|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Professional
|
Both
|
$1,551.00
|
|
|
Service Code
|
HCPCS 27380
|
| Min. Negotiated Rate |
$595.26 |
| Max. Negotiated Rate |
$1,101.23 |
| Rate for Payer: Aetna Commercial |
$797.65
|
| Rate for Payer: Aetna Medicare |
$619.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$857.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$797.65
|
| Rate for Payer: BCBS Complete |
$620.40
|
| Rate for Payer: BCBS MAPPO |
$595.26
|
| Rate for Payer: BCN Medicare Advantage |
$595.26
|
| Rate for Payer: Cash Price |
$1,240.80
|
| Rate for Payer: Cash Price |
$1,240.80
|
| Rate for Payer: Cofinity Commercial |
$857.17
|
| Rate for Payer: Cofinity Commercial |
$797.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$595.26
|
| Rate for Payer: Healthscope Commercial |
$1,101.23
|
| Rate for Payer: Healthscope Commercial |
$952.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$625.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,008.15
|
| Rate for Payer: Nomi Health Commercial |
$714.31
|
| Rate for Payer: PACE SWMI |
$595.26
|
| Rate for Payer: PHP Medicare Advantage |
$595.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.15
|
| Rate for Payer: Priority Health Medicare |
$595.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$595.26
|
| Rate for Payer: UHC Medicare Advantage |
$595.26
|
|
|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Facility
|
OP
|
$1,551.00
|
|
|
Service Code
|
CPT 27380
|
| Hospital Charge Code |
27380
|
| Min. Negotiated Rate |
$977.13 |
| Max. Negotiated Rate |
$19,611.80 |
| Rate for Payer: Aetna Commercial |
$1,318.35
|
| Rate for Payer: Aetna Medicare |
$7,245.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,008.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,708.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,708.92
|
| Rate for Payer: BCBS Complete |
$3,921.11
|
| Rate for Payer: BCBS MAPPO |
$6,967.14
|
| Rate for Payer: BCN Medicare Advantage |
$6,967.14
|
| Rate for Payer: Cash Price |
$1,240.80
|
| Rate for Payer: Cash Price |
$1,240.80
|
| Rate for Payer: Cofinity Commercial |
$1,333.86
|
| Rate for Payer: Cofinity Commercial |
$1,085.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,085.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,240.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,967.14
|
| Rate for Payer: Healthscope Commercial |
$1,395.90
|
| Rate for Payer: Mclaren Medicaid |
$3,734.39
|
| Rate for Payer: Mclaren Medicare |
$6,967.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,315.50
|
| Rate for Payer: Meridian Medicaid |
$3,921.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,012.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,318.35
|
| Rate for Payer: PACE Medicare |
$6,618.78
|
| Rate for Payer: PACE SWMI |
$6,967.14
|
| Rate for Payer: PHP Commercial |
$1,318.35
|
| Rate for Payer: PHP Medicare Advantage |
$6,967.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,734.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.15
|
| Rate for Payer: Priority Health Medicare |
$6,967.14
|
| Rate for Payer: Priority Health SBD |
$977.13
|
| Rate for Payer: Railroad Medicare Medicare |
$6,967.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,611.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,967.14
|
| Rate for Payer: UHC Medicare Advantage |
$6,967.14
|
| Rate for Payer: UHCCP Medicaid |
$3,922.50
|
| Rate for Payer: VA VA |
$6,967.14
|
|
|
PR SUTURE MESENTERY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,979.00
|
|
|
Service Code
|
HCPCS 44850
|
| Min. Negotiated Rate |
$725.87 |
| Max. Negotiated Rate |
$1,342.86 |
| Rate for Payer: Aetna Commercial |
$972.67
|
| Rate for Payer: Aetna Medicare |
$754.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$972.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,045.25
|
| Rate for Payer: BCBS Complete |
$791.60
|
| Rate for Payer: BCBS MAPPO |
$725.87
|
| Rate for Payer: BCN Medicare Advantage |
$725.87
|
| Rate for Payer: Cash Price |
$1,583.20
|
| Rate for Payer: Cash Price |
$1,583.20
|
| Rate for Payer: Cofinity Commercial |
$972.67
|
| Rate for Payer: Cofinity Commercial |
$1,045.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$725.87
|
| Rate for Payer: Healthscope Commercial |
$1,342.86
|
| Rate for Payer: Healthscope Commercial |
$1,161.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$762.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,286.35
|
| Rate for Payer: Nomi Health Commercial |
$871.04
|
| Rate for Payer: PACE SWMI |
$725.87
|
| Rate for Payer: PHP Medicare Advantage |
$725.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,286.35
|
| Rate for Payer: Priority Health Medicare |
$725.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$725.87
|
| Rate for Payer: UHC Medicare Advantage |
$725.87
|
|
|
PR SUTURE NERVE REQ SECONDARY/DELAYED SUTURE
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
HCPCS 64872
|
| Min. Negotiated Rate |
$80.80 |
| Max. Negotiated Rate |
$204.94 |
| Rate for Payer: Aetna Commercial |
$148.45
|
| Rate for Payer: Aetna Medicare |
$115.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.45
|
| Rate for Payer: BCBS Complete |
$80.80
|
| Rate for Payer: BCBS MAPPO |
$110.78
|
| Rate for Payer: BCN Medicare Advantage |
$110.78
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cofinity Commercial |
$159.52
|
| Rate for Payer: Cofinity Commercial |
$148.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.78
|
| Rate for Payer: Healthscope Commercial |
$177.25
|
| Rate for Payer: Healthscope Commercial |
$204.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$116.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.30
|
| Rate for Payer: Nomi Health Commercial |
$132.94
|
| Rate for Payer: PACE SWMI |
$110.78
|
| Rate for Payer: PHP Medicare Advantage |
$110.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.30
|
| Rate for Payer: Priority Health Medicare |
$110.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.78
|
| Rate for Payer: UHC Medicare Advantage |
$110.78
|
|
|
PR SUTURE NERVE REQ XTNSV MOBIL/TRPOS NERVE
|
Professional
|
Both
|
$310.00
|
|
|
Service Code
|
HCPCS 64874
|
| Min. Negotiated Rate |
$124.00 |
| Max. Negotiated Rate |
$306.73 |
| Rate for Payer: Aetna Commercial |
$222.17
|
| Rate for Payer: Aetna Medicare |
$172.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.17
|
| Rate for Payer: BCBS Complete |
$124.00
|
| Rate for Payer: BCBS MAPPO |
$165.80
|
| Rate for Payer: BCN Medicare Advantage |
$165.80
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cofinity Commercial |
$238.75
|
| Rate for Payer: Cofinity Commercial |
$222.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.80
|
| Rate for Payer: Healthscope Commercial |
$306.73
|
| Rate for Payer: Healthscope Commercial |
$265.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.50
|
| Rate for Payer: Nomi Health Commercial |
$198.96
|
| Rate for Payer: PACE SWMI |
$165.80
|
| Rate for Payer: PHP Medicare Advantage |
$165.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.50
|
| Rate for Payer: Priority Health Medicare |
$165.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.80
|
| Rate for Payer: UHC Medicare Advantage |
$165.80
|
|
|
PR SUTURE PHARYNX WOUND/INJURY
|
Professional
|
Both
|
$623.00
|
|
|
Service Code
|
HCPCS 42900
|
| Min. Negotiated Rate |
$249.20 |
| Max. Negotiated Rate |
$587.04 |
| Rate for Payer: Aetna Commercial |
$425.21
|
| Rate for Payer: Aetna Medicare |
$330.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$456.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$425.21
|
| Rate for Payer: BCBS Complete |
$249.20
|
| Rate for Payer: BCBS MAPPO |
$317.32
|
| Rate for Payer: BCN Medicare Advantage |
$317.32
|
| Rate for Payer: Cash Price |
$498.40
|
| Rate for Payer: Cash Price |
$498.40
|
| Rate for Payer: Cofinity Commercial |
$456.94
|
| Rate for Payer: Cofinity Commercial |
$425.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$317.32
|
| Rate for Payer: Healthscope Commercial |
$507.71
|
| Rate for Payer: Healthscope Commercial |
$587.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$333.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$404.95
|
| Rate for Payer: Nomi Health Commercial |
$380.78
|
| Rate for Payer: PACE SWMI |
$317.32
|
| Rate for Payer: PHP Medicare Advantage |
$317.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.95
|
| Rate for Payer: Priority Health Medicare |
$317.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$317.32
|
| Rate for Payer: UHC Medicare Advantage |
$317.32
|
|
|
PR SUTURE POSTERIOR TIBIAL NERVE
|
Professional
|
Both
|
$1,979.00
|
|
|
Service Code
|
HCPCS 64840
|
| Min. Negotiated Rate |
$791.60 |
| Max. Negotiated Rate |
$1,716.97 |
| Rate for Payer: Aetna Commercial |
$1,243.64
|
| Rate for Payer: Aetna Medicare |
$965.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,336.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,243.64
|
| Rate for Payer: BCBS Complete |
$791.60
|
| Rate for Payer: BCBS MAPPO |
$928.09
|
| Rate for Payer: BCN Medicare Advantage |
$928.09
|
| Rate for Payer: Cash Price |
$1,583.20
|
| Rate for Payer: Cash Price |
$1,583.20
|
| Rate for Payer: Cofinity Commercial |
$1,336.45
|
| Rate for Payer: Cofinity Commercial |
$1,243.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$928.09
|
| Rate for Payer: Healthscope Commercial |
$1,716.97
|
| Rate for Payer: Healthscope Commercial |
$1,484.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$974.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,286.35
|
| Rate for Payer: Nomi Health Commercial |
$1,113.71
|
| Rate for Payer: PACE SWMI |
$928.09
|
| Rate for Payer: PHP Medicare Advantage |
$928.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,286.35
|
| Rate for Payer: Priority Health Medicare |
$928.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$928.09
|
| Rate for Payer: UHC Medicare Advantage |
$928.09
|
|
|
PR SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY
|
Facility
|
OP
|
$1,903.00
|
|
|
Service Code
|
CPT 27385
|
| Hospital Charge Code |
27385
|
| Min. Negotiated Rate |
$1,198.89 |
| Max. Negotiated Rate |
$19,611.80 |
| Rate for Payer: Aetna Commercial |
$1,617.55
|
| Rate for Payer: Aetna Medicare |
$7,245.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,708.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,708.92
|
| Rate for Payer: BCBS Complete |
$3,921.11
|
| Rate for Payer: BCBS MAPPO |
$6,967.14
|
| Rate for Payer: BCN Medicare Advantage |
$6,967.14
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cofinity Commercial |
$1,332.10
|
| Rate for Payer: Cofinity Commercial |
$1,636.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,332.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,967.14
|
| Rate for Payer: Healthscope Commercial |
$1,712.70
|
| Rate for Payer: Mclaren Medicaid |
$3,734.39
|
| Rate for Payer: Mclaren Medicare |
$6,967.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,315.50
|
| Rate for Payer: Meridian Medicaid |
$3,921.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,012.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,617.55
|
| Rate for Payer: PACE Medicare |
$6,618.78
|
| Rate for Payer: PACE SWMI |
$6,967.14
|
| Rate for Payer: PHP Commercial |
$1,617.55
|
| Rate for Payer: PHP Medicare Advantage |
$6,967.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,734.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,236.95
|
| Rate for Payer: Priority Health Medicare |
$6,967.14
|
| Rate for Payer: Priority Health SBD |
$1,198.89
|
| Rate for Payer: Railroad Medicare Medicare |
$6,967.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,611.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,967.14
|
| Rate for Payer: UHC Medicare Advantage |
$6,967.14
|
| Rate for Payer: UHCCP Medicaid |
$3,922.50
|
| Rate for Payer: VA VA |
$6,967.14
|
|
|
PR SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY
|
Professional
|
Both
|
$1,903.00
|
|
|
Service Code
|
HCPCS 27385
|
| Hospital Charge Code |
27385
|
| Min. Negotiated Rate |
$579.36 |
| Max. Negotiated Rate |
$1,236.95 |
| Rate for Payer: Aetna Commercial |
$776.34
|
| Rate for Payer: Aetna Medicare |
$602.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$776.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$834.28
|
| Rate for Payer: BCBS Complete |
$761.20
|
| Rate for Payer: BCBS MAPPO |
$579.36
|
| Rate for Payer: BCN Medicare Advantage |
$579.36
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cofinity Commercial |
$834.28
|
| Rate for Payer: Cofinity Commercial |
$776.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$579.36
|
| Rate for Payer: Healthscope Commercial |
$1,071.82
|
| Rate for Payer: Healthscope Commercial |
$926.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$608.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,236.95
|
| Rate for Payer: Nomi Health Commercial |
$695.23
|
| Rate for Payer: PACE SWMI |
$579.36
|
| Rate for Payer: PHP Medicare Advantage |
$579.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,236.95
|
| Rate for Payer: Priority Health Medicare |
$579.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$579.36
|
| Rate for Payer: UHC Medicare Advantage |
$579.36
|
|
|
PR SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY
|
Facility
|
IP
|
$1,903.00
|
|
|
Service Code
|
CPT 27385
|
| Hospital Charge Code |
27385
|
| Min. Negotiated Rate |
$1,198.89 |
| Max. Negotiated Rate |
$1,712.70 |
| Rate for Payer: Aetna Commercial |
$1,617.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.95
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cofinity Commercial |
$1,332.10
|
| Rate for Payer: Cofinity Commercial |
$1,636.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,332.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.40
|
| Rate for Payer: Healthscope Commercial |
$1,712.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,617.55
|
| Rate for Payer: PHP Commercial |
$1,617.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,236.95
|
| Rate for Payer: Priority Health SBD |
$1,198.89
|
|
|
PR SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY
|
Professional
|
Both
|
$1,903.00
|
|
|
Service Code
|
HCPCS 27385
|
| Min. Negotiated Rate |
$579.36 |
| Max. Negotiated Rate |
$1,236.95 |
| Rate for Payer: Aetna Commercial |
$776.34
|
| Rate for Payer: Aetna Medicare |
$602.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$834.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$776.34
|
| Rate for Payer: BCBS Complete |
$761.20
|
| Rate for Payer: BCBS MAPPO |
$579.36
|
| Rate for Payer: BCN Medicare Advantage |
$579.36
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cash Price |
$1,522.40
|
| Rate for Payer: Cofinity Commercial |
$834.28
|
| Rate for Payer: Cofinity Commercial |
$776.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$579.36
|
| Rate for Payer: Healthscope Commercial |
$1,071.82
|
| Rate for Payer: Healthscope Commercial |
$926.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$608.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,236.95
|
| Rate for Payer: Nomi Health Commercial |
$695.23
|
| Rate for Payer: PACE SWMI |
$579.36
|
| Rate for Payer: PHP Medicare Advantage |
$579.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,236.95
|
| Rate for Payer: Priority Health Medicare |
$579.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$579.36
|
| Rate for Payer: UHC Medicare Advantage |
$579.36
|
|
|
PR SUTURE REPAIR AORTA/GREAT VESSEL W/BYPASS
|
Professional
|
Both
|
$5,688.00
|
|
|
Service Code
|
HCPCS 33322
|
| Min. Negotiated Rate |
$1,330.91 |
| Max. Negotiated Rate |
$3,697.20 |
| Rate for Payer: Aetna Commercial |
$1,783.42
|
| Rate for Payer: Aetna Medicare |
$1,384.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,916.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,783.42
|
| Rate for Payer: BCBS Complete |
$2,275.20
|
| Rate for Payer: BCBS MAPPO |
$1,330.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,330.91
|
| Rate for Payer: Cash Price |
$4,550.40
|
| Rate for Payer: Cash Price |
$4,550.40
|
| Rate for Payer: Cofinity Commercial |
$1,916.51
|
| Rate for Payer: Cofinity Commercial |
$1,783.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,330.91
|
| Rate for Payer: Healthscope Commercial |
$2,462.18
|
| Rate for Payer: Healthscope Commercial |
$2,129.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,397.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,697.20
|
| Rate for Payer: Nomi Health Commercial |
$1,597.09
|
| Rate for Payer: PACE SWMI |
$1,330.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,330.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,697.20
|
| Rate for Payer: Priority Health Medicare |
$1,330.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,330.91
|
| Rate for Payer: UHC Medicare Advantage |
$1,330.91
|
|
|
PR SUTURE/REPAIR TESTICULAR INJURY
|
Professional
|
Both
|
$1,256.00
|
|
|
Service Code
|
HCPCS 54670
|
| Min. Negotiated Rate |
$391.41 |
| Max. Negotiated Rate |
$816.40 |
| Rate for Payer: Aetna Commercial |
$524.49
|
| Rate for Payer: Aetna Medicare |
$407.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$563.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$524.49
|
| Rate for Payer: BCBS Complete |
$502.40
|
| Rate for Payer: BCBS MAPPO |
$391.41
|
| Rate for Payer: BCN Medicare Advantage |
$391.41
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cash Price |
$1,004.80
|
| Rate for Payer: Cofinity Commercial |
$563.63
|
| Rate for Payer: Cofinity Commercial |
$524.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.41
|
| Rate for Payer: Healthscope Commercial |
$626.26
|
| Rate for Payer: Healthscope Commercial |
$724.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$410.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$816.40
|
| Rate for Payer: Nomi Health Commercial |
$469.69
|
| Rate for Payer: PACE SWMI |
$391.41
|
| Rate for Payer: PHP Medicare Advantage |
$391.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$816.40
|
| Rate for Payer: Priority Health Medicare |
$391.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.41
|
| Rate for Payer: UHC Medicare Advantage |
$391.41
|
|
|
PR SUTURE SCIATIC NERVE
|
Professional
|
Both
|
$2,500.00
|
|
|
Service Code
|
HCPCS 64858
|
| Min. Negotiated Rate |
$1,000.00 |
| Max. Negotiated Rate |
$2,092.87 |
| Rate for Payer: Aetna Commercial |
$1,515.92
|
| Rate for Payer: Aetna Medicare |
$1,176.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,629.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,515.92
|
| Rate for Payer: BCBS Complete |
$1,000.00
|
| Rate for Payer: BCBS MAPPO |
$1,131.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,131.28
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cofinity Commercial |
$1,629.04
|
| Rate for Payer: Cofinity Commercial |
$1,515.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,131.28
|
| Rate for Payer: Healthscope Commercial |
$2,092.87
|
| Rate for Payer: Healthscope Commercial |
$1,810.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,187.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,625.00
|
| Rate for Payer: Nomi Health Commercial |
$1,357.54
|
| Rate for Payer: PACE SWMI |
$1,131.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,131.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,625.00
|
| Rate for Payer: Priority Health Medicare |
$1,131.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,131.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,131.28
|
|
|
PR SUTURE TRACHEAL WOUND/INJURY CERVICAL
|
Professional
|
Both
|
$1,589.00
|
|
|
Service Code
|
HCPCS 31800
|
| Min. Negotiated Rate |
$635.60 |
| Max. Negotiated Rate |
$1,217.63 |
| Rate for Payer: Aetna Commercial |
$881.96
|
| Rate for Payer: Aetna Medicare |
$684.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$947.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$881.96
|
| Rate for Payer: BCBS Complete |
$635.60
|
| Rate for Payer: BCBS MAPPO |
$658.18
|
| Rate for Payer: BCN Medicare Advantage |
$658.18
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cash Price |
$1,271.20
|
| Rate for Payer: Cofinity Commercial |
$947.78
|
| Rate for Payer: Cofinity Commercial |
$881.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.18
|
| Rate for Payer: Healthscope Commercial |
$1,053.09
|
| Rate for Payer: Healthscope Commercial |
$1,217.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$691.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,032.85
|
| Rate for Payer: Nomi Health Commercial |
$789.82
|
| Rate for Payer: PACE SWMI |
$658.18
|
| Rate for Payer: PHP Medicare Advantage |
$658.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.85
|
| Rate for Payer: Priority Health Medicare |
$658.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$658.18
|
| Rate for Payer: UHC Medicare Advantage |
$658.18
|
|
|
PR SUTURE TRACHEAL WOUND/INJURY INTRATHORACIC
|
Professional
|
Both
|
$1,671.00
|
|
|
Service Code
|
HCPCS 31805
|
| Min. Negotiated Rate |
$668.40 |
| Max. Negotiated Rate |
$1,455.80 |
| Rate for Payer: Aetna Commercial |
$1,054.47
|
| Rate for Payer: Aetna Medicare |
$818.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,133.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,054.47
|
| Rate for Payer: BCBS Complete |
$668.40
|
| Rate for Payer: BCBS MAPPO |
$786.92
|
| Rate for Payer: BCN Medicare Advantage |
$786.92
|
| Rate for Payer: Cash Price |
$1,336.80
|
| Rate for Payer: Cash Price |
$1,336.80
|
| Rate for Payer: Cofinity Commercial |
$1,133.16
|
| Rate for Payer: Cofinity Commercial |
$1,054.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$786.92
|
| Rate for Payer: Healthscope Commercial |
$1,259.07
|
| Rate for Payer: Healthscope Commercial |
$1,455.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,086.15
|
| Rate for Payer: Nomi Health Commercial |
$944.30
|
| Rate for Payer: PACE SWMI |
$786.92
|
| Rate for Payer: PHP Medicare Advantage |
$786.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,086.15
|
| Rate for Payer: Priority Health Medicare |
$786.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$786.92
|
| Rate for Payer: UHC Medicare Advantage |
$786.92
|
|
|
PR SVC PRV EMER BASIS IN OFFICE DISRUPTING SVCS
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 99058
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$37.05 |
| Rate for Payer: Aetna Medicare |
$28.50
|
| Rate for Payer: BCBS Complete |
$22.80
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
|
|
PR SVC PRV OFFICE REG SCHEDD EVN WKEND/HOLIDAY HRS
|
Professional
|
Both
|
$60.00
|
|
|
Service Code
|
HCPCS 99051
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$39.00 |
| Rate for Payer: Aetna Medicare |
$30.00
|
| Rate for Payer: BCBS Complete |
$24.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.00
|
|
|
PR SYMPATHECTOMY CERVICAL
|
Professional
|
Both
|
$1,729.00
|
|
|
Service Code
|
HCPCS 64802
|
| Min. Negotiated Rate |
$691.60 |
| Max. Negotiated Rate |
$1,548.28 |
| Rate for Payer: Aetna Commercial |
$1,121.46
|
| Rate for Payer: Aetna Medicare |
$870.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,205.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,121.46
|
| Rate for Payer: BCBS Complete |
$691.60
|
| Rate for Payer: BCBS MAPPO |
$836.91
|
| Rate for Payer: BCN Medicare Advantage |
$836.91
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cofinity Commercial |
$1,205.15
|
| Rate for Payer: Cofinity Commercial |
$1,121.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$836.91
|
| Rate for Payer: Healthscope Commercial |
$1,548.28
|
| Rate for Payer: Healthscope Commercial |
$1,339.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$878.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,123.85
|
| Rate for Payer: Nomi Health Commercial |
$1,004.29
|
| Rate for Payer: PACE SWMI |
$836.91
|
| Rate for Payer: PHP Medicare Advantage |
$836.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,123.85
|
| Rate for Payer: Priority Health Medicare |
$836.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$836.91
|
| Rate for Payer: UHC Medicare Advantage |
$836.91
|
|
|
PR SYMPATHECTOMY LUMBAR
|
Professional
|
Both
|
$319.00
|
|
|
Service Code
|
HCPCS 64818
|
| Min. Negotiated Rate |
$127.60 |
| Max. Negotiated Rate |
$1,389.72 |
| Rate for Payer: Aetna Commercial |
$1,006.61
|
| Rate for Payer: Aetna Medicare |
$781.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,081.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,006.61
|
| Rate for Payer: BCBS Complete |
$127.60
|
| Rate for Payer: BCBS MAPPO |
$751.20
|
| Rate for Payer: BCN Medicare Advantage |
$751.20
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cofinity Commercial |
$1,081.73
|
| Rate for Payer: Cofinity Commercial |
$1,006.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$751.20
|
| Rate for Payer: Healthscope Commercial |
$1,201.92
|
| Rate for Payer: Healthscope Commercial |
$1,389.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$788.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.35
|
| Rate for Payer: Nomi Health Commercial |
$901.44
|
| Rate for Payer: PACE SWMI |
$751.20
|
| Rate for Payer: PHP Medicare Advantage |
$751.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.35
|
| Rate for Payer: Priority Health Medicare |
$751.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$751.20
|
| Rate for Payer: UHC Medicare Advantage |
$751.20
|
|
|
PR SYMPHYSIOTOMY HORSESHOE KDN W/WO PLOP UNI/BI
|
Professional
|
Both
|
$2,168.00
|
|
|
Service Code
|
HCPCS 50540
|
| Min. Negotiated Rate |
$867.20 |
| Max. Negotiated Rate |
$2,022.77 |
| Rate for Payer: Aetna Commercial |
$1,465.14
|
| Rate for Payer: Aetna Medicare |
$1,137.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,574.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,465.14
|
| Rate for Payer: BCBS Complete |
$867.20
|
| Rate for Payer: BCBS MAPPO |
$1,093.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,093.39
|
| Rate for Payer: Cash Price |
$1,734.40
|
| Rate for Payer: Cash Price |
$1,734.40
|
| Rate for Payer: Cofinity Commercial |
$1,574.48
|
| Rate for Payer: Cofinity Commercial |
$1,465.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,093.39
|
| Rate for Payer: Healthscope Commercial |
$1,749.42
|
| Rate for Payer: Healthscope Commercial |
$2,022.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,148.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,409.20
|
| Rate for Payer: Nomi Health Commercial |
$1,312.07
|
| Rate for Payer: PACE SWMI |
$1,093.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,093.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.20
|
| Rate for Payer: Priority Health Medicare |
$1,093.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,093.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,093.39
|
|
|
PR SYNCHRONOUS AUDIO-ONLY VISIT EST HIGH MDM 40 MIN
|
Professional
|
Both
|
$355.00
|
|
|
Service Code
|
HCPCS 98015
|
| Min. Negotiated Rate |
$142.00 |
| Max. Negotiated Rate |
$230.75 |
| Rate for Payer: Aetna Medicare |
$177.50
|
| Rate for Payer: BCBS Complete |
$142.00
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.75
|
|
|
PR SYNCHRONOUS AUDIO-ONLY VISIT EST LOW MDM 20 MIN
|
Professional
|
Both
|
$162.00
|
|
|
Service Code
|
HCPCS 98013
|
| Min. Negotiated Rate |
$64.80 |
| Max. Negotiated Rate |
$105.30 |
| Rate for Payer: Aetna Medicare |
$81.00
|
| Rate for Payer: BCBS Complete |
$64.80
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.30
|
|
|
PR SYNCHRONOUS AUDIO-ONLY VISIT EST MOD MDM 30 MIN
|
Professional
|
Both
|
$241.00
|
|
|
Service Code
|
HCPCS 98014
|
| Min. Negotiated Rate |
$96.40 |
| Max. Negotiated Rate |
$156.65 |
| Rate for Payer: Aetna Medicare |
$120.50
|
| Rate for Payer: BCBS Complete |
$96.40
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.65
|
|
|
PR SYNCHRONOUS AUDIO-ONLY VISIT EST SF MDM 10 MIN
|
Professional
|
Both
|
$89.00
|
|
|
Service Code
|
HCPCS 98012
|
| Min. Negotiated Rate |
$35.60 |
| Max. Negotiated Rate |
$57.85 |
| Rate for Payer: Aetna Medicare |
$44.50
|
| Rate for Payer: BCBS Complete |
$35.60
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.85
|
|
