
|
| Rate for Payer: Healthscope Commercial |
$1,135.94
|
| Rate for Payer: Mclaren Medicaid |
$417.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$644.72
|
| Rate for Payer: Meridian Medicaid |
$437.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112,676.00
|
| Rate for Payer: Nomi Health Commercial |
$736.82
|
| Rate for Payer: PACE SWMI |
$614.02
|
| Rate for Payer: PHP Medicare Advantage |
$614.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$417.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$815.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$987.19
|
| Rate for Payer: Priority Health Medicare |
$614.02
|
| Rate for Payer: Priority Health Narrow Network |
$987.19
|
| Rate for Payer: Priority Health SBD |
$987.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$983.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.02
|
| Rate for Payer: UHC Exchange |
$983.00
|
| Rate for Payer: UHC Medicare Advantage |
$614.02
|
| Rate for Payer: UHCCP Medicaid |
$417.05
|
|
|
PR RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU
|
Professional
|
Both
|
$1,701.00
|
|
|
Service Code
|
HCPCS 25260
|
| Min. Negotiated Rate |
$418.12 |
| Max. Negotiated Rate |
$112,819.00 |
| Rate for Payer: Aetna Commercial |
$823.63
|
| Rate for Payer: Aetna Medicare |
$639.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$823.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$885.10
|
| Rate for Payer: BCBS Complete |
$439.03
|
| Rate for Payer: BCBS MAPPO |
$614.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,459.69
|
| Rate for Payer: BCN Commercial |
$940.22
|
| Rate for Payer: BCN Medicare Advantage |
$614.65
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cofinity Commercial |
$885.10
|
| Rate for Payer: Cofinity Commercial |
$823.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.65
|
| Rate for Payer: Healthscope Commercial |
$983.44
|
| Rate for Payer: Healthscope Commercial |
$1,137.10
|
| Rate for Payer: Mclaren Medicaid |
$418.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$645.38
|
| Rate for Payer: Meridian Medicaid |
$439.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112,819.00
|
| Rate for Payer: Nomi Health Commercial |
$737.58
|
| Rate for Payer: PACE SWMI |
$614.65
|
| Rate for Payer: PHP Medicare Advantage |
$614.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$987.19
|
| Rate for Payer: Priority Health Medicare |
$614.65
|
| Rate for Payer: Priority Health Narrow Network |
$987.19
|
| Rate for Payer: Priority Health SBD |
$987.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$988.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.65
|
| Rate for Payer: UHC Exchange |
$988.82
|
| Rate for Payer: UHC Medicare Advantage |
$614.65
|
| Rate for Payer: UHCCP Medicaid |
$418.12
|
|
|
PR RPR TDN/MUSC XTNSR F/ARM&/WRIST PRIM 1 EA TDN
|
Professional
|
Both
|
$1,418.00
|
|
|
Service Code
|
HCPCS 25270
|
| Min. Negotiated Rate |
$326.32 |
| Max. Negotiated Rate |
$87,849.00 |
| Rate for Payer: Aetna Commercial |
$641.91
|
| Rate for Payer: Aetna Medicare |
$498.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$641.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$689.82
|
| Rate for Payer: BCBS Complete |
$342.64
|
| Rate for Payer: BCBS MAPPO |
$479.04
|
| Rate for Payer: BCBS Trust/PPO |
$3,579.76
|
| Rate for Payer: BCN Commercial |
$733.02
|
| Rate for Payer: BCN Medicare Advantage |
$479.04
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cofinity Commercial |
$689.82
|
| Rate for Payer: Cofinity Commercial |
$641.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$479.04
|
| Rate for Payer: Healthscope Commercial |
$886.22
|
| Rate for Payer: Healthscope Commercial |
$766.46
|
| Rate for Payer: Mclaren Medicaid |
$326.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$502.99
|
| Rate for Payer: Meridian Medicaid |
$342.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87,849.00
|
| Rate for Payer: Nomi Health Commercial |
$574.85
|
| Rate for Payer: PACE SWMI |
$479.04
|
| Rate for Payer: PHP Medicare Advantage |
$479.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$921.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$771.44
|
| Rate for Payer: Priority Health Medicare |
$479.04
|
| Rate for Payer: Priority Health Narrow Network |
$771.44
|
| Rate for Payer: Priority Health SBD |
$771.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$871.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$479.04
|
| Rate for Payer: UHC Exchange |
$871.24
|
| Rate for Payer: UHC Medicare Advantage |
$479.04
|
| Rate for Payer: UHCCP Medicaid |
$326.32
|
|
|
PR RPR TDN/MUSC XTNSR F/ARM&/WRIST SEC 1 EA TDN/MU
|
Professional
|
Both
|
$1,621.00
|
|
|
Service Code
|
HCPCS 25272
|
| Min. Negotiated Rate |
$368.28 |
| Max. Negotiated Rate |
$99,673.00 |
| Rate for Payer: Aetna Commercial |
$727.23
|
| Rate for Payer: Aetna Medicare |
$564.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$727.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$781.50
|
| Rate for Payer: BCBS Complete |
$386.69
|
| Rate for Payer: BCBS MAPPO |
$542.71
|
| Rate for Payer: BCBS Trust/PPO |
$3,566.55
|
| Rate for Payer: BCN Commercial |
$829.29
|
| Rate for Payer: BCN Medicare Advantage |
$542.71
|
| Rate for Payer: Cash Price |
$1,296.80
|
| Rate for Payer: Cash Price |
$1,296.80
|
| Rate for Payer: Cofinity Commercial |
$781.50
|
| Rate for Payer: Cofinity Commercial |
$727.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$542.71
|
| Rate for Payer: Healthscope Commercial |
$868.34
|
| Rate for Payer: Healthscope Commercial |
$1,004.01
|
| Rate for Payer: Mclaren Medicaid |
$368.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$569.85
|
| Rate for Payer: Meridian Medicaid |
$386.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99,673.00
|
| Rate for Payer: Nomi Health Commercial |
$651.25
|
| Rate for Payer: PACE SWMI |
$542.71
|
| Rate for Payer: PHP Medicare Advantage |
$542.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,053.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$872.70
|
| Rate for Payer: Priority Health Medicare |
$542.71
|
| Rate for Payer: Priority Health Narrow Network |
$872.70
|
| Rate for Payer: Priority Health SBD |
$872.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$940.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$542.71
|
| Rate for Payer: UHC Exchange |
$940.47
|
| Rate for Payer: UHC Medicare Advantage |
$542.71
|
| Rate for Payer: UHCCP Medicaid |
$368.28
|
|
|
PR RPR TDN/MUSC XTNSR F/ARM&/WRST SEC FR GRF EA TDN
|
Professional
|
Both
|
$2,302.00
|
|
|
Service Code
|
HCPCS 25274
|
| Min. Negotiated Rate |
$437.08 |
| Max. Negotiated Rate |
$118,267.00 |
| Rate for Payer: Aetna Commercial |
$863.38
|
| Rate for Payer: Aetna Medicare |
$670.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$863.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$927.81
|
| Rate for Payer: BCBS Complete |
$458.93
|
| Rate for Payer: BCBS MAPPO |
$644.31
|
| Rate for Payer: BCN Commercial |
$983.22
|
| Rate for Payer: BCN Medicare Advantage |
$644.31
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cash Price |
$1,841.60
|
| Rate for Payer: Cofinity Commercial |
$927.81
|
| Rate for Payer: Cofinity Commercial |
$863.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.31
|
| Rate for Payer: Healthscope Commercial |
$1,191.97
|
| Rate for Payer: Healthscope Commercial |
$1,030.90
|
| Rate for Payer: Mclaren Medicaid |
$437.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$676.53
|
| Rate for Payer: Meridian Medicaid |
$458.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118,267.00
|
| Rate for Payer: Nomi Health Commercial |
$773.17
|
| Rate for Payer: PACE SWMI |
$644.31
|
| Rate for Payer: PHP Medicare Advantage |
$644.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$437.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,496.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,031.46
|
| Rate for Payer: Priority Health Medicare |
$644.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,031.46
|
| Rate for Payer: Priority Health SBD |
$1,031.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,037.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$644.31
|
| Rate for Payer: UHC Exchange |
$1,037.99
|
| Rate for Payer: UHC Medicare Advantage |
$644.31
|
| Rate for Payer: UHCCP Medicaid |
$437.08
|
|
|
PR RPR TENDON SHEATH EXTENSOR F/ARM&/WRIST W/GRAFT
|
Professional
|
Both
|
$2,025.00
|
|
|
Service Code
|
HCPCS 25275
|
| Min. Negotiated Rate |
$441.55 |
| Max. Negotiated Rate |
$119,459.00 |
| Rate for Payer: Aetna Commercial |
$872.21
|
| Rate for Payer: Aetna Medicare |
$676.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$872.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$937.30
|
| Rate for Payer: BCBS Complete |
$463.63
|
| Rate for Payer: BCBS MAPPO |
$650.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,102.56
|
| Rate for Payer: BCN Commercial |
$993.00
|
| Rate for Payer: BCN Medicare Advantage |
$650.90
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Cofinity Commercial |
$937.30
|
| Rate for Payer: Cofinity Commercial |
$872.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$650.90
|
| Rate for Payer: Healthscope Commercial |
$1,204.16
|
| Rate for Payer: Healthscope Commercial |
$1,041.44
|
| Rate for Payer: Mclaren Medicaid |
$441.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$683.44
|
| Rate for Payer: Meridian Medicaid |
$463.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119,459.00
|
| Rate for Payer: Nomi Health Commercial |
$781.08
|
| Rate for Payer: PACE SWMI |
$650.90
|
| Rate for Payer: PHP Medicare Advantage |
$650.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$441.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,316.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,043.68
|
| Rate for Payer: Priority Health Medicare |
$650.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,043.68
|
| Rate for Payer: Priority Health SBD |
$1,043.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$719.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$650.90
|
| Rate for Payer: UHC Exchange |
$719.41
|
| Rate for Payer: UHC Medicare Advantage |
$650.90
|
| Rate for Payer: UHCCP Medicaid |
$441.55
|
|
|
PR RPR TENDON XTNSR FOOT SEC W/FREE GRAFT EA TENDON
|
Professional
|
Both
|
$947.00
|
|
|
Service Code
|
HCPCS 28210
|
| Min. Negotiated Rate |
$273.07 |
| Max. Negotiated Rate |
$74,921.00 |
| Rate for Payer: Aetna Commercial |
$539.78
|
| Rate for Payer: Aetna Medicare |
$418.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$539.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.06
|
| Rate for Payer: BCBS Complete |
$286.72
|
| Rate for Payer: BCBS MAPPO |
$402.82
|
| Rate for Payer: BCBS Trust/PPO |
$912.90
|
| Rate for Payer: BCN Commercial |
$867.89
|
| Rate for Payer: BCN Medicare Advantage |
$402.82
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cofinity Commercial |
$580.06
|
| Rate for Payer: Cofinity Commercial |
$539.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$402.82
|
| Rate for Payer: Healthscope Commercial |
$745.22
|
| Rate for Payer: Healthscope Commercial |
$644.51
|
| Rate for Payer: Mclaren Medicaid |
$273.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$422.96
|
| Rate for Payer: Meridian Medicaid |
$286.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74,921.00
|
| Rate for Payer: Nomi Health Commercial |
$483.38
|
| Rate for Payer: PACE SWMI |
$402.82
|
| Rate for Payer: PHP Medicare Advantage |
$402.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$615.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$653.37
|
| Rate for Payer: Priority Health Medicare |
$402.82
|
| Rate for Payer: Priority Health Narrow Network |
$653.37
|
| Rate for Payer: Priority Health SBD |
$653.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$645.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$402.82
|
| Rate for Payer: UHC Exchange |
$645.15
|
| Rate for Payer: UHC Medicare Advantage |
$402.82
|
| Rate for Payer: UHCCP Medicaid |
$273.07
|
|
|
PR RPR THORACOABDOMINAL AORTIC ANEURYS W/WO BYPASS
|
Professional
|
Both
|
$8,690.00
|
|
|
Service Code
|
HCPCS 33877
|
| Min. Negotiated Rate |
$2,114.78 |
| Max. Negotiated Rate |
$639,169.00 |
| Rate for Payer: Aetna Commercial |
$4,636.05
|
| Rate for Payer: Aetna Medicare |
$3,598.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,636.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,982.03
|
| Rate for Payer: BCBS Complete |
$2,367.78
|
| Rate for Payer: BCBS MAPPO |
$3,459.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,114.78
|
| Rate for Payer: BCN Commercial |
$5,146.27
|
| Rate for Payer: BCN Medicare Advantage |
$3,459.74
|
| Rate for Payer: Cash Price |
$6,952.00
|
| Rate for Payer: Cash Price |
$6,952.00
|
| Rate for Payer: Cofinity Commercial |
$4,982.03
|
| Rate for Payer: Cofinity Commercial |
$4,636.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,459.74
|
| Rate for Payer: Healthscope Commercial |
$6,400.52
|
| Rate for Payer: Healthscope Commercial |
$5,535.58
|
| Rate for Payer: Mclaren Medicaid |
$2,255.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,632.73
|
| Rate for Payer: Meridian Medicaid |
$2,367.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$639,169.00
|
| Rate for Payer: Nomi Health Commercial |
$4,151.69
|
| Rate for Payer: PACE SWMI |
$3,459.74
|
| Rate for Payer: PHP Medicare Advantage |
$3,459.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,255.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,648.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,617.67
|
| Rate for Payer: Priority Health Medicare |
$3,459.74
|
| Rate for Payer: Priority Health Narrow Network |
$5,617.67
|
| Rate for Payer: Priority Health SBD |
$5,617.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,507.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,459.74
|
| Rate for Payer: UHC Exchange |
$4,507.63
|
| Rate for Payer: UHC Medicare Advantage |
$3,459.74
|
| Rate for Payer: UHCCP Medicaid |
$2,255.03
|
|
|
PR RPR TUNICA VAGINALIS HYDROCELE BOTTLE TYPE
|
Professional
|
Both
|
$630.00
|
|
|
Service Code
|
HCPCS 55060
|
| Min. Negotiated Rate |
$245.38 |
| Max. Negotiated Rate |
$66,775.00 |
| Rate for Payer: Aetna Commercial |
$487.24
|
| Rate for Payer: Aetna Medicare |
$378.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$523.60
|
| Rate for Payer: BCBS Complete |
$257.65
|
| Rate for Payer: BCBS MAPPO |
$363.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,220.90
|
| Rate for Payer: BCN Commercial |
$551.23
|
| Rate for Payer: BCN Medicare Advantage |
$363.61
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Cofinity Commercial |
$523.60
|
| Rate for Payer: Cofinity Commercial |
$487.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.61
|
| Rate for Payer: Healthscope Commercial |
$672.68
|
| Rate for Payer: Healthscope Commercial |
$581.78
|
| Rate for Payer: Mclaren Medicaid |
$245.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.79
|
| Rate for Payer: Meridian Medicaid |
$257.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66,775.00
|
| Rate for Payer: Nomi Health Commercial |
$436.33
|
| Rate for Payer: PACE SWMI |
$363.61
|
| Rate for Payer: PHP Medicare Advantage |
$363.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$245.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$409.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$609.30
|
| Rate for Payer: Priority Health Medicare |
$363.61
|
| Rate for Payer: Priority Health Narrow Network |
$609.30
|
| Rate for Payer: Priority Health SBD |
$609.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$530.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.61
|
| Rate for Payer: UHC Exchange |
$530.20
|
| Rate for Payer: UHC Medicare Advantage |
$363.61
|
| Rate for Payer: UHCCP Medicaid |
$245.38
|
|
|
PR RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$448.00
|
|
|
Service Code
|
HCPCS 36575
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$5,881.00 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: Aetna Medicare |
$32.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.65
|
| Rate for Payer: BCBS Complete |
$22.14
|
| Rate for Payer: BCBS MAPPO |
$31.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,177.58
|
| Rate for Payer: BCN Commercial |
$212.57
|
| Rate for Payer: BCN Medicare Advantage |
$31.70
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: Cofinity Commercial |
$45.65
|
| Rate for Payer: Cofinity Commercial |
$42.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.70
|
| Rate for Payer: Healthscope Commercial |
$58.64
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| Rate for Payer: Mclaren Medicaid |
$21.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.28
|
| Rate for Payer: Meridian Medicaid |
$22.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,881.00
|
| Rate for Payer: Nomi Health Commercial |
$38.04
|
| Rate for Payer: PACE SWMI |
$31.70
|
| Rate for Payer: PHP Medicare Advantage |
$31.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.12
|
| Rate for Payer: Priority Health Medicare |
$31.70
|
| Rate for Payer: Priority Health Narrow Network |
$52.12
|
| Rate for Payer: Priority Health SBD |
$52.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.70
|
| Rate for Payer: UHC Exchange |
$197.55
|
| Rate for Payer: UHC Medicare Advantage |
$31.70
|
| Rate for Payer: UHCCP Medicaid |
$21.09
|
|
|
PR RPR UMBILICAL HERNIA < 5 YRS INCARCERATED
|
Professional
|
Both
|
$1,463.00
|
|
|
Service Code
|
HCPCS 49582
|
| Min. Negotiated Rate |
$585.20 |
| Max. Negotiated Rate |
$950.95 |
| Rate for Payer: Aetna Medicare |
$731.50
|
| Rate for Payer: BCBS Complete |
$585.20
|
| Rate for Payer: Cash Price |
$1,170.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$950.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$950.95
|
|
|
PR RPR UMBILICAL HERNIA < 5 YRS REDUCIBLE
|
Professional
|
Both
|
$1,268.00
|
|
|
Service Code
|
HCPCS 49580
|
| Min. Negotiated Rate |
$507.20 |
| Max. Negotiated Rate |
$824.20 |
| Rate for Payer: Aetna Medicare |
$634.00
|
| Rate for Payer: BCBS Complete |
$507.20
|
| Rate for Payer: Cash Price |
$1,014.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$824.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.20
|
|
|
PR RPR UMBILICAL HERNIA AGE 5 YRS/> INCARCERATED
|
Professional
|
Both
|
$1,685.00
|
|
|
Service Code
|
HCPCS 49587
|
| Min. Negotiated Rate |
$674.00 |
| Max. Negotiated Rate |
$1,095.25 |
| Rate for Payer: Aetna Medicare |
$842.50
|
| Rate for Payer: BCBS Complete |
$674.00
|
| Rate for Payer: Cash Price |
$1,348.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,095.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,095.25
|
|
|
PR RPR UMBILICAL HRNA 5 YRS/> REDUCIBLE
|
Professional
|
Both
|
$1,463.00
|
|
|
Service Code
|
HCPCS 49585
|
| Min. Negotiated Rate |
$585.20 |
| Max. Negotiated Rate |
$950.95 |
| Rate for Payer: Aetna Medicare |
$731.50
|
| Rate for Payer: BCBS Complete |
$585.20
|
| Rate for Payer: Cash Price |
$1,170.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$950.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$950.95
|
|
