|
PR SUTR LG INTESTINE 1/MULT PERFORAT W/O COLOSTOMY
|
Professional
|
Both
|
$3,081.00
|
|
|
Service Code
|
HCPCS 44604
|
| Min. Negotiated Rate |
$54.94 |
| Max. Negotiated Rate |
$188,555.00 |
| Rate for Payer: Aetna Commercial |
$1,367.85
|
| Rate for Payer: Aetna Medicare |
$1,061.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,469.92
|
| Rate for Payer: BCBS Complete |
$708.30
|
| Rate for Payer: BCBS MAPPO |
$1,020.78
|
| Rate for Payer: BCBS Trust/PPO |
$54.94
|
| Rate for Payer: BCN Commercial |
$1,534.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,020.78
|
| Rate for Payer: Cash Price |
$2,464.80
|
| Rate for Payer: Cash Price |
$2,464.80
|
| Rate for Payer: Cofinity Commercial |
$1,469.92
|
| Rate for Payer: Cofinity Commercial |
$1,367.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,020.78
|
| Rate for Payer: Healthscope Commercial |
$1,888.44
|
| Rate for Payer: Healthscope Commercial |
$1,633.25
|
| Rate for Payer: Mclaren Medicaid |
$674.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,071.82
|
| Rate for Payer: Meridian Medicaid |
$708.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188,555.00
|
| Rate for Payer: Nomi Health Commercial |
$1,224.94
|
| Rate for Payer: PACE SWMI |
$1,020.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,020.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$674.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,002.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,881.05
|
| Rate for Payer: Priority Health Medicare |
$1,020.78
|
| Rate for Payer: Priority Health Narrow Network |
$1,881.05
|
| Rate for Payer: Priority Health SBD |
$1,881.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,035.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,020.78
|
| Rate for Payer: UHC Exchange |
$1,035.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,020.78
|
| Rate for Payer: UHCCP Medicaid |
$674.57
|
|
|
PR SUTR&/LIG THORACIC DUCT THORACIC APPROACH
|
Professional
|
Both
|
$5,927.00
|
|
|
Service Code
|
HCPCS 38381
|
| Min. Negotiated Rate |
$516.53 |
| Max. Negotiated Rate |
$142,706.00 |
| Rate for Payer: Aetna Commercial |
$1,045.51
|
| Rate for Payer: Aetna Medicare |
$811.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,045.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,123.53
|
| Rate for Payer: BCBS Complete |
$542.36
|
| Rate for Payer: BCBS MAPPO |
$780.23
|
| Rate for Payer: BCBS Trust/PPO |
$540.98
|
| Rate for Payer: BCN Commercial |
$1,163.05
|
| Rate for Payer: BCN Medicare Advantage |
$780.23
|
| Rate for Payer: Cash Price |
$4,741.60
|
| Rate for Payer: Cash Price |
$4,741.60
|
| Rate for Payer: Cofinity Commercial |
$1,123.53
|
| Rate for Payer: Cofinity Commercial |
$1,045.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$780.23
|
| Rate for Payer: Healthscope Commercial |
$1,443.43
|
| Rate for Payer: Healthscope Commercial |
$1,248.37
|
| Rate for Payer: Mclaren Medicaid |
$516.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$819.24
|
| Rate for Payer: Meridian Medicaid |
$542.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142,706.00
|
| Rate for Payer: Nomi Health Commercial |
$936.28
|
| Rate for Payer: PACE SWMI |
$780.23
|
| Rate for Payer: PHP Medicare Advantage |
$780.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$516.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,852.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,596.46
|
| Rate for Payer: Priority Health Medicare |
$780.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,596.46
|
| Rate for Payer: Priority Health SBD |
$1,596.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,024.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$780.23
|
| Rate for Payer: UHC Exchange |
$1,024.03
|
| Rate for Payer: UHC Medicare Advantage |
$780.23
|
| Rate for Payer: UHCCP Medicaid |
$516.53
|
|
|
PR SUTR NRV ITPRL W/WO GRF/DCMPRN LAT GENICULATE
|
Professional
|
Both
|
$2,055.00
|
|
|
Service Code
|
HCPCS 69740
|
| Min. Negotiated Rate |
$740.81 |
| Max. Negotiated Rate |
$205,546.00 |
| Rate for Payer: Aetna Commercial |
$1,462.68
|
| Rate for Payer: Aetna Medicare |
$1,135.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,462.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,571.83
|
| Rate for Payer: BCBS Complete |
$777.85
|
| Rate for Payer: BCBS MAPPO |
$1,091.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,902.94
|
| Rate for Payer: BCN Commercial |
$1,709.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,091.55
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Cofinity Commercial |
$1,571.83
|
| Rate for Payer: Cofinity Commercial |
$1,462.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,091.55
|
| Rate for Payer: Healthscope Commercial |
$2,019.37
|
| Rate for Payer: Healthscope Commercial |
$1,746.48
|
| Rate for Payer: Mclaren Medicaid |
$740.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,146.13
|
| Rate for Payer: Meridian Medicaid |
$777.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205,546.00
|
| Rate for Payer: Nomi Health Commercial |
$1,309.86
|
| Rate for Payer: PACE SWMI |
$1,091.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,091.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$740.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,335.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,699.40
|
| Rate for Payer: Priority Health Medicare |
$1,091.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,699.40
|
| Rate for Payer: Priority Health SBD |
$1,699.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,386.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,091.55
|
| Rate for Payer: UHC Exchange |
$1,386.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,091.55
|
| Rate for Payer: UHCCP Medicaid |
$740.81
|
|
|
PR SUTR PRPH NRV ARM/LEG XCP SCIATIC W/O TRPOS
|
Professional
|
Both
|
$3,175.00
|
|
|
Service Code
|
HCPCS 64857
|
| Min. Negotiated Rate |
$202.87 |
| Max. Negotiated Rate |
$186,714.00 |
| Rate for Payer: Aetna Commercial |
$1,351.18
|
| Rate for Payer: Aetna Medicare |
$1,048.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,351.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,452.01
|
| Rate for Payer: BCBS Complete |
$710.54
|
| Rate for Payer: BCBS MAPPO |
$1,008.34
|
| Rate for Payer: BCBS Trust/PPO |
$202.87
|
| Rate for Payer: BCN Commercial |
$1,539.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,008.34
|
| Rate for Payer: Cash Price |
$2,540.00
|
| Rate for Payer: Cash Price |
$2,540.00
|
| Rate for Payer: Cofinity Commercial |
$1,452.01
|
| Rate for Payer: Cofinity Commercial |
$1,351.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,008.34
|
| Rate for Payer: Healthscope Commercial |
$1,865.43
|
| Rate for Payer: Healthscope Commercial |
$1,613.34
|
| Rate for Payer: Mclaren Medicaid |
$676.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,058.76
|
| Rate for Payer: Meridian Medicaid |
$710.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186,714.00
|
| Rate for Payer: Nomi Health Commercial |
$1,210.01
|
| Rate for Payer: PACE SWMI |
$1,008.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,008.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$676.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,063.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,801.13
|
| Rate for Payer: Priority Health Medicare |
$1,008.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,801.13
|
| Rate for Payer: Priority Health SBD |
$1,801.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,179.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,008.34
|
| Rate for Payer: UHC Exchange |
$1,179.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,008.34
|
| Rate for Payer: UHCCP Medicaid |
$676.70
|
|
|
PR SUTR PRPH NRV ARM/LEG XCP SCIATIC W/TRPOS
|
Professional
|
Both
|
$3,953.00
|
|
|
Service Code
|
HCPCS 64856
|
| Min. Negotiated Rate |
$183.32 |
| Max. Negotiated Rate |
$179,689.00 |
| Rate for Payer: Aetna Commercial |
$1,306.22
|
| Rate for Payer: Aetna Medicare |
$1,013.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,306.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,403.70
|
| Rate for Payer: BCBS Complete |
$685.49
|
| Rate for Payer: BCBS MAPPO |
$974.79
|
| Rate for Payer: BCBS Trust/PPO |
$183.32
|
| Rate for Payer: BCN Commercial |
$1,480.20
|
| Rate for Payer: BCN Medicare Advantage |
$974.79
|
| Rate for Payer: Cash Price |
$3,162.40
|
| Rate for Payer: Cash Price |
$3,162.40
|
| Rate for Payer: Cofinity Commercial |
$1,403.70
|
| Rate for Payer: Cofinity Commercial |
$1,306.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$974.79
|
| Rate for Payer: Healthscope Commercial |
$1,803.36
|
| Rate for Payer: Healthscope Commercial |
$1,559.66
|
| Rate for Payer: Mclaren Medicaid |
$652.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,023.53
|
| Rate for Payer: Meridian Medicaid |
$685.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179,689.00
|
| Rate for Payer: Nomi Health Commercial |
$1,169.75
|
| Rate for Payer: PACE SWMI |
$974.79
|
| Rate for Payer: PHP Medicare Advantage |
$974.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$652.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,569.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,723.21
|
| Rate for Payer: Priority Health Medicare |
$974.79
|
| Rate for Payer: Priority Health Narrow Network |
$1,723.21
|
| Rate for Payer: Priority Health SBD |
$1,723.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,084.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$974.79
|
| Rate for Payer: UHC Exchange |
$1,084.23
|
| Rate for Payer: UHC Medicare Advantage |
$974.79
|
| Rate for Payer: UHCCP Medicaid |
$652.85
|
|
|
PR SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ
|
Professional
|
Both
|
$2,342.00
|
|
|
Service Code
|
HCPCS 27386
|
| Min. Negotiated Rate |
$557.00 |
| Max. Negotiated Rate |
$151,637.00 |
| Rate for Payer: Aetna Commercial |
$1,100.61
|
| Rate for Payer: Aetna Medicare |
$854.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,100.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,182.74
|
| Rate for Payer: BCBS Complete |
$584.85
|
| Rate for Payer: BCBS MAPPO |
$821.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,335.54
|
| Rate for Payer: BCN Commercial |
$1,261.27
|
| Rate for Payer: BCN Medicare Advantage |
$821.35
|
| Rate for Payer: Cash Price |
$1,873.60
|
| Rate for Payer: Cash Price |
$1,873.60
|
| Rate for Payer: Cofinity Commercial |
$1,182.74
|
| Rate for Payer: Cofinity Commercial |
$1,100.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$821.35
|
| Rate for Payer: Healthscope Commercial |
$1,519.50
|
| Rate for Payer: Healthscope Commercial |
$1,314.16
|
| Rate for Payer: Mclaren Medicaid |
$557.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$862.42
|
| Rate for Payer: Meridian Medicaid |
$584.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151,637.00
|
| Rate for Payer: Nomi Health Commercial |
$985.62
|
| Rate for Payer: PACE SWMI |
$821.35
|
| Rate for Payer: PHP Medicare Advantage |
$821.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$557.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,323.05
|
| Rate for Payer: Priority Health Medicare |
$821.35
|
| Rate for Payer: Priority Health Narrow Network |
$1,323.05
|
| Rate for Payer: Priority Health SBD |
$1,323.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$987.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$821.35
|
| Rate for Payer: UHC Exchange |
$987.64
|
| Rate for Payer: UHC Medicare Advantage |
$821.35
|
| Rate for Payer: UHCCP Medicaid |
$557.00
|
|
|
PR SUTR RPR AORTA/GRT VSL W/O SHUNT/CARD BYP
|
Professional
|
Both
|
$2,203.00
|
|
|
Service Code
|
HCPCS 33320
|
| Min. Negotiated Rate |
$375.26 |
| Max. Negotiated Rate |
$189,547.00 |
| Rate for Payer: Aetna Commercial |
$1,376.56
|
| Rate for Payer: Aetna Medicare |
$1,068.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,376.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,479.28
|
| Rate for Payer: BCBS Complete |
$710.09
|
| Rate for Payer: BCBS MAPPO |
$1,027.28
|
| Rate for Payer: BCBS Trust/PPO |
$375.26
|
| Rate for Payer: BCN Commercial |
$1,538.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,027.28
|
| Rate for Payer: Cash Price |
$1,762.40
|
| Rate for Payer: Cash Price |
$1,762.40
|
| Rate for Payer: Cofinity Commercial |
$1,479.28
|
| Rate for Payer: Cofinity Commercial |
$1,376.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,027.28
|
| Rate for Payer: Healthscope Commercial |
$1,900.47
|
| Rate for Payer: Healthscope Commercial |
$1,643.65
|
| Rate for Payer: Mclaren Medicaid |
$676.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,078.64
|
| Rate for Payer: Meridian Medicaid |
$710.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189,547.00
|
| Rate for Payer: Nomi Health Commercial |
$1,232.74
|
| Rate for Payer: PACE SWMI |
$1,027.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,027.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$676.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,431.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,682.16
|
| Rate for Payer: Priority Health Medicare |
$1,027.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,682.16
|
| Rate for Payer: Priority Health SBD |
$1,682.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,549.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,027.28
|
| Rate for Payer: UHC Exchange |
$1,549.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,027.28
|
| Rate for Payer: UHCCP Medicaid |
$676.28
|
|
|
PR SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK
|
Professional
|
Both
|
$1,151.00
|
|
|
Service Code
|
HCPCS 67935
|
| Min. Negotiated Rate |
$277.33 |
| Max. Negotiated Rate |
$75,755.00 |
| Rate for Payer: Aetna Commercial |
$545.35
|
| Rate for Payer: Aetna Medicare |
$423.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$586.05
|
| Rate for Payer: BCBS Complete |
$291.20
|
| Rate for Payer: BCBS MAPPO |
$406.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,017.58
|
| Rate for Payer: BCN Commercial |
$870.33
|
| Rate for Payer: BCN Medicare Advantage |
$406.98
|
| Rate for Payer: Cash Price |
$920.80
|
| Rate for Payer: Cash Price |
$920.80
|
| Rate for Payer: Cofinity Commercial |
$586.05
|
| Rate for Payer: Cofinity Commercial |
$545.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$406.98
|
| Rate for Payer: Healthscope Commercial |
$752.91
|
| Rate for Payer: Healthscope Commercial |
$651.17
|
| Rate for Payer: Mclaren Medicaid |
$277.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$427.33
|
| Rate for Payer: Meridian Medicaid |
$291.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75,755.00
|
| Rate for Payer: Nomi Health Commercial |
$488.38
|
| Rate for Payer: PACE SWMI |
$406.98
|
| Rate for Payer: PHP Medicare Advantage |
$406.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$748.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.38
|
| Rate for Payer: Priority Health Medicare |
$406.98
|
| Rate for Payer: Priority Health Narrow Network |
$760.38
|
| Rate for Payer: Priority Health SBD |
$760.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$877.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$406.98
|
| Rate for Payer: UHC Exchange |
$877.61
|
| Rate for Payer: UHC Medicare Advantage |
$406.98
|
| Rate for Payer: UHCCP Medicaid |
$277.33
|
|
|
PR SUTR WND EYELID/MARGIN/TARSUS/CONJUNC PRTL THICK
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 67930
|
| Min. Negotiated Rate |
$149.10 |
| Max. Negotiated Rate |
$40,792.00 |
| Rate for Payer: Aetna Commercial |
$294.24
|
| Rate for Payer: Aetna Medicare |
$228.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.20
|
| Rate for Payer: BCBS Complete |
$156.56
|
| Rate for Payer: BCBS MAPPO |
$219.58
|
| Rate for Payer: BCBS Trust/PPO |
$668.30
|
| Rate for Payer: BCN Commercial |
$539.50
|
| Rate for Payer: BCN Medicare Advantage |
$219.58
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$316.20
|
| Rate for Payer: Cofinity Commercial |
$294.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.58
|
| Rate for Payer: Healthscope Commercial |
$406.22
|
| Rate for Payer: Healthscope Commercial |
$351.33
|
| Rate for Payer: Mclaren Medicaid |
$149.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.56
|
| Rate for Payer: Meridian Medicaid |
$156.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40,792.00
|
| Rate for Payer: Nomi Health Commercial |
$263.50
|
| Rate for Payer: PACE SWMI |
$219.58
|
| Rate for Payer: PHP Medicare Advantage |
$219.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$149.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$408.85
|
| Rate for Payer: Priority Health Medicare |
$219.58
|
| Rate for Payer: Priority Health Narrow Network |
$408.85
|
| Rate for Payer: Priority Health SBD |
$408.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$650.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.58
|
| Rate for Payer: UHC Exchange |
$650.83
|
| Rate for Payer: UHC Medicare Advantage |
$219.58
|
| Rate for Payer: UHCCP Medicaid |
$149.10
|
|
|
PR SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE
|
Professional
|
Both
|
$2,150.00
|
|
|
Service Code
|
HCPCS 64834
|
| Min. Negotiated Rate |
$404.68 |
| Max. Negotiated Rate |
$130,349.00 |
| Rate for Payer: Aetna Commercial |
$961.70
|
| Rate for Payer: Aetna Medicare |
$746.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$961.70
|
| Rate for Payer: BCBS Complete |
$509.25
|
| Rate for Payer: BCBS MAPPO |
$717.69
|
| Rate for Payer: BCBS Trust/PPO |
$404.68
|
| Rate for Payer: BCN Commercial |
$1,077.53
|
| Rate for Payer: BCN Medicare Advantage |
$717.69
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cofinity Commercial |
$961.70
|
| Rate for Payer: Cofinity Commercial |
$1,033.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.69
|
| Rate for Payer: Healthscope Commercial |
$1,327.73
|
| Rate for Payer: Healthscope Commercial |
$1,148.30
|
| Rate for Payer: Mclaren Medicaid |
$485.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$753.57
|
| Rate for Payer: Meridian Medicaid |
$509.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130,349.00
|
| Rate for Payer: Nomi Health Commercial |
$861.23
|
| Rate for Payer: PACE SWMI |
$717.69
|
| Rate for Payer: PHP Medicare Advantage |
$717.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,397.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,280.18
|
| Rate for Payer: Priority Health Medicare |
$717.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,280.18
|
| Rate for Payer: Priority Health SBD |
$1,280.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$796.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$717.69
|
| Rate for Payer: UHC Exchange |
$796.43
|
| Rate for Payer: UHC Medicare Advantage |
$717.69
|
| Rate for Payer: UHCCP Medicaid |
$485.00
|
|
|
PR SUTURE 1 NERVE MEDIAN MOTOR THENAR
|
Professional
|
Both
|
$2,287.00
|
|
|
Service Code
|
HCPCS 64835
|
| Min. Negotiated Rate |
$302.72 |
| Max. Negotiated Rate |
$144,886.00 |
| Rate for Payer: Aetna Commercial |
$1,055.21
|
| Rate for Payer: Aetna Medicare |
$818.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,133.96
|
| Rate for Payer: BCBS Complete |
$556.67
|
| Rate for Payer: BCBS MAPPO |
$787.47
|
| Rate for Payer: BCBS Trust/PPO |
$302.72
|
| Rate for Payer: BCN Commercial |
$1,197.26
|
| Rate for Payer: BCN Medicare Advantage |
$787.47
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cofinity Commercial |
$1,133.96
|
| Rate for Payer: Cofinity Commercial |
$1,055.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.47
|
| Rate for Payer: Healthscope Commercial |
$1,456.82
|
| Rate for Payer: Healthscope Commercial |
$1,259.95
|
| Rate for Payer: Mclaren Medicaid |
$530.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.84
|
| Rate for Payer: Meridian Medicaid |
$556.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144,886.00
|
| Rate for Payer: Nomi Health Commercial |
$944.96
|
| Rate for Payer: PACE SWMI |
$787.47
|
| Rate for Payer: PHP Medicare Advantage |
$787.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$530.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,486.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,404.16
|
| Rate for Payer: Priority Health Medicare |
$787.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,404.16
|
| Rate for Payer: Priority Health SBD |
$1,404.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$863.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$787.47
|
| Rate for Payer: UHC Exchange |
$863.68
|
| Rate for Payer: UHC Medicare Advantage |
$787.47
|
| Rate for Payer: UHCCP Medicaid |
$530.16
|
|
|
PR SUTURE 1 NERVE ULNAR MOTOR
|
Professional
|
Both
|
$1,805.00
|
|
|
Service Code
|
HCPCS 64836
|
| Min. Negotiated Rate |
$219.24 |
| Max. Negotiated Rate |
$144,886.00 |
| Rate for Payer: Aetna Commercial |
$1,055.21
|
| Rate for Payer: Aetna Medicare |
$818.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,133.96
|
| Rate for Payer: BCBS Complete |
$556.67
|
| Rate for Payer: BCBS MAPPO |
$787.47
|
| Rate for Payer: BCBS Trust/PPO |
$219.24
|
| Rate for Payer: BCN Commercial |
$1,197.26
|
| Rate for Payer: BCN Medicare Advantage |
$787.47
|
| Rate for Payer: Cash Price |
$1,444.00
|
| Rate for Payer: Cash Price |
$1,444.00
|
| Rate for Payer: Cofinity Commercial |
$1,133.96
|
| Rate for Payer: Cofinity Commercial |
$1,055.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.47
|
| Rate for Payer: Healthscope Commercial |
$1,456.82
|
| Rate for Payer: Healthscope Commercial |
$1,259.95
|
| Rate for Payer: Mclaren Medicaid |
$530.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.84
|
| Rate for Payer: Meridian Medicaid |
$556.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144,886.00
|
| Rate for Payer: Nomi Health Commercial |
$944.96
|
| Rate for Payer: PACE SWMI |
$787.47
|
| Rate for Payer: PHP Medicare Advantage |
$787.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$530.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,173.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,404.16
|
| Rate for Payer: Priority Health Medicare |
$787.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,404.16
|
| Rate for Payer: Priority Health SBD |
$1,404.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$859.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$787.47
|
| Rate for Payer: UHC Exchange |
$859.83
|
| Rate for Payer: UHC Medicare Advantage |
$787.47
|
| Rate for Payer: UHCCP Medicaid |
$530.16
|
|
|
PR SUTURE BRACHIAL PLEXUS
|
Professional
|
Both
|
$3,705.00
|
|
|
Service Code
|
HCPCS 64861
|
| Min. Negotiated Rate |
$244.60 |
| Max. Negotiated Rate |
$275,812.00 |
| Rate for Payer: Aetna Commercial |
$2,023.86
|
| Rate for Payer: Aetna Medicare |
$1,570.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,023.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,174.89
|
| Rate for Payer: BCBS Complete |
$1,045.34
|
| Rate for Payer: BCBS MAPPO |
$1,510.34
|
| Rate for Payer: BCBS Trust/PPO |
$244.60
|
| Rate for Payer: BCN Commercial |
$2,250.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,510.34
|
| Rate for Payer: Cash Price |
$2,964.00
|
| Rate for Payer: Cash Price |
$2,964.00
|
| Rate for Payer: Cofinity Commercial |
$2,174.89
|
| Rate for Payer: Cofinity Commercial |
$2,023.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,510.34
|
| Rate for Payer: Healthscope Commercial |
$2,794.13
|
| Rate for Payer: Healthscope Commercial |
$2,416.54
|
| Rate for Payer: Mclaren Medicaid |
$995.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,585.86
|
| Rate for Payer: Meridian Medicaid |
$1,045.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$275,812.00
|
| Rate for Payer: Nomi Health Commercial |
$1,812.41
|
| Rate for Payer: PACE SWMI |
$1,510.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,510.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$995.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,408.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,643.96
|
| Rate for Payer: Priority Health Medicare |
$1,510.34
|
| Rate for Payer: Priority Health Narrow Network |
$2,643.96
|
| Rate for Payer: Priority Health SBD |
$2,643.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,475.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,510.34
|
| Rate for Payer: UHC Exchange |
$1,475.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,510.34
|
| Rate for Payer: UHCCP Medicaid |
$995.56
|
|
|
PR SUTURE DIGITAL NERVE HAND/FOOT 1 NERVE
|
Professional
|
Both
|
$1,985.00
|
|
|
Service Code
|
HCPCS 64831
|
| Min. Negotiated Rate |
$364.00 |
| Max. Negotiated Rate |
$122,625.00 |
| Rate for Payer: Aetna Commercial |
$895.43
|
| Rate for Payer: Aetna Medicare |
$694.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$895.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$962.25
|
| Rate for Payer: BCBS Complete |
$476.15
|
| Rate for Payer: BCBS MAPPO |
$668.23
|
| Rate for Payer: BCBS Trust/PPO |
$364.00
|
| Rate for Payer: BCN Commercial |
$1,019.87
|
| Rate for Payer: BCN Medicare Advantage |
$668.23
|
| Rate for Payer: Cash Price |
$1,588.00
|
| Rate for Payer: Cash Price |
$1,588.00
|
| Rate for Payer: Cofinity Commercial |
$962.25
|
| Rate for Payer: Cofinity Commercial |
$895.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$668.23
|
| Rate for Payer: Healthscope Commercial |
$1,236.23
|
| Rate for Payer: Healthscope Commercial |
$1,069.17
|
| Rate for Payer: Mclaren Medicaid |
$453.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$701.64
|
| Rate for Payer: Meridian Medicaid |
$476.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122,625.00
|
| Rate for Payer: Nomi Health Commercial |
$801.88
|
| Rate for Payer: PACE SWMI |
$668.23
|
| Rate for Payer: PHP Medicare Advantage |
$668.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,290.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,197.14
|
| Rate for Payer: Priority Health Medicare |
$668.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,197.14
|
| Rate for Payer: Priority Health SBD |
$1,197.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$761.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$668.23
|
| Rate for Payer: UHC Exchange |
$761.20
|
| Rate for Payer: UHC Medicare Advantage |
$668.23
|
| Rate for Payer: UHCCP Medicaid |
$453.48
|
|
|
PR SUTURE EACH ADDITIONAL NERVE HAND/FOOT
|
Professional
|
Both
|
$1,311.00
|
|
|
Service Code
|
HCPCS 64837
|
| Min. Negotiated Rate |
$206.57 |
| Max. Negotiated Rate |
$64,397.00 |
| Rate for Payer: Aetna Commercial |
$466.68
|
| Rate for Payer: Aetna Medicare |
$362.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$466.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$501.51
|
| Rate for Payer: BCBS Complete |
$242.43
|
| Rate for Payer: BCBS MAPPO |
$348.27
|
| Rate for Payer: BCBS Trust/PPO |
$206.57
|
| Rate for Payer: BCN Commercial |
$525.33
|
| Rate for Payer: BCN Medicare Advantage |
$348.27
|
| Rate for Payer: Cash Price |
$1,048.80
|
| Rate for Payer: Cash Price |
$1,048.80
|
| Rate for Payer: Cofinity Commercial |
$501.51
|
| Rate for Payer: Cofinity Commercial |
$466.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.27
|
| Rate for Payer: Healthscope Commercial |
$644.30
|
| Rate for Payer: Healthscope Commercial |
$557.23
|
| Rate for Payer: Mclaren Medicaid |
$230.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.68
|
| Rate for Payer: Meridian Medicaid |
$242.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64,397.00
|
| Rate for Payer: Nomi Health Commercial |
$417.92
|
| Rate for Payer: PACE SWMI |
$348.27
|
| Rate for Payer: PHP Medicare Advantage |
$348.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$230.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$852.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$612.51
|
| Rate for Payer: Priority Health Medicare |
$348.27
|
| Rate for Payer: Priority Health Narrow Network |
$612.51
|
| Rate for Payer: Priority Health SBD |
$612.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$448.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.27
|
| Rate for Payer: UHC Exchange |
$448.53
|
| Rate for Payer: UHC Medicare Advantage |
$348.27
|
| Rate for Payer: UHCCP Medicaid |
$230.89
|
|
|
PR SUTURE EACH ADDITIONAL PERIPHERAL NERVE
|
Professional
|
Both
|
$1,633.00
|
|
|
Service Code
|
HCPCS 64859
|
| Min. Negotiated Rate |
$156.77 |
| Max. Negotiated Rate |
$43,783.00 |
| Rate for Payer: Aetna Commercial |
$316.79
|
| Rate for Payer: Aetna Medicare |
$245.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.43
|
| Rate for Payer: BCBS Complete |
$164.61
|
| Rate for Payer: BCBS MAPPO |
$236.41
|
| Rate for Payer: BCBS Trust/PPO |
$304.83
|
| Rate for Payer: BCN Commercial |
$357.23
|
| Rate for Payer: BCN Medicare Advantage |
$236.41
|
| Rate for Payer: Cash Price |
$1,306.40
|
| Rate for Payer: Cash Price |
$1,306.40
|
| Rate for Payer: Cofinity Commercial |
$340.43
|
| Rate for Payer: Cofinity Commercial |
$316.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.41
|
| Rate for Payer: Healthscope Commercial |
$437.36
|
| Rate for Payer: Healthscope Commercial |
$378.26
|
| Rate for Payer: Mclaren Medicaid |
$156.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.23
|
| Rate for Payer: Meridian Medicaid |
$164.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,783.00
|
| Rate for Payer: Nomi Health Commercial |
$283.69
|
| Rate for Payer: PACE SWMI |
$236.41
|
| Rate for Payer: PHP Medicare Advantage |
$236.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,061.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$416.29
|
| Rate for Payer: Priority Health Medicare |
$236.41
|
| Rate for Payer: Priority Health Narrow Network |
$416.29
|
| Rate for Payer: Priority Health SBD |
$416.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.41
|
| Rate for Payer: UHC Exchange |
$328.46
|
| Rate for Payer: UHC Medicare Advantage |
$236.41
|
| Rate for Payer: UHCCP Medicaid |
$156.77
|
|
|
PR SUTURE EXTRAHEPATIC BILE DUCT PRE-EXIST INJURY
|
Professional
|
Both
|
$3,048.00
|
|
|
Service Code
|
HCPCS 47900
|
| Min. Negotiated Rate |
$886.08 |
| Max. Negotiated Rate |
$247,068.00 |
| Rate for Payer: Aetna Commercial |
$1,794.29
|
| Rate for Payer: Aetna Medicare |
$1,392.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,794.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,928.19
|
| Rate for Payer: BCBS Complete |
$930.38
|
| Rate for Payer: BCBS MAPPO |
$1,339.02
|
| Rate for Payer: BCBS Trust/PPO |
$3,830.18
|
| Rate for Payer: BCN Commercial |
$2,015.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,339.02
|
| Rate for Payer: Cash Price |
$2,438.40
|
| Rate for Payer: Cash Price |
$2,438.40
|
| Rate for Payer: Cofinity Commercial |
$1,928.19
|
| Rate for Payer: Cofinity Commercial |
$1,794.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,339.02
|
| Rate for Payer: Healthscope Commercial |
$2,477.19
|
| Rate for Payer: Healthscope Commercial |
$2,142.43
|
| Rate for Payer: Mclaren Medicaid |
$886.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,405.97
|
| Rate for Payer: Meridian Medicaid |
$930.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247,068.00
|
| Rate for Payer: Nomi Health Commercial |
$1,606.82
|
| Rate for Payer: PACE SWMI |
$1,339.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,339.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,981.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,469.89
|
| Rate for Payer: Priority Health Medicare |
$1,339.02
|
| Rate for Payer: Priority Health Narrow Network |
$2,469.89
|
| Rate for Payer: Priority Health SBD |
$2,469.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,342.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,339.02
|
| Rate for Payer: UHC Exchange |
$1,342.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,339.02
|
| Rate for Payer: UHCCP Medicaid |
$886.08
|
|
|
PR SUTURE FACIAL NERVE EXTRACRANIAL
|
Professional
|
Both
|
$2,429.00
|
|
|
Service Code
|
HCPCS 64864
|
| Min. Negotiated Rate |
$305.89 |
| Max. Negotiated Rate |
$152,809.00 |
| Rate for Payer: Aetna Commercial |
$1,103.32
|
| Rate for Payer: Aetna Medicare |
$856.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,103.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,185.65
|
| Rate for Payer: BCBS Complete |
$581.27
|
| Rate for Payer: BCBS MAPPO |
$823.37
|
| Rate for Payer: BCBS Trust/PPO |
$305.89
|
| Rate for Payer: BCN Commercial |
$1,260.78
|
| Rate for Payer: BCN Medicare Advantage |
$823.37
|
| Rate for Payer: Cash Price |
$1,943.20
|
| Rate for Payer: Cash Price |
$1,943.20
|
| Rate for Payer: Cofinity Commercial |
$1,185.65
|
| Rate for Payer: Cofinity Commercial |
$1,103.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$823.37
|
| Rate for Payer: Healthscope Commercial |
$1,523.23
|
| Rate for Payer: Healthscope Commercial |
$1,317.39
|
| Rate for Payer: Mclaren Medicaid |
$553.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$864.54
|
| Rate for Payer: Meridian Medicaid |
$581.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152,809.00
|
| Rate for Payer: Nomi Health Commercial |
$988.04
|
| Rate for Payer: PACE SWMI |
$823.37
|
| Rate for Payer: PHP Medicare Advantage |
$823.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$553.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,466.71
|
| Rate for Payer: Priority Health Medicare |
$823.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,466.71
|
| Rate for Payer: Priority Health SBD |
$1,466.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,002.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$823.37
|
| Rate for Payer: UHC Exchange |
$1,002.18
|
| Rate for Payer: UHC Medicare Advantage |
$823.37
|
| Rate for Payer: UHCCP Medicaid |
$553.59
|
|
|
PR SUTURE FACIAL NERVE INFRATEMPORAL W/WO GRAFT
|
Professional
|
Both
|
$3,037.00
|
|
|
Service Code
|
HCPCS 64865
|
| Min. Negotiated Rate |
$354.49 |
| Max. Negotiated Rate |
$192,082.00 |
| Rate for Payer: Aetna Commercial |
$1,371.62
|
| Rate for Payer: Aetna Medicare |
$1,064.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,371.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,473.98
|
| Rate for Payer: BCBS Complete |
$726.86
|
| Rate for Payer: BCBS MAPPO |
$1,023.60
|
| Rate for Payer: BCBS Trust/PPO |
$354.49
|
| Rate for Payer: BCN Commercial |
$1,592.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,023.60
|
| Rate for Payer: Cash Price |
$2,429.60
|
| Rate for Payer: Cash Price |
$2,429.60
|
| Rate for Payer: Cofinity Commercial |
$1,473.98
|
| Rate for Payer: Cofinity Commercial |
$1,371.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,023.60
|
| Rate for Payer: Healthscope Commercial |
$1,893.66
|
| Rate for Payer: Healthscope Commercial |
$1,637.76
|
| Rate for Payer: Mclaren Medicaid |
$692.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,074.78
|
| Rate for Payer: Meridian Medicaid |
$726.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192,082.00
|
| Rate for Payer: Nomi Health Commercial |
$1,228.32
|
| Rate for Payer: PACE SWMI |
$1,023.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,023.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,974.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,853.44
|
| Rate for Payer: Priority Health Medicare |
$1,023.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,853.44
|
| Rate for Payer: Priority Health SBD |
$1,853.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,200.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,023.60
|
| Rate for Payer: UHC Exchange |
$1,200.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,023.60
|
| Rate for Payer: UHCCP Medicaid |
$692.25
|
|
|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Facility
|
OP
|
$1,551.00
|
|
|
Service Code
|
CPT 27380
|
| Hospital Charge Code |
27380
|
| Min. Negotiated Rate |
$661.25 |
| Max. Negotiated Rate |
$21,998.64 |
| Rate for Payer: Aetna Commercial |
$1,318.35
|
| Rate for Payer: Aetna Medicare |
$7,279.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,008.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,749.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,749.10
|
| Rate for Payer: BCBS Complete |
$3,939.19
|
| Rate for Payer: BCBS MAPPO |
$6,999.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,840.64
|
| Rate for Payer: BCN Commercial |
$2,840.64
|
| Rate for Payer: BCN Medicare Advantage |
$6,999.28
|
| Rate for Payer: Cash Price |
$1,240.80
|
| 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 |
$6,999.28
|
| Rate for Payer: Healthscope Commercial |
$1,395.90
|
| Rate for Payer: Mclaren Medicaid |
$3,751.61
|
| Rate for Payer: Mclaren Medicare |
$6,999.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,349.24
|
| Rate for Payer: Meridian Medicaid |
$3,939.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,049.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,318.35
|
| Rate for Payer: Nomi Health Commercial |
$14,698.49
|
| Rate for Payer: PACE Medicare |
$6,649.32
|
| Rate for Payer: PACE SWMI |
$6,999.28
|
| Rate for Payer: PHP Commercial |
$1,318.35
|
| Rate for Payer: PHP Medicare Advantage |
$6,999.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,751.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,998.64
|
| Rate for Payer: Priority Health Medicare |
$6,999.28
|
| Rate for Payer: Priority Health Narrow Network |
$17,598.91
|
| Rate for Payer: Priority Health SBD |
$977.13
|
| Rate for Payer: Railroad Medicare Medicare |
$6,999.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$661.25
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,999.28
|
| Rate for Payer: UHC Medicare Advantage |
$6,999.28
|
| Rate for Payer: UHCCP Medicaid |
$3,940.59
|
| Rate for Payer: VA VA |
$6,999.28
|
|
|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Professional
|
Both
|
$1,551.00
|
|
|
Service Code
|
HCPCS 27380
|
| Min. Negotiated Rate |
$405.77 |
| Max. Negotiated Rate |
$110,502.00 |
| Rate for Payer: Aetna Commercial |
$797.65
|
| Rate for Payer: Aetna Medicare |
$619.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$797.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$857.17
|
| Rate for Payer: BCBS Complete |
$426.06
|
| Rate for Payer: BCBS MAPPO |
$595.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,533.73
|
| Rate for Payer: BCN Commercial |
$923.11
|
| 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 |
$952.42
|
| Rate for Payer: Healthscope Commercial |
$1,101.23
|
| Rate for Payer: Mclaren Medicaid |
$405.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$625.02
|
| Rate for Payer: Meridian Medicaid |
$426.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110,502.00
|
| 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 Choice Medicaid |
$405.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$966.33
|
| Rate for Payer: Priority Health Medicare |
$595.26
|
| Rate for Payer: Priority Health Narrow Network |
$966.33
|
| Rate for Payer: Priority Health SBD |
$966.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$712.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$595.26
|
| Rate for Payer: UHC Exchange |
$712.47
|
| Rate for Payer: UHC Medicare Advantage |
$595.26
|
| Rate for Payer: UHCCP Medicaid |
$405.77
|
|
|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Professional
|
Both
|
$1,551.00
|
|
|
Service Code
|
HCPCS 27380
|
| Hospital Charge Code |
27380
|
| Min. Negotiated Rate |
$405.77 |
| Max. Negotiated Rate |
$110,502.00 |
| Rate for Payer: Aetna Commercial |
$797.65
|
| Rate for Payer: Aetna Medicare |
$619.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$797.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$857.17
|
| Rate for Payer: BCBS Complete |
$426.06
|
| Rate for Payer: BCBS MAPPO |
$595.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,533.73
|
| Rate for Payer: BCN Commercial |
$923.11
|
| 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 |
$952.42
|
| Rate for Payer: Healthscope Commercial |
$1,101.23
|
| Rate for Payer: Mclaren Medicaid |
$405.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$625.02
|
| Rate for Payer: Meridian Medicaid |
$426.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110,502.00
|
| 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 Choice Medicaid |
$405.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$966.33
|
| Rate for Payer: Priority Health Medicare |
$595.26
|
| Rate for Payer: Priority Health Narrow Network |
$966.33
|
| Rate for Payer: Priority Health SBD |
$966.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$712.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$595.26
|
| Rate for Payer: UHC Exchange |
$712.47
|
| Rate for Payer: UHC Medicare Advantage |
$595.26
|
| Rate for Payer: UHCCP Medicaid |
$405.77
|
|
|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Facility
|
IP
|
$1,551.00
|
|
|
Service Code
|
CPT 27380
|
| Hospital Charge Code |
27380
|
| Min. Negotiated Rate |
$977.13 |
| Max. Negotiated Rate |
$1,395.90 |
| Rate for Payer: Aetna Commercial |
$1,318.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,008.15
|
| Rate for Payer: Cash Price |
$1,240.80
|
| Rate for Payer: Cofinity Commercial |
$1,085.70
|
| Rate for Payer: Cofinity Commercial |
$1,333.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,085.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,240.80
|
| Rate for Payer: Healthscope Commercial |
$1,395.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,318.35
|
| Rate for Payer: PHP Commercial |
$1,318.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.15
|
| Rate for Payer: Priority Health SBD |
$977.13
|
|
|
PR SUTURE MESENTERY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,979.00
|
|
|
Service Code
|
HCPCS 44850
|
| Min. Negotiated Rate |
$330.19 |
| Max. Negotiated Rate |
$133,441.00 |
| Rate for Payer: Aetna Commercial |
$972.67
|
| Rate for Payer: Aetna Medicare |
$754.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,045.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$972.67
|
| Rate for Payer: BCBS Complete |
$506.57
|
| Rate for Payer: BCBS MAPPO |
$725.87
|
| Rate for Payer: BCBS Trust/PPO |
$330.19
|
| Rate for Payer: BCN Commercial |
$1,090.73
|
| 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: Mclaren Medicaid |
$482.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$762.16
|
| Rate for Payer: Meridian Medicaid |
$506.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133,441.00
|
| 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 Choice Medicaid |
$482.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,286.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,342.93
|
| Rate for Payer: Priority Health Medicare |
$725.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,342.93
|
| Rate for Payer: Priority Health SBD |
$1,342.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$748.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$725.87
|
| Rate for Payer: UHC Exchange |
$748.15
|
| Rate for Payer: UHC Medicare Advantage |
$725.87
|
| Rate for Payer: UHCCP Medicaid |
$482.45
|
|
|
PR SUTURE NERVE REQ SECONDARY/DELAYED SUTURE
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
HCPCS 64872
|
| Min. Negotiated Rate |
$73.49 |
| Max. Negotiated Rate |
$20,488.00 |
| Rate for Payer: Aetna Commercial |
$148.45
|
| Rate for Payer: Aetna Medicare |
$115.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.52
|
| Rate for Payer: BCBS Complete |
$77.16
|
| Rate for Payer: BCBS MAPPO |
$110.78
|
| Rate for Payer: BCBS Trust/PPO |
$213.43
|
| Rate for Payer: BCN Commercial |
$167.13
|
| 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 |
$204.94
|
| Rate for Payer: Healthscope Commercial |
$177.25
|
| Rate for Payer: Mclaren Medicaid |
$73.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$116.32
|
| Rate for Payer: Meridian Medicaid |
$77.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,488.00
|
| 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 Choice Medicaid |
$73.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$194.50
|
| Rate for Payer: Priority Health Medicare |
$110.78
|
| Rate for Payer: Priority Health Narrow Network |
$194.50
|
| Rate for Payer: Priority Health SBD |
$194.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.78
|
| Rate for Payer: UHC Exchange |
$161.36
|
| Rate for Payer: UHC Medicare Advantage |
$110.78
|
| Rate for Payer: UHCCP Medicaid |
$73.49
|
|
