|
PR TEAEC W/PATCH GRF CAROTID VERTB SUBCLAV NECK INC
|
Professional
|
Both
|
$3,698.00
|
|
|
Service Code
|
HCPCS 35301
|
| Min. Negotiated Rate |
$276.83 |
| Max. Negotiated Rate |
$200,162.00 |
| Rate for Payer: Aetna Commercial |
$1,449.61
|
| Rate for Payer: Aetna Medicare |
$1,125.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,449.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,557.79
|
| Rate for Payer: BCBS Complete |
$740.73
|
| Rate for Payer: BCBS MAPPO |
$1,081.80
|
| Rate for Payer: BCBS Trust/PPO |
$276.83
|
| Rate for Payer: BCN Commercial |
$1,613.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,081.80
|
| Rate for Payer: Cash Price |
$2,958.40
|
| Rate for Payer: Cash Price |
$2,958.40
|
| Rate for Payer: Cofinity Commercial |
$1,557.79
|
| Rate for Payer: Cofinity Commercial |
$1,449.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,081.80
|
| Rate for Payer: Healthscope Commercial |
$2,001.33
|
| Rate for Payer: Healthscope Commercial |
$1,730.88
|
| Rate for Payer: Mclaren Medicaid |
$705.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,135.89
|
| Rate for Payer: Meridian Medicaid |
$740.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200,162.00
|
| Rate for Payer: Nomi Health Commercial |
$1,298.16
|
| Rate for Payer: PACE SWMI |
$1,081.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,081.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$705.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,403.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,760.35
|
| Rate for Payer: Priority Health Medicare |
$1,081.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,760.35
|
| Rate for Payer: Priority Health SBD |
$1,760.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,759.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,081.80
|
| Rate for Payer: UHC Exchange |
$1,759.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,081.80
|
| Rate for Payer: UHCCP Medicaid |
$705.46
|
|
|
PR TEAEC W/WO PATCH GRAFT ABDOMINAL AORTA
|
Professional
|
Both
|
$4,734.00
|
|
|
Service Code
|
HCPCS 35331
|
| Min. Negotiated Rate |
$763.92 |
| Max. Negotiated Rate |
$258,845.00 |
| Rate for Payer: Aetna Commercial |
$1,859.91
|
| Rate for Payer: Aetna Medicare |
$1,443.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,859.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,998.71
|
| Rate for Payer: BCBS Complete |
$949.40
|
| Rate for Payer: BCBS MAPPO |
$1,387.99
|
| Rate for Payer: BCBS Trust/PPO |
$763.92
|
| Rate for Payer: BCN Commercial |
$2,084.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,387.99
|
| Rate for Payer: Cash Price |
$3,787.20
|
| Rate for Payer: Cash Price |
$3,787.20
|
| Rate for Payer: Cofinity Commercial |
$1,998.71
|
| Rate for Payer: Cofinity Commercial |
$1,859.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,387.99
|
| Rate for Payer: Healthscope Commercial |
$2,567.78
|
| Rate for Payer: Healthscope Commercial |
$2,220.78
|
| Rate for Payer: Mclaren Medicaid |
$904.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,457.39
|
| Rate for Payer: Meridian Medicaid |
$949.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258,845.00
|
| Rate for Payer: Nomi Health Commercial |
$1,665.59
|
| Rate for Payer: PACE SWMI |
$1,387.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,387.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$904.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,077.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,265.58
|
| Rate for Payer: Priority Health Medicare |
$1,387.99
|
| Rate for Payer: Priority Health Narrow Network |
$2,265.58
|
| Rate for Payer: Priority Health SBD |
$2,265.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,863.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,387.99
|
| Rate for Payer: UHC Exchange |
$1,863.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,387.99
|
| Rate for Payer: UHCCP Medicaid |
$904.19
|
|
|
PR TEAEC W/WO PATCH GRAFT COMBINED AORTOILIOFEMORAL
|
Professional
|
Both
|
$3,341.00
|
|
|
Service Code
|
HCPCS 35363
|
| Min. Negotiated Rate |
$1,015.37 |
| Max. Negotiated Rate |
$288,391.00 |
| Rate for Payer: Aetna Commercial |
$2,097.86
|
| Rate for Payer: Aetna Medicare |
$1,628.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,097.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,254.42
|
| Rate for Payer: BCBS Complete |
$1,066.14
|
| Rate for Payer: BCBS MAPPO |
$1,565.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,218.79
|
| Rate for Payer: BCN Commercial |
$2,312.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,565.57
|
| Rate for Payer: Cash Price |
$2,672.80
|
| Rate for Payer: Cash Price |
$2,672.80
|
| Rate for Payer: Cofinity Commercial |
$2,254.42
|
| Rate for Payer: Cofinity Commercial |
$2,097.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,565.57
|
| Rate for Payer: Healthscope Commercial |
$2,896.30
|
| Rate for Payer: Healthscope Commercial |
$2,504.91
|
| Rate for Payer: Mclaren Medicaid |
$1,015.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,643.85
|
| Rate for Payer: Meridian Medicaid |
$1,066.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288,391.00
|
| Rate for Payer: Nomi Health Commercial |
$1,878.68
|
| Rate for Payer: PACE SWMI |
$1,565.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,565.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,015.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,171.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,528.30
|
| Rate for Payer: Priority Health Medicare |
$1,565.57
|
| Rate for Payer: Priority Health Narrow Network |
$2,528.30
|
| Rate for Payer: Priority Health SBD |
$2,528.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,275.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,565.57
|
| Rate for Payer: UHC Exchange |
$2,275.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,565.57
|
| Rate for Payer: UHCCP Medicaid |
$1,015.37
|
|
|
PR TEAEC W/WO PATCH GRAFT COMMON FEMORAL
|
Professional
|
Both
|
$1,751.00
|
|
|
Service Code
|
HCPCS 35371
|
| Min. Negotiated Rate |
$508.86 |
| Max. Negotiated Rate |
$144,344.00 |
| Rate for Payer: Aetna Commercial |
$1,045.09
|
| Rate for Payer: Aetna Medicare |
$811.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,045.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,123.08
|
| Rate for Payer: BCBS Complete |
$534.30
|
| Rate for Payer: BCBS MAPPO |
$779.92
|
| Rate for Payer: BCBS Trust/PPO |
$666.19
|
| Rate for Payer: BCN Commercial |
$1,163.54
|
| Rate for Payer: BCN Medicare Advantage |
$779.92
|
| Rate for Payer: Cash Price |
$1,400.80
|
| Rate for Payer: Cash Price |
$1,400.80
|
| Rate for Payer: Cofinity Commercial |
$1,123.08
|
| Rate for Payer: Cofinity Commercial |
$1,045.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$779.92
|
| Rate for Payer: Healthscope Commercial |
$1,442.85
|
| Rate for Payer: Healthscope Commercial |
$1,247.87
|
| Rate for Payer: Mclaren Medicaid |
$508.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$818.92
|
| Rate for Payer: Meridian Medicaid |
$534.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144,344.00
|
| Rate for Payer: Nomi Health Commercial |
$935.90
|
| Rate for Payer: PACE SWMI |
$779.92
|
| Rate for Payer: PHP Medicare Advantage |
$779.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,138.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,269.46
|
| Rate for Payer: Priority Health Medicare |
$779.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,269.46
|
| Rate for Payer: Priority Health SBD |
$1,269.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,222.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$779.92
|
| Rate for Payer: UHC Exchange |
$1,222.61
|
| Rate for Payer: UHC Medicare Advantage |
$779.92
|
| Rate for Payer: UHCCP Medicaid |
$508.86
|
|
|
PR TEAEC W/WO PATCH GRAFT DEEP PROFUNDA FEMORAL
|
Professional
|
Both
|
$3,773.00
|
|
|
Service Code
|
HCPCS 35372
|
| Min. Negotiated Rate |
$608.97 |
| Max. Negotiated Rate |
$172,930.00 |
| Rate for Payer: Aetna Commercial |
$1,252.04
|
| Rate for Payer: Aetna Medicare |
$971.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,252.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,345.48
|
| Rate for Payer: BCBS Complete |
$639.42
|
| Rate for Payer: BCBS MAPPO |
$934.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,194.49
|
| Rate for Payer: BCN Commercial |
$1,392.25
|
| Rate for Payer: BCN Medicare Advantage |
$934.36
|
| Rate for Payer: Cash Price |
$3,018.40
|
| Rate for Payer: Cash Price |
$3,018.40
|
| Rate for Payer: Cofinity Commercial |
$1,345.48
|
| Rate for Payer: Cofinity Commercial |
$1,252.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$934.36
|
| Rate for Payer: Healthscope Commercial |
$1,728.57
|
| Rate for Payer: Healthscope Commercial |
$1,494.98
|
| Rate for Payer: Mclaren Medicaid |
$608.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$981.08
|
| Rate for Payer: Meridian Medicaid |
$639.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172,930.00
|
| Rate for Payer: Nomi Health Commercial |
$1,121.23
|
| Rate for Payer: PACE SWMI |
$934.36
|
| Rate for Payer: PHP Medicare Advantage |
$934.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$608.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,452.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,521.01
|
| Rate for Payer: Priority Health Medicare |
$934.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,521.01
|
| Rate for Payer: Priority Health SBD |
$1,521.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,522.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$934.36
|
| Rate for Payer: UHC Exchange |
$1,522.95
|
| Rate for Payer: UHC Medicare Advantage |
$934.36
|
| Rate for Payer: UHCCP Medicaid |
$608.97
|
|
|
PR TEAEC W/WO PATCH GRAFT ILIAC
|
Professional
|
Both
|
$2,528.00
|
|
|
Service Code
|
HCPCS 35351
|
| Min. Negotiated Rate |
$804.08 |
| Max. Negotiated Rate |
$227,588.00 |
| Rate for Payer: Aetna Commercial |
$1,654.38
|
| Rate for Payer: Aetna Medicare |
$1,283.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,654.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,777.84
|
| Rate for Payer: BCBS Complete |
$844.28
|
| Rate for Payer: BCBS MAPPO |
$1,234.61
|
| Rate for Payer: BCBS Trust/PPO |
$942.49
|
| Rate for Payer: BCN Commercial |
$1,831.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,234.61
|
| Rate for Payer: Cash Price |
$2,022.40
|
| Rate for Payer: Cash Price |
$2,022.40
|
| Rate for Payer: Cofinity Commercial |
$1,777.84
|
| Rate for Payer: Cofinity Commercial |
$1,654.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,234.61
|
| Rate for Payer: Healthscope Commercial |
$2,284.03
|
| Rate for Payer: Healthscope Commercial |
$1,975.38
|
| Rate for Payer: Mclaren Medicaid |
$804.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,296.34
|
| Rate for Payer: Meridian Medicaid |
$844.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227,588.00
|
| Rate for Payer: Nomi Health Commercial |
$1,481.53
|
| Rate for Payer: PACE SWMI |
$1,234.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,234.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$804.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,643.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,001.79
|
| Rate for Payer: Priority Health Medicare |
$1,234.61
|
| Rate for Payer: Priority Health Narrow Network |
$2,001.79
|
| Rate for Payer: Priority Health SBD |
$2,001.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,635.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,234.61
|
| Rate for Payer: UHC Exchange |
$1,635.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,234.61
|
| Rate for Payer: UHCCP Medicaid |
$804.08
|
|
|
PR TEAEC W/WO PATCH GRAFT ILIOFEMORAL
|
Professional
|
Both
|
$2,053.00
|
|
|
Service Code
|
HCPCS 35355
|
| Min. Negotiated Rate |
$642.20 |
| Max. Negotiated Rate |
$182,372.00 |
| Rate for Payer: Aetna Commercial |
$1,322.67
|
| Rate for Payer: Aetna Medicare |
$1,026.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,322.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,421.38
|
| Rate for Payer: BCBS Complete |
$674.31
|
| Rate for Payer: BCBS MAPPO |
$987.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,096.22
|
| Rate for Payer: BCN Commercial |
$1,466.52
|
| Rate for Payer: BCN Medicare Advantage |
$987.07
|
| Rate for Payer: Cash Price |
$1,642.40
|
| Rate for Payer: Cash Price |
$1,642.40
|
| Rate for Payer: Cofinity Commercial |
$1,421.38
|
| Rate for Payer: Cofinity Commercial |
$1,322.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$987.07
|
| Rate for Payer: Healthscope Commercial |
$1,826.08
|
| Rate for Payer: Healthscope Commercial |
$1,579.31
|
| Rate for Payer: Mclaren Medicaid |
$642.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,036.42
|
| Rate for Payer: Meridian Medicaid |
$674.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182,372.00
|
| Rate for Payer: Nomi Health Commercial |
$1,184.48
|
| Rate for Payer: PACE SWMI |
$987.07
|
| Rate for Payer: PHP Medicare Advantage |
$987.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$642.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,334.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,601.33
|
| Rate for Payer: Priority Health Medicare |
$987.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,601.33
|
| Rate for Payer: Priority Health SBD |
$1,601.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,381.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$987.07
|
| Rate for Payer: UHC Exchange |
$1,381.50
|
| Rate for Payer: UHC Medicare Advantage |
$987.07
|
| Rate for Payer: UHCCP Medicaid |
$642.20
|
|
|
PR TEAEC W/WO PATCH GRAFT MESENTERIC CELIAC/RENAL
|
Professional
|
Both
|
$4,508.00
|
|
|
Service Code
|
HCPCS 35341
|
| Min. Negotiated Rate |
$859.67 |
| Max. Negotiated Rate |
$244,894.00 |
| Rate for Payer: Aetna Commercial |
$1,768.49
|
| Rate for Payer: Aetna Medicare |
$1,372.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,768.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,900.47
|
| Rate for Payer: BCBS Complete |
$902.65
|
| Rate for Payer: BCBS MAPPO |
$1,319.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,030.71
|
| Rate for Payer: BCN Commercial |
$1,972.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,319.77
|
| Rate for Payer: Cash Price |
$3,606.40
|
| Rate for Payer: Cash Price |
$3,606.40
|
| Rate for Payer: Cofinity Commercial |
$1,900.47
|
| Rate for Payer: Cofinity Commercial |
$1,768.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,319.77
|
| Rate for Payer: Healthscope Commercial |
$2,441.57
|
| Rate for Payer: Healthscope Commercial |
$2,111.63
|
| Rate for Payer: Mclaren Medicaid |
$859.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,385.76
|
| Rate for Payer: Meridian Medicaid |
$902.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244,894.00
|
| Rate for Payer: Nomi Health Commercial |
$1,583.72
|
| Rate for Payer: PACE SWMI |
$1,319.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,319.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$859.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,930.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,160.80
|
| Rate for Payer: Priority Health Medicare |
$1,319.77
|
| Rate for Payer: Priority Health Narrow Network |
$2,160.80
|
| Rate for Payer: Priority Health SBD |
$2,160.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,838.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,319.77
|
| Rate for Payer: UHC Exchange |
$1,838.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,319.77
|
| Rate for Payer: UHCCP Medicaid |
$859.67
|
|
|
PR TEAEC W/WO PATCH GRF AXILLARY-BRACHIAL
|
Professional
|
Both
|
$3,855.00
|
|
|
Service Code
|
HCPCS 35321
|
| Min. Negotiated Rate |
$568.50 |
| Max. Negotiated Rate |
$158,621.00 |
| Rate for Payer: Aetna Commercial |
$1,164.80
|
| Rate for Payer: Aetna Medicare |
$904.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,164.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,251.72
|
| Rate for Payer: BCBS Complete |
$596.92
|
| Rate for Payer: BCBS MAPPO |
$869.25
|
| Rate for Payer: BCBS Trust/PPO |
$677.28
|
| Rate for Payer: BCN Commercial |
$1,280.34
|
| Rate for Payer: BCN Medicare Advantage |
$869.25
|
| Rate for Payer: Cash Price |
$3,084.00
|
| Rate for Payer: Cash Price |
$3,084.00
|
| Rate for Payer: Cofinity Commercial |
$1,251.72
|
| Rate for Payer: Cofinity Commercial |
$1,164.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$869.25
|
| Rate for Payer: Healthscope Commercial |
$1,608.11
|
| Rate for Payer: Healthscope Commercial |
$1,390.80
|
| Rate for Payer: Mclaren Medicaid |
$568.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$912.71
|
| Rate for Payer: Meridian Medicaid |
$596.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158,621.00
|
| Rate for Payer: Nomi Health Commercial |
$1,043.10
|
| Rate for Payer: PACE SWMI |
$869.25
|
| Rate for Payer: PHP Medicare Advantage |
$869.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$568.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,505.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,402.95
|
| Rate for Payer: Priority Health Medicare |
$869.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,402.95
|
| Rate for Payer: Priority Health SBD |
$1,402.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,304.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$869.25
|
| Rate for Payer: UHC Exchange |
$1,304.78
|
| Rate for Payer: UHC Medicare Advantage |
$869.25
|
| Rate for Payer: UHCCP Medicaid |
$568.50
|
|
|
PR TEAEC W/WO PATCH GRF SUBCLAV INNOM THORACIC INC
|
Professional
|
Both
|
$2,846.00
|
|
|
Service Code
|
HCPCS 35311
|
| Min. Negotiated Rate |
$973.84 |
| Max. Negotiated Rate |
$274,964.00 |
| Rate for Payer: Aetna Commercial |
$1,989.93
|
| Rate for Payer: Aetna Medicare |
$1,544.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,989.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,138.43
|
| Rate for Payer: BCBS Complete |
$1,022.53
|
| Rate for Payer: BCBS MAPPO |
$1,485.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,646.71
|
| Rate for Payer: BCN Commercial |
$2,224.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,485.02
|
| Rate for Payer: Cash Price |
$2,276.80
|
| Rate for Payer: Cash Price |
$2,276.80
|
| Rate for Payer: Cofinity Commercial |
$2,138.43
|
| Rate for Payer: Cofinity Commercial |
$1,989.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,485.02
|
| Rate for Payer: Healthscope Commercial |
$2,747.29
|
| Rate for Payer: Healthscope Commercial |
$2,376.03
|
| Rate for Payer: Mclaren Medicaid |
$973.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,559.27
|
| Rate for Payer: Meridian Medicaid |
$1,022.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274,964.00
|
| Rate for Payer: Nomi Health Commercial |
$1,782.02
|
| Rate for Payer: PACE SWMI |
$1,485.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,485.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$973.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,849.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,421.92
|
| Rate for Payer: Priority Health Medicare |
$1,485.02
|
| Rate for Payer: Priority Health Narrow Network |
$2,421.92
|
| Rate for Payer: Priority Health SBD |
$2,421.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,060.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,485.02
|
| Rate for Payer: UHC Exchange |
$2,060.03
|
| Rate for Payer: UHC Medicare Advantage |
$1,485.02
|
| Rate for Payer: UHCCP Medicaid |
$973.84
|
|
|
PR TEAM CONFERENCE NON-FACE-TO-FACE NONPHYSICIAN
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 99368
|
| Min. Negotiated Rate |
$23.60 |
| Max. Negotiated Rate |
$5,175.00 |
| Rate for Payer: Aetna Commercial |
$36.09
|
| Rate for Payer: Aetna Medicare |
$29.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.09
|
| Rate for Payer: BCBS Complete |
$23.60
|
| Rate for Payer: BCBS Trust/PPO |
$852.68
|
| Rate for Payer: BCN Commercial |
$50.82
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,175.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.67
|
| Rate for Payer: Priority Health Narrow Network |
$46.67
|
| Rate for Payer: Priority Health SBD |
$46.67
|
|
|
PR TEAM CONFERENCE NON-FACE-TO-FACE PHYSICIAN
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 99367
|
| Min. Negotiated Rate |
$55.68 |
| Max. Negotiated Rate |
$7,965.00 |
| Rate for Payer: Aetna Commercial |
$55.68
|
| Rate for Payer: Aetna Medicare |
$76.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.68
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: BCBS Trust/PPO |
$232.98
|
| Rate for Payer: BCN Commercial |
$145.07
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,965.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.80
|
| Rate for Payer: Priority Health Narrow Network |
$71.80
|
| Rate for Payer: Priority Health SBD |
$71.80
|
|
|
PR TELEPHONE ASSMT&MGMT SVC NQHP EST PT 11-20 MIN
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 98967
|
| Min. Negotiated Rate |
$21.65 |
| Max. Negotiated Rate |
$3,254.00 |
| Rate for Payer: Aetna Commercial |
$29.01
|
| Rate for Payer: Aetna Medicare |
$22.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.01
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS MAPPO |
$21.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,248.37
|
| Rate for Payer: BCN Commercial |
$28.04
|
| Rate for Payer: BCN Medicare Advantage |
$21.65
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$31.18
|
| Rate for Payer: Cofinity Commercial |
$29.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.65
|
| Rate for Payer: Healthscope Commercial |
$34.64
|
| Rate for Payer: Healthscope Commercial |
$40.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,254.00
|
| Rate for Payer: Nomi Health Commercial |
$25.98
|
| Rate for Payer: PACE SWMI |
$21.65
|
| Rate for Payer: PHP Medicare Advantage |
$21.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.85
|
| Rate for Payer: Priority Health Medicare |
$21.65
|
| Rate for Payer: Priority Health Narrow Network |
$29.85
|
| Rate for Payer: Priority Health SBD |
$29.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.65
|
| Rate for Payer: UHC Medicare Advantage |
$21.65
|
|
|
PR TELEPHONE ASSMT&MGMT SVC NQHP EST PT 21-30 MIN
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 98968
|
| Min. Negotiated Rate |
$30.32 |
| Max. Negotiated Rate |
$4,617.00 |
| Rate for Payer: Aetna Commercial |
$40.63
|
| Rate for Payer: Aetna Medicare |
$31.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.66
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: BCBS MAPPO |
$30.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,647.77
|
| Rate for Payer: BCN Commercial |
$41.49
|
| Rate for Payer: BCN Medicare Advantage |
$30.32
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$43.66
|
| Rate for Payer: Cofinity Commercial |
$40.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.32
|
| Rate for Payer: Healthscope Commercial |
$48.51
|
| Rate for Payer: Healthscope Commercial |
$56.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,617.00
|
| Rate for Payer: Nomi Health Commercial |
$36.38
|
| Rate for Payer: PACE SWMI |
$30.32
|
| Rate for Payer: PHP Medicare Advantage |
$30.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.61
|
| Rate for Payer: Priority Health Medicare |
$30.32
|
| Rate for Payer: Priority Health Narrow Network |
$41.61
|
| Rate for Payer: Priority Health SBD |
$41.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.32
|
| Rate for Payer: UHC Medicare Advantage |
$30.32
|
|
|
PR TELEPHONE ASSMT&MGMT SVC NQHP EST PT 5-10 MIN
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS 98966
|
| Min. Negotiated Rate |
$11.12 |
| Max. Negotiated Rate |
$1,650.00 |
| Rate for Payer: Aetna Commercial |
$14.90
|
| Rate for Payer: Aetna Medicare |
$11.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.01
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: BCBS MAPPO |
$11.12
|
| Rate for Payer: BCBS Trust/PPO |
$564.75
|
| Rate for Payer: BCN Commercial |
$14.56
|
| Rate for Payer: BCN Medicare Advantage |
$11.12
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cofinity Commercial |
$16.01
|
| Rate for Payer: Cofinity Commercial |
$14.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.12
|
| Rate for Payer: Healthscope Commercial |
$17.79
|
| Rate for Payer: Healthscope Commercial |
$20.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,650.00
|
| Rate for Payer: Nomi Health Commercial |
$13.34
|
| Rate for Payer: PACE SWMI |
$11.12
|
| Rate for Payer: PHP Medicare Advantage |
$11.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.38
|
| Rate for Payer: Priority Health Medicare |
$11.12
|
| Rate for Payer: Priority Health Narrow Network |
$15.38
|
| Rate for Payer: Priority Health SBD |
$15.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.12
|
| Rate for Payer: UHC Medicare Advantage |
$11.12
|
|
|
PR TEMPORARY CLOSURE EYELIDS SUTURE
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 67875
|
| Min. Negotiated Rate |
$89.27 |
| Max. Negotiated Rate |
$16,412.00 |
| Rate for Payer: Aetna Commercial |
$119.62
|
| Rate for Payer: Aetna Medicare |
$92.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.55
|
| Rate for Payer: BCBS Complete |
$152.40
|
| Rate for Payer: BCBS MAPPO |
$89.27
|
| Rate for Payer: BCN Commercial |
$266.33
|
| Rate for Payer: BCN Medicare Advantage |
$89.27
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cofinity Commercial |
$128.55
|
| Rate for Payer: Cofinity Commercial |
$119.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.27
|
| Rate for Payer: Healthscope Commercial |
$142.83
|
| Rate for Payer: Healthscope Commercial |
$165.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,412.00
|
| Rate for Payer: Nomi Health Commercial |
$107.12
|
| Rate for Payer: PACE SWMI |
$89.27
|
| Rate for Payer: PHP Medicare Advantage |
$89.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$166.12
|
| Rate for Payer: Priority Health Medicare |
$89.27
|
| Rate for Payer: Priority Health Narrow Network |
$166.12
|
| Rate for Payer: Priority Health SBD |
$166.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$505.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.27
|
| Rate for Payer: UHC Exchange |
$505.34
|
| Rate for Payer: UHC Medicare Advantage |
$89.27
|
|
|
PR TENDON GRAFT FROM A DISTANCE
|
Professional
|
Both
|
$1,113.00
|
|
|
Service Code
|
HCPCS 20924
|
| Min. Negotiated Rate |
$329.72 |
| Max. Negotiated Rate |
$89,197.00 |
| Rate for Payer: Aetna Commercial |
$650.99
|
| Rate for Payer: Aetna Medicare |
$505.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$650.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$699.57
|
| Rate for Payer: BCBS Complete |
$346.21
|
| Rate for Payer: BCBS MAPPO |
$485.81
|
| Rate for Payer: BCBS Trust/PPO |
$11,952.59
|
| Rate for Payer: BCN Commercial |
$741.81
|
| Rate for Payer: BCN Medicare Advantage |
$485.81
|
| Rate for Payer: Cash Price |
$890.40
|
| Rate for Payer: Cash Price |
$890.40
|
| Rate for Payer: Cofinity Commercial |
$699.57
|
| Rate for Payer: Cofinity Commercial |
$650.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$485.81
|
| Rate for Payer: Healthscope Commercial |
$898.75
|
| Rate for Payer: Healthscope Commercial |
$777.30
|
| Rate for Payer: Mclaren Medicaid |
$329.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$510.10
|
| Rate for Payer: Meridian Medicaid |
$346.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89,197.00
|
| Rate for Payer: Nomi Health Commercial |
$582.97
|
| Rate for Payer: PACE SWMI |
$485.81
|
| Rate for Payer: PHP Medicare Advantage |
$485.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$723.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$779.57
|
| Rate for Payer: Priority Health Medicare |
$485.81
|
| Rate for Payer: Priority Health Narrow Network |
$779.57
|
| Rate for Payer: Priority Health SBD |
$779.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$564.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$485.81
|
| Rate for Payer: UHC Exchange |
$564.03
|
| Rate for Payer: UHC Medicare Advantage |
$485.81
|
| Rate for Payer: UHCCP Medicaid |
$329.72
|
|
|
PR TENDON LENGTHENING UPPER ARM/ELBOW EA TENDON
|
Professional
|
Both
|
$1,029.00
|
|
|
Service Code
|
HCPCS 24305
|
| Min. Negotiated Rate |
$148.45 |
| Max. Negotiated Rate |
$102,901.00 |
| Rate for Payer: Aetna Commercial |
$752.45
|
| Rate for Payer: Aetna Medicare |
$583.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$752.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.60
|
| Rate for Payer: BCBS Complete |
$400.33
|
| Rate for Payer: BCBS MAPPO |
$561.53
|
| Rate for Payer: BCBS Trust/PPO |
$148.45
|
| Rate for Payer: BCN Commercial |
$856.16
|
| Rate for Payer: BCN Medicare Advantage |
$561.53
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cofinity Commercial |
$808.60
|
| Rate for Payer: Cofinity Commercial |
$752.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.53
|
| Rate for Payer: Healthscope Commercial |
$898.45
|
| Rate for Payer: Healthscope Commercial |
$1,038.83
|
| Rate for Payer: Mclaren Medicaid |
$381.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.61
|
| Rate for Payer: Meridian Medicaid |
$400.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102,901.00
|
| Rate for Payer: Nomi Health Commercial |
$673.84
|
| Rate for Payer: PACE SWMI |
$561.53
|
| Rate for Payer: PHP Medicare Advantage |
$561.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$381.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$668.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$901.69
|
| Rate for Payer: Priority Health Medicare |
$561.53
|
| Rate for Payer: Priority Health Narrow Network |
$901.69
|
| Rate for Payer: Priority Health SBD |
$901.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$634.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$561.53
|
| Rate for Payer: UHC Exchange |
$634.58
|
| Rate for Payer: UHC Medicare Advantage |
$561.53
|
| Rate for Payer: UHCCP Medicaid |
$381.27
|
|
|
PR TENDON SHEATH INCISION
|
Professional
|
Both
|
$1,180.00
|
|
|
Service Code
|
HCPCS 26055
|
| Min. Negotiated Rate |
$163.86 |
| Max. Negotiated Rate |
$51,505.00 |
| Rate for Payer: Aetna Commercial |
$378.13
|
| Rate for Payer: Aetna Medicare |
$293.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.35
|
| Rate for Payer: BCBS Complete |
$203.52
|
| Rate for Payer: BCBS MAPPO |
$282.19
|
| Rate for Payer: BCBS Trust/PPO |
$163.86
|
| Rate for Payer: BCN Commercial |
$875.71
|
| Rate for Payer: BCN Medicare Advantage |
$282.19
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$406.35
|
| Rate for Payer: Cofinity Commercial |
$378.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.19
|
| Rate for Payer: Healthscope Commercial |
$522.05
|
| Rate for Payer: Healthscope Commercial |
$451.50
|
| Rate for Payer: Mclaren Medicaid |
$193.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.30
|
| Rate for Payer: Meridian Medicaid |
$203.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51,505.00
|
| Rate for Payer: Nomi Health Commercial |
$338.63
|
| Rate for Payer: PACE SWMI |
$282.19
|
| Rate for Payer: PHP Medicare Advantage |
$282.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.95
|
| Rate for Payer: Priority Health Medicare |
$282.19
|
| Rate for Payer: Priority Health Narrow Network |
$456.95
|
| Rate for Payer: Priority Health SBD |
$456.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$698.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$282.19
|
| Rate for Payer: UHC Exchange |
$698.94
|
| Rate for Payer: UHC Medicare Advantage |
$282.19
|
| Rate for Payer: UHCCP Medicaid |
$193.83
|
|
|
PR TENDON SHEATH INCISION
|
Professional
|
Both
|
$1,180.00
|
|
|
Service Code
|
HCPCS 26055
|
| Hospital Charge Code |
26055
|
| Min. Negotiated Rate |
$163.86 |
| Max. Negotiated Rate |
$51,505.00 |
| Rate for Payer: Aetna Commercial |
$378.13
|
| Rate for Payer: Aetna Medicare |
$293.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.35
|
| Rate for Payer: BCBS Complete |
$203.52
|
| Rate for Payer: BCBS MAPPO |
$282.19
|
| Rate for Payer: BCBS Trust/PPO |
$163.86
|
| Rate for Payer: BCN Commercial |
$875.71
|
| Rate for Payer: BCN Medicare Advantage |
$282.19
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$406.35
|
| Rate for Payer: Cofinity Commercial |
$378.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.19
|
| Rate for Payer: Healthscope Commercial |
$522.05
|
| Rate for Payer: Healthscope Commercial |
$451.50
|
| Rate for Payer: Mclaren Medicaid |
$193.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.30
|
| Rate for Payer: Meridian Medicaid |
$203.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51,505.00
|
| Rate for Payer: Nomi Health Commercial |
$338.63
|
| Rate for Payer: PACE SWMI |
$282.19
|
| Rate for Payer: PHP Medicare Advantage |
$282.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.95
|
| Rate for Payer: Priority Health Medicare |
$282.19
|
| Rate for Payer: Priority Health Narrow Network |
$456.95
|
| Rate for Payer: Priority Health SBD |
$456.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$698.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$282.19
|
| Rate for Payer: UHC Exchange |
$698.94
|
| Rate for Payer: UHC Medicare Advantage |
$282.19
|
| Rate for Payer: UHCCP Medicaid |
$193.83
|
|
|
PR TENDON SHEATH INCISION
|
Facility
|
IP
|
$1,180.00
|
|
|
Service Code
|
CPT 26055
|
| Hospital Charge Code |
26055
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$743.40 |
| Max. Negotiated Rate |
$1,062.00 |
| Rate for Payer: Aetna Commercial |
$1,003.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$1,014.80
|
| Rate for Payer: Cofinity Commercial |
$826.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$826.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.00
|
| Rate for Payer: Healthscope Commercial |
$1,062.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,003.00
|
| Rate for Payer: PHP Commercial |
$1,003.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.00
|
| Rate for Payer: Priority Health SBD |
$743.40
|
|
|
PR TENDON SHEATH INCISION
|
Facility
|
OP
|
$1,180.00
|
|
|
Service Code
|
CPT 26055
|
| Hospital Charge Code |
26055
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$310.20 |
| Max. Negotiated Rate |
$4,928.37 |
| Rate for Payer: Aetna Commercial |
$1,003.00
|
| Rate for Payer: Aetna Medicare |
$1,630.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.06
|
| Rate for Payer: BCBS Complete |
$882.50
|
| Rate for Payer: BCBS MAPPO |
$1,568.05
|
| Rate for Payer: BCBS Trust/PPO |
$882.60
|
| Rate for Payer: BCN Commercial |
$882.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.05
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$826.00
|
| Rate for Payer: Cofinity Commercial |
$1,014.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$826.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.05
|
| Rate for Payer: Healthscope Commercial |
$1,062.00
|
| Rate for Payer: Mclaren Medicaid |
$840.47
|
| Rate for Payer: Mclaren Medicare |
$1,568.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.45
|
| Rate for Payer: Meridian Medicaid |
$882.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,003.00
|
| Rate for Payer: Nomi Health Commercial |
$3,292.90
|
| Rate for Payer: PACE Medicare |
$1,489.65
|
| Rate for Payer: PACE SWMI |
$1,568.05
|
| Rate for Payer: PHP Commercial |
$1,003.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,928.37
|
| Rate for Payer: Priority Health Medicare |
$1,568.05
|
| Rate for Payer: Priority Health Narrow Network |
$3,942.70
|
| Rate for Payer: Priority Health SBD |
$743.40
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$310.20
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.05
|
| Rate for Payer: UHCCP Medicaid |
$882.81
|
| Rate for Payer: VA VA |
$1,568.05
|
|
|
PR TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT
|
Professional
|
Both
|
$1,419.00
|
|
|
Service Code
|
HCPCS 26483
|
| Min. Negotiated Rate |
$560.83 |
| Max. Negotiated Rate |
$153,263.00 |
| Rate for Payer: Aetna Commercial |
$1,090.34
|
| Rate for Payer: Aetna Medicare |
$846.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,090.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,171.71
|
| Rate for Payer: BCBS Complete |
$588.87
|
| Rate for Payer: BCBS MAPPO |
$813.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,202.41
|
| Rate for Payer: BCN Commercial |
$1,293.53
|
| Rate for Payer: BCN Medicare Advantage |
$813.69
|
| Rate for Payer: Cash Price |
$1,135.20
|
| Rate for Payer: Cash Price |
$1,135.20
|
| Rate for Payer: Cofinity Commercial |
$1,171.71
|
| Rate for Payer: Cofinity Commercial |
$1,090.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$813.69
|
| Rate for Payer: Healthscope Commercial |
$1,505.33
|
| Rate for Payer: Healthscope Commercial |
$1,301.90
|
| Rate for Payer: Mclaren Medicaid |
$560.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$854.37
|
| Rate for Payer: Meridian Medicaid |
$588.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153,263.00
|
| Rate for Payer: Nomi Health Commercial |
$976.43
|
| Rate for Payer: PACE SWMI |
$813.69
|
| Rate for Payer: PHP Medicare Advantage |
$813.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$560.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$922.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,346.45
|
| Rate for Payer: Priority Health Medicare |
$813.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,346.45
|
| Rate for Payer: Priority Health SBD |
$1,346.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,132.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$813.69
|
| Rate for Payer: UHC Exchange |
$1,132.61
|
| Rate for Payer: UHC Medicare Advantage |
$813.69
|
| Rate for Payer: UHCCP Medicaid |
$560.83
|
|
|
PR TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,092.00
|
|
|
Service Code
|
HCPCS 24340
|
| Min. Negotiated Rate |
$86.64 |
| Max. Negotiated Rate |
$106,646.00 |
| Rate for Payer: Aetna Commercial |
$785.71
|
| Rate for Payer: Aetna Medicare |
$609.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$785.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$844.34
|
| Rate for Payer: BCBS Complete |
$417.33
|
| Rate for Payer: BCBS MAPPO |
$586.35
|
| Rate for Payer: BCBS Trust/PPO |
$86.64
|
| Rate for Payer: BCN Commercial |
$886.46
|
| Rate for Payer: BCN Medicare Advantage |
$586.35
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cofinity Commercial |
$844.34
|
| Rate for Payer: Cofinity Commercial |
$785.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$586.35
|
| Rate for Payer: Healthscope Commercial |
$938.16
|
| Rate for Payer: Healthscope Commercial |
$1,084.75
|
| Rate for Payer: Mclaren Medicaid |
$397.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$615.67
|
| Rate for Payer: Meridian Medicaid |
$417.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106,646.00
|
| Rate for Payer: Nomi Health Commercial |
$703.62
|
| Rate for Payer: PACE SWMI |
$586.35
|
| Rate for Payer: PHP Medicare Advantage |
$586.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$397.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$709.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$927.65
|
| Rate for Payer: Priority Health Medicare |
$586.35
|
| Rate for Payer: Priority Health Narrow Network |
$927.65
|
| Rate for Payer: Priority Health SBD |
$927.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$757.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$586.35
|
| Rate for Payer: UHC Exchange |
$757.33
|
| Rate for Payer: UHC Medicare Advantage |
$586.35
|
| Rate for Payer: UHCCP Medicaid |
$397.46
|
|
|
PR TENODESIS DISTAL JOINT EACH
|
Professional
|
Both
|
$1,015.00
|
|
|
Service Code
|
HCPCS 26474
|
| Min. Negotiated Rate |
$420.46 |
| Max. Negotiated Rate |
$114,689.00 |
| Rate for Payer: Aetna Commercial |
$813.47
|
| Rate for Payer: Aetna Medicare |
$631.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$813.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$874.18
|
| Rate for Payer: BCBS Complete |
$441.48
|
| Rate for Payer: BCBS MAPPO |
$607.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.66
|
| Rate for Payer: BCN Commercial |
$972.47
|
| Rate for Payer: BCN Medicare Advantage |
$607.07
|
| Rate for Payer: Cash Price |
$812.00
|
| Rate for Payer: Cash Price |
$812.00
|
| Rate for Payer: Cofinity Commercial |
$874.18
|
| Rate for Payer: Cofinity Commercial |
$813.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.07
|
| Rate for Payer: Healthscope Commercial |
$971.31
|
| Rate for Payer: Healthscope Commercial |
$1,123.08
|
| Rate for Payer: Mclaren Medicaid |
$420.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$637.42
|
| Rate for Payer: Meridian Medicaid |
$441.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114,689.00
|
| Rate for Payer: Nomi Health Commercial |
$728.48
|
| Rate for Payer: PACE SWMI |
$607.07
|
| Rate for Payer: PHP Medicare Advantage |
$607.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$420.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$659.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,011.10
|
| Rate for Payer: Priority Health Medicare |
$607.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,011.10
|
| Rate for Payer: Priority Health SBD |
$1,011.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$772.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$607.07
|
| Rate for Payer: UHC Exchange |
$772.48
|
| Rate for Payer: UHC Medicare Advantage |
$607.07
|
| Rate for Payer: UHCCP Medicaid |
$420.46
|
|
