|
PR TEAEC W/WO PATCH GRF SUBCLAV INNOM THORACIC INC
|
Professional
|
Both
|
$2,931.00
|
|
|
Service Code
|
HCPCS 35311
|
| Min. Negotiated Rate |
$932.30 |
| Max. Negotiated Rate |
$2,779.67 |
| Rate for Payer: Aetna Commercial |
$1,961.67
|
| Rate for Payer: Aetna Medicare |
$1,522.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,961.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,108.06
|
| Rate for Payer: BCBS Complete |
$978.91
|
| Rate for Payer: BCBS MAPPO |
$1,463.93
|
| Rate for Payer: BCN Commercial |
$2,276.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,463.93
|
| Rate for Payer: Cash Price |
$2,344.80
|
| Rate for Payer: Cash Price |
$2,344.80
|
| Rate for Payer: Cofinity Commercial |
$2,108.06
|
| Rate for Payer: Cofinity Commercial |
$1,961.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,463.93
|
| Rate for Payer: Healthscope Commercial |
$2,708.27
|
| Rate for Payer: Healthscope Commercial |
$2,342.29
|
| Rate for Payer: Mclaren Medicaid |
$932.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,537.13
|
| Rate for Payer: Meridian Medicaid |
$978.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,610.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,749.64
|
| Rate for Payer: Nomi Health Commercial |
$1,756.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,198.25
|
| Rate for Payer: PACE SWMI |
$1,463.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,463.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$932.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,448.37
|
| Rate for Payer: Priority Health Medicare |
$1,463.93
|
| Rate for Payer: Priority Health SBD |
$2,448.37
|
| Rate for Payer: Priority Health Tiered Network |
$2,448.37
|
| Rate for Payer: Railroad Medicare Medicare |
$1,463.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,779.67
|
| Rate for Payer: UHC Core |
$2,779.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,463.93
|
| Rate for Payer: UHC Exchange |
$2,779.67
|
| Rate for Payer: UHC Medicaid |
$932.30
|
| Rate for Payer: UHCCP Medicaid |
$932.30
|
|
|
PR TEAM CONFERENCE FACE-TO-FACE NONPHYSICIAN
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS 99366
|
| Min. Negotiated Rate |
$38.80 |
| Max. Negotiated Rate |
$72.75 |
| Rate for Payer: Aetna Commercial |
$41.24
|
| Rate for Payer: Aetna Medicare |
$48.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.24
|
| Rate for Payer: BCBS Complete |
$38.80
|
| Rate for Payer: BCN Commercial |
$58.76
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$52.86
|
| Rate for Payer: Priority Health SBD |
$52.86
|
| Rate for Payer: Priority Health Tiered Network |
$52.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.12
|
| Rate for Payer: UHC Core |
$61.12
|
| Rate for Payer: UHC Exchange |
$61.12
|
|
|
PR TEAM CONFERENCE NON-FACE-TO-FACE NONPHYSICIAN
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 99368
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$53.09 |
| Rate for Payer: Aetna Commercial |
$36.09
|
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.09
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: BCN Commercial |
$51.79
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$46.59
|
| Rate for Payer: Priority Health SBD |
$46.59
|
| Rate for Payer: Priority Health Tiered Network |
$46.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.09
|
| Rate for Payer: UHC Core |
$53.09
|
| Rate for Payer: UHC Exchange |
$53.09
|
|
|
PR TEAM CONFERENCE NON-FACE-TO-FACE PHYSICIAN
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 99367
|
| Min. Negotiated Rate |
$55.68 |
| Max. Negotiated Rate |
$146.64 |
| Rate for Payer: Aetna Commercial |
$55.68
|
| Rate for Payer: Aetna Medicare |
$79.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.68
|
| Rate for Payer: BCBS Complete |
$63.20
|
| Rate for Payer: BCN Commercial |
$146.64
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$71.22
|
| Rate for Payer: Priority Health SBD |
$71.22
|
| Rate for Payer: Priority Health Tiered Network |
$71.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.67
|
| Rate for Payer: UHC Core |
$80.67
|
| Rate for Payer: UHC Exchange |
$80.67
|
|
|
PR TELEPHONE ASSMT&MGMT SVC NQHP EST PT 11-20 MIN
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
HCPCS 98967
|
| Min. Negotiated Rate |
$19.89 |
| Max. Negotiated Rate |
$43.50 |
| Rate for Payer: Aetna Commercial |
$26.65
|
| Rate for Payer: Aetna Medicare |
$20.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.64
|
| Rate for Payer: BCBS Complete |
$23.20
|
| Rate for Payer: BCBS MAPPO |
$19.89
|
| Rate for Payer: BCN Commercial |
$26.84
|
| Rate for Payer: BCN Medicare Advantage |
$19.89
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$28.64
|
| Rate for Payer: Cofinity Commercial |
$26.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.89
|
| Rate for Payer: Healthscope Commercial |
$31.82
|
| Rate for Payer: Healthscope Commercial |
$36.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.54
|
| Rate for Payer: Nomi Health Commercial |
$23.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.50
|
| Rate for Payer: PACE SWMI |
$19.89
|
| Rate for Payer: PHP Medicare Advantage |
$19.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$31.23
|
| Rate for Payer: Priority Health Medicare |
$19.89
|
| Rate for Payer: Priority Health SBD |
$31.23
|
| Rate for Payer: Priority Health Tiered Network |
$31.23
|
| Rate for Payer: Railroad Medicare Medicare |
$19.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.05
|
| Rate for Payer: UHC Core |
$42.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.89
|
| Rate for Payer: UHC Exchange |
$42.05
|
|
|
PR TELEPHONE ASSMT&MGMT SVC NQHP EST PT 21-30 MIN
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 98968
|
| Min. Negotiated Rate |
$28.85 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna Commercial |
$38.66
|
| Rate for Payer: Aetna Medicare |
$30.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.54
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCBS MAPPO |
$28.85
|
| Rate for Payer: BCN Commercial |
$40.84
|
| Rate for Payer: BCN Medicare Advantage |
$28.85
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$41.54
|
| Rate for Payer: Cofinity Commercial |
$38.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.85
|
| Rate for Payer: Healthscope Commercial |
$53.37
|
| Rate for Payer: Healthscope Commercial |
$46.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.17
|
| Rate for Payer: Nomi Health Commercial |
$34.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.00
|
| Rate for Payer: PACE SWMI |
$28.85
|
| Rate for Payer: PHP Medicare Advantage |
$28.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$43.63
|
| Rate for Payer: Priority Health Medicare |
$28.85
|
| Rate for Payer: Priority Health SBD |
$43.63
|
| Rate for Payer: Priority Health Tiered Network |
$43.63
|
| Rate for Payer: Railroad Medicare Medicare |
$28.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.48
|
| Rate for Payer: UHC Core |
$62.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.85
|
| Rate for Payer: UHC Exchange |
$62.48
|
|
|
PR TELEPHONE ASSMT&MGMT SVC NQHP EST PT 5-10 MIN
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS 98966
|
| Min. Negotiated Rate |
$10.25 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Aetna Commercial |
$13.73
|
| Rate for Payer: Aetna Medicare |
$10.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.76
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$10.25
|
| Rate for Payer: BCN Commercial |
$13.24
|
| Rate for Payer: BCN Medicare Advantage |
$10.25
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$14.76
|
| Rate for Payer: Cofinity Commercial |
$13.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.25
|
| Rate for Payer: Healthscope Commercial |
$16.40
|
| Rate for Payer: Healthscope Commercial |
$18.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.50
|
| Rate for Payer: Nomi Health Commercial |
$12.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.50
|
| Rate for Payer: PACE SWMI |
$10.25
|
| Rate for Payer: PHP Medicare Advantage |
$10.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.07
|
| Rate for Payer: Priority Health Medicare |
$10.25
|
| Rate for Payer: Priority Health SBD |
$16.07
|
| Rate for Payer: Priority Health Tiered Network |
$16.07
|
| Rate for Payer: Railroad Medicare Medicare |
$10.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.01
|
| Rate for Payer: UHC Core |
$21.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.25
|
| Rate for Payer: UHC Exchange |
$21.01
|
|
|
PR TEMPORARY CLOSURE EYELIDS SUTURE
|
Professional
|
Both
|
$392.00
|
|
|
Service Code
|
HCPCS 67875
|
| Min. Negotiated Rate |
$78.73 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: BCBS Complete |
$156.80
|
| Rate for Payer: Aetna Commercial |
$105.50
|
| Rate for Payer: Aetna Medicare |
$81.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.37
|
| Rate for Payer: BCBS MAPPO |
$78.73
|
| Rate for Payer: BCN Commercial |
$142.42
|
| Rate for Payer: BCN Medicare Advantage |
$78.73
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cofinity Commercial |
$113.37
|
| Rate for Payer: Cofinity Commercial |
$105.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.73
|
| Rate for Payer: Healthscope Commercial |
$145.65
|
| Rate for Payer: Healthscope Commercial |
$125.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.12
|
| Rate for Payer: Nomi Health Commercial |
$94.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$294.00
|
| Rate for Payer: PACE SWMI |
$78.73
|
| Rate for Payer: PHP Medicare Advantage |
$78.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$166.82
|
| Rate for Payer: Priority Health Medicare |
$78.73
|
| Rate for Payer: Priority Health SBD |
$166.82
|
| Rate for Payer: Priority Health Tiered Network |
$166.82
|
| Rate for Payer: Railroad Medicare Medicare |
$78.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.06
|
| Rate for Payer: UHC Core |
$164.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$78.73
|
| Rate for Payer: UHC Exchange |
$164.06
|
|
|
PR TENDON GRAFT FROM A DISTANCE
|
Professional
|
Both
|
$1,146.00
|
|
|
Service Code
|
HCPCS 20924
|
| Min. Negotiated Rate |
$299.69 |
| Max. Negotiated Rate |
$891.97 |
| Rate for Payer: Aetna Commercial |
$612.19
|
| Rate for Payer: Aetna Medicare |
$475.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$657.88
|
| Rate for Payer: BCBS Complete |
$314.67
|
| Rate for Payer: BCBS MAPPO |
$456.86
|
| Rate for Payer: BCN Commercial |
$770.87
|
| Rate for Payer: BCN Medicare Advantage |
$456.86
|
| Rate for Payer: Cash Price |
$916.80
|
| Rate for Payer: Cash Price |
$916.80
|
| Rate for Payer: Cofinity Commercial |
$657.88
|
| Rate for Payer: Cofinity Commercial |
$612.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$456.86
|
| Rate for Payer: Healthscope Commercial |
$845.19
|
| Rate for Payer: Healthscope Commercial |
$730.98
|
| Rate for Payer: Mclaren Medicaid |
$299.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$479.70
|
| Rate for Payer: Meridian Medicaid |
$314.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$502.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$891.97
|
| Rate for Payer: Nomi Health Commercial |
$548.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$859.50
|
| Rate for Payer: PACE SWMI |
$456.86
|
| Rate for Payer: PHP Medicare Advantage |
$456.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$299.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$824.04
|
| Rate for Payer: Priority Health Medicare |
$456.86
|
| Rate for Payer: Priority Health SBD |
$824.04
|
| Rate for Payer: Priority Health Tiered Network |
$824.04
|
| Rate for Payer: Railroad Medicare Medicare |
$456.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$880.98
|
| Rate for Payer: UHC Core |
$880.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$456.86
|
| Rate for Payer: UHC Exchange |
$880.98
|
| Rate for Payer: UHC Medicaid |
$299.69
|
| Rate for Payer: UHCCP Medicaid |
$299.69
|
|
|
PR TENDON LENGTHENING UPPER ARM/ELBOW EA TENDON
|
Professional
|
Both
|
$1,060.00
|
|
|
Service Code
|
HCPCS 24305
|
| Min. Negotiated Rate |
$344.85 |
| Max. Negotiated Rate |
$1,029.01 |
| Rate for Payer: Aetna Commercial |
$704.14
|
| Rate for Payer: Aetna Medicare |
$546.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$704.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$756.69
|
| Rate for Payer: BCBS Complete |
$362.09
|
| Rate for Payer: BCBS MAPPO |
$525.48
|
| Rate for Payer: BCN Commercial |
$891.38
|
| Rate for Payer: BCN Medicare Advantage |
$525.48
|
| Rate for Payer: Cash Price |
$848.00
|
| Rate for Payer: Cash Price |
$848.00
|
| Rate for Payer: Cofinity Commercial |
$756.69
|
| Rate for Payer: Cofinity Commercial |
$704.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$525.48
|
| Rate for Payer: Healthscope Commercial |
$972.14
|
| Rate for Payer: Healthscope Commercial |
$840.77
|
| Rate for Payer: Mclaren Medicaid |
$344.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$551.75
|
| Rate for Payer: Meridian Medicaid |
$362.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$578.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,029.01
|
| Rate for Payer: Nomi Health Commercial |
$630.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$795.00
|
| Rate for Payer: PACE SWMI |
$525.48
|
| Rate for Payer: PHP Medicare Advantage |
$525.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$344.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$952.86
|
| Rate for Payer: Priority Health Medicare |
$525.48
|
| Rate for Payer: Priority Health SBD |
$952.86
|
| Rate for Payer: Priority Health Tiered Network |
$952.86
|
| Rate for Payer: Railroad Medicare Medicare |
$525.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.51
|
| Rate for Payer: UHC Core |
$1,007.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$525.48
|
| Rate for Payer: UHC Exchange |
$1,007.51
|
| Rate for Payer: UHC Medicaid |
$344.85
|
| Rate for Payer: UHCCP Medicaid |
$344.85
|
|
|
PR TENDON SHEATH INCISION
|
Facility
|
OP
|
$1,215.00
|
|
|
Service Code
|
CPT 26055
|
| Hospital Charge Code |
26055
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$765.45 |
| Max. Negotiated Rate |
$5,181.40 |
| Rate for Payer: Aetna Commercial |
$1,032.75
|
| Rate for Payer: Aetna Medicare |
$1,666.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$789.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,002.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,002.76
|
| Rate for Payer: BCBS Complete |
$879.93
|
| Rate for Payer: BCBS MAPPO |
$1,602.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,130.50
|
| Rate for Payer: BCN Commercial |
$1,130.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.21
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cofinity Advantage |
$850.50
|
| Rate for Payer: Cofinity Commercial |
$1,044.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$972.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.21
|
| Rate for Payer: Healthscope Commercial |
$1,093.50
|
| Rate for Payer: Mclaren Medicaid |
$837.96
|
| Rate for Payer: Mclaren Medicare |
$1,602.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,682.32
|
| Rate for Payer: Meridian Medicaid |
$1,682.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,842.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,762.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,032.75
|
| Rate for Payer: Nomi Health Commercial |
$4,806.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$911.25
|
| Rate for Payer: PACE Medicare |
$1,522.10
|
| Rate for Payer: PACE SWMI |
$1,602.21
|
| Rate for Payer: PHP Commercial |
$1,032.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,602.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,181.40
|
| Rate for Payer: Priority Health Medicare |
$1,602.21
|
| Rate for Payer: Priority Health SBD |
$765.45
|
| Rate for Payer: Priority Health Tiered Network |
$4,145.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,602.21
|
| Rate for Payer: UHC Medicaid |
$837.96
|
| Rate for Payer: UHCCP Medicaid |
$837.96
|
| Rate for Payer: VA VA |
$1,602.21
|
|
|
PR TENDON SHEATH INCISION
|
Facility
|
IP
|
$1,215.00
|
|
|
Service Code
|
CPT 26055
|
| Hospital Charge Code |
26055
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$765.45 |
| Max. Negotiated Rate |
$1,093.50 |
| Rate for Payer: Aetna Commercial |
$1,032.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$789.75
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cofinity Advantage |
$850.50
|
| Rate for Payer: Cofinity Commercial |
$1,044.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$972.00
|
| Rate for Payer: Healthscope Commercial |
$1,093.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,032.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$911.25
|
| Rate for Payer: PHP Commercial |
$1,032.75
|
| Rate for Payer: Priority Health SBD |
$765.45
|
|
|
PR TENDON SHEATH INCISION
|
Professional
|
Both
|
$1,215.00
|
|
|
Service Code
|
HCPCS 26055
|
| Min. Negotiated Rate |
$183.39 |
| Max. Negotiated Rate |
$911.25 |
| Rate for Payer: Aetna Commercial |
$369.24
|
| Rate for Payer: Aetna Medicare |
$286.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$369.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.79
|
| Rate for Payer: BCBS Complete |
$192.56
|
| Rate for Payer: BCBS MAPPO |
$275.55
|
| Rate for Payer: BCN Commercial |
$453.17
|
| Rate for Payer: BCN Medicare Advantage |
$275.55
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cofinity Commercial |
$396.79
|
| Rate for Payer: Cofinity Commercial |
$369.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$275.55
|
| Rate for Payer: Healthscope Commercial |
$509.77
|
| Rate for Payer: Healthscope Commercial |
$440.88
|
| Rate for Payer: Mclaren Medicaid |
$183.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$289.33
|
| Rate for Payer: Meridian Medicaid |
$192.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$303.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$515.05
|
| Rate for Payer: Nomi Health Commercial |
$330.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$911.25
|
| Rate for Payer: PACE SWMI |
$275.55
|
| Rate for Payer: PHP Medicare Advantage |
$275.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$484.41
|
| Rate for Payer: Priority Health Medicare |
$275.55
|
| Rate for Payer: Priority Health SBD |
$484.41
|
| Rate for Payer: Priority Health Tiered Network |
$484.41
|
| Rate for Payer: Railroad Medicare Medicare |
$275.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$497.03
|
| Rate for Payer: UHC Core |
$497.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$275.55
|
| Rate for Payer: UHC Exchange |
$497.03
|
| Rate for Payer: UHC Medicaid |
$183.39
|
| Rate for Payer: UHCCP Medicaid |
$183.39
|
|
|
PR TENDON SHEATH INCISION
|
Professional
|
Both
|
$1,215.00
|
|
|
Service Code
|
HCPCS 26055
|
| Hospital Charge Code |
26055
|
| Min. Negotiated Rate |
$183.39 |
| Max. Negotiated Rate |
$911.25 |
| Rate for Payer: Aetna Commercial |
$369.24
|
| Rate for Payer: Aetna Medicare |
$286.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$369.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.79
|
| Rate for Payer: BCBS Complete |
$192.56
|
| Rate for Payer: BCBS MAPPO |
$275.55
|
| Rate for Payer: BCN Commercial |
$453.17
|
| Rate for Payer: BCN Medicare Advantage |
$275.55
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cofinity Commercial |
$396.79
|
| Rate for Payer: Cofinity Commercial |
$369.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$275.55
|
| Rate for Payer: Healthscope Commercial |
$509.77
|
| Rate for Payer: Healthscope Commercial |
$440.88
|
| Rate for Payer: Mclaren Medicaid |
$183.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$289.33
|
| Rate for Payer: Meridian Medicaid |
$192.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$303.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$515.05
|
| Rate for Payer: Nomi Health Commercial |
$330.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$911.25
|
| Rate for Payer: PACE SWMI |
$275.55
|
| Rate for Payer: PHP Medicare Advantage |
$275.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$484.41
|
| Rate for Payer: Priority Health Medicare |
$275.55
|
| Rate for Payer: Priority Health SBD |
$484.41
|
| Rate for Payer: Priority Health Tiered Network |
$484.41
|
| Rate for Payer: Railroad Medicare Medicare |
$275.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$497.03
|
| Rate for Payer: UHC Core |
$497.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$275.55
|
| Rate for Payer: UHC Exchange |
$497.03
|
| Rate for Payer: UHC Medicaid |
$183.39
|
| Rate for Payer: UHCCP Medicaid |
$183.39
|
|
|
PR TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT
|
Professional
|
Both
|
$1,462.00
|
|
|
Service Code
|
HCPCS 26483
|
| Min. Negotiated Rate |
$532.50 |
| Max. Negotiated Rate |
$1,532.63 |
| Rate for Payer: Aetna Commercial |
$1,068.96
|
| Rate for Payer: Aetna Medicare |
$829.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,068.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,148.73
|
| Rate for Payer: BCBS Complete |
$559.12
|
| Rate for Payer: BCBS MAPPO |
$797.73
|
| Rate for Payer: BCN Commercial |
$1,311.19
|
| Rate for Payer: BCN Medicare Advantage |
$797.73
|
| Rate for Payer: Cash Price |
$1,169.60
|
| Rate for Payer: Cash Price |
$1,169.60
|
| Rate for Payer: Cofinity Commercial |
$1,148.73
|
| Rate for Payer: Cofinity Commercial |
$1,068.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$797.73
|
| Rate for Payer: Healthscope Commercial |
$1,475.80
|
| Rate for Payer: Healthscope Commercial |
$1,276.37
|
| Rate for Payer: Mclaren Medicaid |
$532.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$837.62
|
| Rate for Payer: Meridian Medicaid |
$559.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$877.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,532.63
|
| Rate for Payer: Nomi Health Commercial |
$957.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,096.50
|
| Rate for Payer: PACE SWMI |
$797.73
|
| Rate for Payer: PHP Medicare Advantage |
$797.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$532.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,401.61
|
| Rate for Payer: Priority Health Medicare |
$797.73
|
| Rate for Payer: Priority Health SBD |
$1,401.61
|
| Rate for Payer: Priority Health Tiered Network |
$1,401.61
|
| Rate for Payer: Railroad Medicare Medicare |
$797.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,458.03
|
| Rate for Payer: UHC Core |
$1,458.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$797.73
|
| Rate for Payer: UHC Exchange |
$1,458.03
|
| Rate for Payer: UHC Medicaid |
$532.50
|
| Rate for Payer: UHCCP Medicaid |
$532.50
|
|
|
PR TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,125.00
|
|
|
Service Code
|
HCPCS 24340
|
| Min. Negotiated Rate |
$372.11 |
| Max. Negotiated Rate |
$1,069.53 |
| Rate for Payer: Aetna Commercial |
$760.22
|
| Rate for Payer: Aetna Medicare |
$590.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$760.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$816.96
|
| Rate for Payer: BCBS Complete |
$390.72
|
| Rate for Payer: BCBS MAPPO |
$567.33
|
| Rate for Payer: BCN Commercial |
$929.23
|
| Rate for Payer: BCN Medicare Advantage |
$567.33
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cofinity Commercial |
$816.96
|
| Rate for Payer: Cofinity Commercial |
$760.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$567.33
|
| Rate for Payer: Healthscope Commercial |
$907.73
|
| Rate for Payer: Healthscope Commercial |
$1,049.56
|
| Rate for Payer: Mclaren Medicaid |
$372.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$595.70
|
| Rate for Payer: Meridian Medicaid |
$390.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$624.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,066.46
|
| Rate for Payer: Nomi Health Commercial |
$680.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$843.75
|
| Rate for Payer: PACE SWMI |
$567.33
|
| Rate for Payer: PHP Medicare Advantage |
$567.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$372.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$993.33
|
| Rate for Payer: Priority Health Medicare |
$567.33
|
| Rate for Payer: Priority Health SBD |
$993.33
|
| Rate for Payer: Priority Health Tiered Network |
$993.33
|
| Rate for Payer: Railroad Medicare Medicare |
$567.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,069.53
|
| Rate for Payer: UHC Core |
$1,069.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$567.33
|
| Rate for Payer: UHC Exchange |
$1,069.53
|
| Rate for Payer: UHC Medicaid |
$372.11
|
| Rate for Payer: UHCCP Medicaid |
$372.11
|
|
|
PR TENODESIS DISTAL JOINT EACH
|
Professional
|
Both
|
$1,045.00
|
|
|
Service Code
|
HCPCS 26474
|
| Min. Negotiated Rate |
$417.69 |
| Max. Negotiated Rate |
$1,150.29 |
| Rate for Payer: Aetna Commercial |
$833.19
|
| Rate for Payer: Aetna Medicare |
$646.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$833.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$895.36
|
| Rate for Payer: BCBS Complete |
$438.57
|
| Rate for Payer: BCBS MAPPO |
$621.78
|
| Rate for Payer: BCN Commercial |
$983.01
|
| Rate for Payer: BCN Medicare Advantage |
$621.78
|
| Rate for Payer: Cash Price |
$836.00
|
| Rate for Payer: Cash Price |
$836.00
|
| Rate for Payer: Cofinity Commercial |
$895.36
|
| Rate for Payer: Cofinity Commercial |
$833.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$621.78
|
| Rate for Payer: Healthscope Commercial |
$994.85
|
| Rate for Payer: Healthscope Commercial |
$1,150.29
|
| Rate for Payer: Mclaren Medicaid |
$417.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$652.87
|
| Rate for Payer: Meridian Medicaid |
$438.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$683.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,146.89
|
| Rate for Payer: Nomi Health Commercial |
$746.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$783.75
|
| Rate for Payer: PACE SWMI |
$621.78
|
| Rate for Payer: PHP Medicare Advantage |
$621.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$417.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,050.82
|
| Rate for Payer: Priority Health Medicare |
$621.78
|
| Rate for Payer: Priority Health SBD |
$1,050.82
|
| Rate for Payer: Priority Health Tiered Network |
$1,050.82
|
| Rate for Payer: Railroad Medicare Medicare |
$621.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,056.04
|
| Rate for Payer: UHC Core |
$1,056.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$621.78
|
| Rate for Payer: UHC Exchange |
$1,056.04
|
| Rate for Payer: UHC Medicaid |
$417.69
|
| Rate for Payer: UHCCP Medicaid |
$417.69
|
|
|
PR TENODESIS LONG TENDON BICEPS
|
Professional
|
Both
|
$2,428.00
|
|
|
Service Code
|
HCPCS 23430
|
| Min. Negotiated Rate |
$444.11 |
| Max. Negotiated Rate |
$1,821.00 |
| Rate for Payer: Aetna Commercial |
$909.86
|
| Rate for Payer: Aetna Medicare |
$706.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$909.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$977.76
|
| Rate for Payer: BCBS Complete |
$466.32
|
| Rate for Payer: BCBS MAPPO |
$679.00
|
| Rate for Payer: BCN Commercial |
$1,134.90
|
| Rate for Payer: BCN Medicare Advantage |
$679.00
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cash Price |
$1,942.40
|
| Rate for Payer: Cofinity Commercial |
$977.76
|
| Rate for Payer: Cofinity Commercial |
$909.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$679.00
|
| Rate for Payer: Healthscope Commercial |
$1,256.15
|
| Rate for Payer: Healthscope Commercial |
$1,086.40
|
| Rate for Payer: Mclaren Medicaid |
$444.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$712.95
|
| Rate for Payer: Meridian Medicaid |
$466.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$746.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,321.33
|
| Rate for Payer: Nomi Health Commercial |
$814.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,821.00
|
| Rate for Payer: PACE SWMI |
$679.00
|
| Rate for Payer: PHP Medicare Advantage |
$679.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,213.18
|
| Rate for Payer: Priority Health Medicare |
$679.00
|
| Rate for Payer: Priority Health SBD |
$1,213.18
|
| Rate for Payer: Priority Health Tiered Network |
$1,213.18
|
| Rate for Payer: Railroad Medicare Medicare |
$679.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,299.29
|
| Rate for Payer: UHC Core |
$1,299.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$679.00
|
| Rate for Payer: UHC Exchange |
$1,299.29
|
| Rate for Payer: UHC Medicaid |
$444.11
|
| Rate for Payer: UHCCP Medicaid |
$444.11
|
|
|
PR TENODESIS PROXIMAL INTERPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$2,042.00
|
|
|
Service Code
|
HCPCS 26471
|
| Min. Negotiated Rate |
$410.45 |
| Max. Negotiated Rate |
$1,531.50 |
| Rate for Payer: Aetna Commercial |
$820.17
|
| Rate for Payer: Aetna Medicare |
$636.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$820.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$881.38
|
| Rate for Payer: BCBS Complete |
$430.97
|
| Rate for Payer: BCBS MAPPO |
$612.07
|
| Rate for Payer: BCN Commercial |
$998.45
|
| Rate for Payer: BCN Medicare Advantage |
$612.07
|
| Rate for Payer: Cash Price |
$1,633.60
|
| Rate for Payer: Cash Price |
$1,633.60
|
| Rate for Payer: Cofinity Commercial |
$881.38
|
| Rate for Payer: Cofinity Commercial |
$820.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$612.07
|
| Rate for Payer: Healthscope Commercial |
$979.31
|
| Rate for Payer: Healthscope Commercial |
$1,132.33
|
| Rate for Payer: Mclaren Medicaid |
$410.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$642.67
|
| Rate for Payer: Meridian Medicaid |
$430.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$673.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,160.73
|
| Rate for Payer: Nomi Health Commercial |
$734.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,531.50
|
| Rate for Payer: PACE SWMI |
$612.07
|
| Rate for Payer: PHP Medicare Advantage |
$612.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,067.32
|
| Rate for Payer: Priority Health Medicare |
$612.07
|
| Rate for Payer: Priority Health SBD |
$1,067.32
|
| Rate for Payer: Priority Health Tiered Network |
$1,067.32
|
| Rate for Payer: Railroad Medicare Medicare |
$612.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,076.40
|
| Rate for Payer: UHC Core |
$1,076.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$612.07
|
| Rate for Payer: UHC Exchange |
$1,076.40
|
| Rate for Payer: UHC Medicaid |
$410.45
|
| Rate for Payer: UHCCP Medicaid |
$410.45
|
|
|
PR TENODESIS WRIST EXTENSORS FINGERS
|
Professional
|
Both
|
$1,350.00
|
|
|
Service Code
|
HCPCS 25301
|
| Min. Negotiated Rate |
$382.12 |
| Max. Negotiated Rate |
$1,144.10 |
| Rate for Payer: Aetna Commercial |
$781.47
|
| Rate for Payer: Aetna Medicare |
$606.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$781.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$839.79
|
| Rate for Payer: BCBS Complete |
$401.23
|
| Rate for Payer: BCBS MAPPO |
$583.19
|
| Rate for Payer: BCN Commercial |
$987.00
|
| Rate for Payer: BCN Medicare Advantage |
$583.19
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cofinity Commercial |
$839.79
|
| Rate for Payer: Cofinity Commercial |
$781.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$583.19
|
| Rate for Payer: Healthscope Commercial |
$933.10
|
| Rate for Payer: Healthscope Commercial |
$1,078.90
|
| Rate for Payer: Mclaren Medicaid |
$382.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$612.35
|
| Rate for Payer: Meridian Medicaid |
$401.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$641.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,144.10
|
| Rate for Payer: Nomi Health Commercial |
$699.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,012.50
|
| Rate for Payer: PACE SWMI |
$583.19
|
| Rate for Payer: PHP Medicare Advantage |
$583.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$382.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,055.08
|
| Rate for Payer: Priority Health Medicare |
$583.19
|
| Rate for Payer: Priority Health SBD |
$1,055.08
|
| Rate for Payer: Priority Health Tiered Network |
$1,055.08
|
| Rate for Payer: Railroad Medicare Medicare |
$583.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,119.36
|
| Rate for Payer: UHC Core |
$1,119.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$583.19
|
| Rate for Payer: UHC Exchange |
$1,119.36
|
| Rate for Payer: UHC Medicaid |
$382.12
|
| Rate for Payer: UHCCP Medicaid |
$382.12
|
|
|
PR TENOLYSIS CPLX XTNSR TENDON FINGER W/FOREARM EA
|
Professional
|
Both
|
$1,899.00
|
|
|
Service Code
|
HCPCS 26449
|
| Min. Negotiated Rate |
$421.31 |
| Max. Negotiated Rate |
$1,424.25 |
| Rate for Payer: Aetna Commercial |
$855.99
|
| Rate for Payer: Aetna Medicare |
$664.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$855.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$919.87
|
| Rate for Payer: BCBS Complete |
$442.38
|
| Rate for Payer: BCBS MAPPO |
$638.80
|
| Rate for Payer: BCN Commercial |
$1,077.13
|
| Rate for Payer: BCN Medicare Advantage |
$638.80
|
| Rate for Payer: Cash Price |
$1,519.20
|
| Rate for Payer: Cash Price |
$1,519.20
|
| Rate for Payer: Cofinity Commercial |
$919.87
|
| Rate for Payer: Cofinity Commercial |
$855.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$638.80
|
| Rate for Payer: Healthscope Commercial |
$1,181.78
|
| Rate for Payer: Healthscope Commercial |
$1,022.08
|
| Rate for Payer: Mclaren Medicaid |
$421.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$670.74
|
| Rate for Payer: Meridian Medicaid |
$442.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$702.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,237.14
|
| Rate for Payer: Nomi Health Commercial |
$766.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,424.25
|
| Rate for Payer: PACE SWMI |
$638.80
|
| Rate for Payer: PHP Medicare Advantage |
$638.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$421.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,151.42
|
| Rate for Payer: Priority Health Medicare |
$638.80
|
| Rate for Payer: Priority Health SBD |
$1,151.42
|
| Rate for Payer: Priority Health Tiered Network |
$1,151.42
|
| Rate for Payer: Railroad Medicare Medicare |
$638.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,201.47
|
| Rate for Payer: UHC Core |
$1,201.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$638.80
|
| Rate for Payer: UHC Exchange |
$1,201.47
|
| Rate for Payer: UHC Medicaid |
$421.31
|
| Rate for Payer: UHCCP Medicaid |
$421.31
|
|
|
PR TENOLYSIS EXTENSOR FOOT MULTIPLE TENDON
|
Professional
|
Both
|
$820.00
|
|
|
Service Code
|
HCPCS 28226
|
| Min. Negotiated Rate |
$249.21 |
| Max. Negotiated Rate |
$704.97 |
| Rate for Payer: Aetna Commercial |
$505.29
|
| Rate for Payer: Aetna Medicare |
$392.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$543.00
|
| Rate for Payer: BCBS Complete |
$261.67
|
| Rate for Payer: BCBS MAPPO |
$377.08
|
| Rate for Payer: BCN Commercial |
$614.51
|
| Rate for Payer: BCN Medicare Advantage |
$377.08
|
| Rate for Payer: Cash Price |
$656.00
|
| Rate for Payer: Cash Price |
$656.00
|
| Rate for Payer: Cofinity Commercial |
$543.00
|
| Rate for Payer: Cofinity Commercial |
$505.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$377.08
|
| Rate for Payer: Healthscope Commercial |
$697.60
|
| Rate for Payer: Healthscope Commercial |
$603.33
|
| Rate for Payer: Mclaren Medicaid |
$249.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$395.93
|
| Rate for Payer: Meridian Medicaid |
$261.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$414.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$704.97
|
| Rate for Payer: Nomi Health Commercial |
$452.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$615.00
|
| Rate for Payer: PACE SWMI |
$377.08
|
| Rate for Payer: PHP Medicare Advantage |
$377.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$656.90
|
| Rate for Payer: Priority Health Medicare |
$377.08
|
| Rate for Payer: Priority Health SBD |
$656.90
|
| Rate for Payer: Priority Health Tiered Network |
$656.90
|
| Rate for Payer: Railroad Medicare Medicare |
$377.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$681.87
|
| Rate for Payer: UHC Core |
$681.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$377.08
|
| Rate for Payer: UHC Exchange |
$681.87
|
| Rate for Payer: UHC Medicaid |
$249.21
|
| Rate for Payer: UHCCP Medicaid |
$249.21
|
|
|
PR TENOLYSIS EXTENSOR FOOT SINGLE TENDON
|
Professional
|
Both
|
$670.00
|
|
|
Service Code
|
HCPCS 28225
|
| Min. Negotiated Rate |
$160.18 |
| Max. Negotiated Rate |
$502.50 |
| Rate for Payer: Aetna Commercial |
$325.43
|
| Rate for Payer: Aetna Medicare |
$252.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$349.72
|
| Rate for Payer: BCBS Complete |
$168.19
|
| Rate for Payer: BCBS MAPPO |
$242.86
|
| Rate for Payer: BCN Commercial |
$404.86
|
| Rate for Payer: BCN Medicare Advantage |
$242.86
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Cofinity Commercial |
$349.72
|
| Rate for Payer: Cofinity Commercial |
$325.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.86
|
| Rate for Payer: Healthscope Commercial |
$449.29
|
| Rate for Payer: Healthscope Commercial |
$388.58
|
| Rate for Payer: Mclaren Medicaid |
$160.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$255.00
|
| Rate for Payer: Meridian Medicaid |
$168.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$267.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$462.42
|
| Rate for Payer: Nomi Health Commercial |
$291.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$502.50
|
| Rate for Payer: PACE SWMI |
$242.86
|
| Rate for Payer: PHP Medicare Advantage |
$242.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$432.79
|
| Rate for Payer: Priority Health Medicare |
$242.86
|
| Rate for Payer: Priority Health SBD |
$432.79
|
| Rate for Payer: Priority Health Tiered Network |
$432.79
|
| Rate for Payer: Railroad Medicare Medicare |
$242.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$458.40
|
| Rate for Payer: UHC Core |
$458.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$242.86
|
| Rate for Payer: UHC Exchange |
$458.40
|
| Rate for Payer: UHC Medicaid |
$160.18
|
| Rate for Payer: UHCCP Medicaid |
$160.18
|
|
|
PR TENOLYSIS EXTENSOR TENDON HAND/FINGER EACH
|
Professional
|
Both
|
$1,266.00
|
|
|
Service Code
|
HCPCS 26445
|
| Min. Negotiated Rate |
$385.74 |
| Max. Negotiated Rate |
$1,062.09 |
| Rate for Payer: Aetna Commercial |
$764.95
|
| Rate for Payer: Aetna Medicare |
$593.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$764.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$822.04
|
| Rate for Payer: BCBS Complete |
$405.03
|
| Rate for Payer: BCBS MAPPO |
$570.86
|
| Rate for Payer: BCN Commercial |
$909.32
|
| Rate for Payer: BCN Medicare Advantage |
$570.86
|
| Rate for Payer: Cash Price |
$1,012.80
|
| Rate for Payer: Cash Price |
$1,012.80
|
| Rate for Payer: Cofinity Commercial |
$822.04
|
| Rate for Payer: Cofinity Commercial |
$764.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$570.86
|
| Rate for Payer: Healthscope Commercial |
$913.38
|
| Rate for Payer: Healthscope Commercial |
$1,056.09
|
| Rate for Payer: Mclaren Medicaid |
$385.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$599.40
|
| Rate for Payer: Meridian Medicaid |
$405.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$627.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,062.09
|
| Rate for Payer: Nomi Health Commercial |
$685.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$949.50
|
| Rate for Payer: PACE SWMI |
$570.86
|
| Rate for Payer: PHP Medicare Advantage |
$570.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$972.04
|
| Rate for Payer: Priority Health Medicare |
$570.86
|
| Rate for Payer: Priority Health SBD |
$972.04
|
| Rate for Payer: Priority Health Tiered Network |
$972.04
|
| Rate for Payer: Railroad Medicare Medicare |
$570.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$993.80
|
| Rate for Payer: UHC Core |
$993.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$570.86
|
| Rate for Payer: UHC Exchange |
$993.80
|
| Rate for Payer: UHC Medicaid |
$385.74
|
| Rate for Payer: UHCCP Medicaid |
$385.74
|
|
|
PR TENOLYSIS FLEXOR FOOT MULTIPLE TENDONS
|
Professional
|
Both
|
$862.00
|
|
|
Service Code
|
HCPCS 28222
|
| Min. Negotiated Rate |
$222.59 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna Commercial |
$454.90
|
| Rate for Payer: Aetna Medicare |
$353.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$454.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$488.85
|
| Rate for Payer: BCBS Complete |
$233.72
|
| Rate for Payer: BCBS MAPPO |
$339.48
|
| Rate for Payer: BCN Commercial |
$561.72
|
| Rate for Payer: BCN Medicare Advantage |
$339.48
|
| Rate for Payer: Cash Price |
$689.60
|
| Rate for Payer: Cash Price |
$689.60
|
| Rate for Payer: Cofinity Commercial |
$488.85
|
| Rate for Payer: Cofinity Commercial |
$454.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.48
|
| Rate for Payer: Healthscope Commercial |
$628.04
|
| Rate for Payer: Healthscope Commercial |
$543.17
|
| Rate for Payer: Mclaren Medicaid |
$222.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.45
|
| Rate for Payer: Meridian Medicaid |
$233.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$373.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$640.58
|
| Rate for Payer: Nomi Health Commercial |
$407.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$646.50
|
| Rate for Payer: PACE SWMI |
$339.48
|
| Rate for Payer: PHP Medicare Advantage |
$339.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$600.47
|
| Rate for Payer: Priority Health Medicare |
$339.48
|
| Rate for Payer: Priority Health SBD |
$600.47
|
| Rate for Payer: Priority Health Tiered Network |
$600.47
|
| Rate for Payer: Railroad Medicare Medicare |
$339.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$624.83
|
| Rate for Payer: UHC Core |
$624.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$339.48
|
| Rate for Payer: UHC Exchange |
$624.83
|
| Rate for Payer: UHC Medicaid |
$222.59
|
| Rate for Payer: UHCCP Medicaid |
$222.59
|
|
