|
PR THYROIDECT W/SUBSTERNAL SPLIT/TRANSTHORACIC
|
Professional
|
Both
|
$5,453.00
|
|
|
Service Code
|
HCPCS 60270
|
| Min. Negotiated Rate |
$309.58 |
| Max. Negotiated Rate |
$243,796.00 |
| Rate for Payer: Aetna Commercial |
$1,759.51
|
| Rate for Payer: Aetna Medicare |
$1,365.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,759.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,890.82
|
| Rate for Payer: BCBS Complete |
$915.85
|
| Rate for Payer: BCBS MAPPO |
$1,313.07
|
| Rate for Payer: BCBS Trust/PPO |
$309.58
|
| Rate for Payer: BCN Commercial |
$1,991.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,313.07
|
| Rate for Payer: Cash Price |
$4,362.40
|
| Rate for Payer: Cash Price |
$4,362.40
|
| Rate for Payer: Cofinity Commercial |
$1,890.82
|
| Rate for Payer: Cofinity Commercial |
$1,759.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,313.07
|
| Rate for Payer: Healthscope Commercial |
$2,429.18
|
| Rate for Payer: Healthscope Commercial |
$2,100.91
|
| Rate for Payer: Mclaren Medicaid |
$872.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,378.72
|
| Rate for Payer: Meridian Medicaid |
$915.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243,796.00
|
| Rate for Payer: Nomi Health Commercial |
$1,575.68
|
| Rate for Payer: PACE SWMI |
$1,313.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,313.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$872.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,544.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,201.38
|
| Rate for Payer: Priority Health Medicare |
$1,313.07
|
| Rate for Payer: Priority Health Narrow Network |
$2,201.38
|
| Rate for Payer: Priority Health SBD |
$2,201.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,594.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,313.07
|
| Rate for Payer: UHC Exchange |
$1,594.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,313.07
|
| Rate for Payer: UHCCP Medicaid |
$872.24
|
|
|
PR TIS CLTR SKN AGRFT F/S/N/H/F/G/M/DGT 1ST 25SQCM/
|
Professional
|
Both
|
$1,325.00
|
|
|
Service Code
|
HCPCS 15155
|
| Min. Negotiated Rate |
$206.12 |
| Max. Negotiated Rate |
$128,495.00 |
| Rate for Payer: Aetna Commercial |
$933.12
|
| Rate for Payer: Aetna Medicare |
$724.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,002.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$933.12
|
| Rate for Payer: BCBS Complete |
$494.27
|
| Rate for Payer: BCBS MAPPO |
$696.36
|
| Rate for Payer: BCBS Trust/PPO |
$206.12
|
| Rate for Payer: BCN Commercial |
$1,166.47
|
| Rate for Payer: BCN Medicare Advantage |
$696.36
|
| Rate for Payer: Cash Price |
$1,060.00
|
| Rate for Payer: Cash Price |
$1,060.00
|
| Rate for Payer: Cofinity Commercial |
$933.12
|
| Rate for Payer: Cofinity Commercial |
$1,002.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$696.36
|
| Rate for Payer: Healthscope Commercial |
$1,288.27
|
| Rate for Payer: Healthscope Commercial |
$1,114.18
|
| Rate for Payer: Mclaren Medicaid |
$470.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$731.18
|
| Rate for Payer: Meridian Medicaid |
$494.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128,495.00
|
| Rate for Payer: Nomi Health Commercial |
$835.63
|
| Rate for Payer: PACE SWMI |
$696.36
|
| Rate for Payer: PHP Medicare Advantage |
$696.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$987.01
|
| Rate for Payer: Priority Health Medicare |
$696.36
|
| Rate for Payer: Priority Health Narrow Network |
$987.01
|
| Rate for Payer: Priority Health SBD |
$987.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$715.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$696.36
|
| Rate for Payer: UHC Exchange |
$715.64
|
| Rate for Payer: UHC Medicare Advantage |
$696.36
|
| Rate for Payer: UHCCP Medicaid |
$470.73
|
|
|
PR TIS CLTR SKN AGRFT F/S/N/H/F/G/M/DGT AD 1-75SQCM
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 15156
|
| Min. Negotiated Rate |
$95.85 |
| Max. Negotiated Rate |
$26,915.00 |
| Rate for Payer: Aetna Commercial |
$196.36
|
| Rate for Payer: Aetna Medicare |
$152.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.02
|
| Rate for Payer: BCBS Complete |
$100.64
|
| Rate for Payer: BCBS MAPPO |
$146.54
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$231.63
|
| Rate for Payer: BCN Medicare Advantage |
$146.54
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$211.02
|
| Rate for Payer: Cofinity Commercial |
$196.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.54
|
| Rate for Payer: Healthscope Commercial |
$271.10
|
| Rate for Payer: Healthscope Commercial |
$234.46
|
| Rate for Payer: Mclaren Medicaid |
$95.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.87
|
| Rate for Payer: Meridian Medicaid |
$100.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26,915.00
|
| Rate for Payer: Nomi Health Commercial |
$175.85
|
| Rate for Payer: PACE SWMI |
$146.54
|
| Rate for Payer: PHP Medicare Advantage |
$146.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$201.83
|
| Rate for Payer: Priority Health Medicare |
$146.54
|
| Rate for Payer: Priority Health Narrow Network |
$201.83
|
| Rate for Payer: Priority Health SBD |
$201.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.54
|
| Rate for Payer: UHC Exchange |
$190.14
|
| Rate for Payer: UHC Medicare Advantage |
$146.54
|
| Rate for Payer: UHCCP Medicaid |
$95.85
|
|
|
PR TISS CLTR SKIN AGRFT T/A/L EA ADD 100 SQCM/EA 1%
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 15152
|
| Min. Negotiated Rate |
$92.23 |
| Max. Negotiated Rate |
$25,153.00 |
| Rate for Payer: Aetna Commercial |
$186.53
|
| Rate for Payer: Aetna Medicare |
$144.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.45
|
| Rate for Payer: BCBS Complete |
$96.84
|
| Rate for Payer: BCBS MAPPO |
$139.20
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$218.44
|
| Rate for Payer: BCN Medicare Advantage |
$139.20
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$200.45
|
| Rate for Payer: Cofinity Commercial |
$186.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.20
|
| Rate for Payer: Healthscope Commercial |
$257.52
|
| Rate for Payer: Healthscope Commercial |
$222.72
|
| Rate for Payer: Mclaren Medicaid |
$92.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.16
|
| Rate for Payer: Meridian Medicaid |
$96.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,153.00
|
| Rate for Payer: Nomi Health Commercial |
$167.04
|
| Rate for Payer: PACE SWMI |
$139.20
|
| Rate for Payer: PHP Medicare Advantage |
$139.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.48
|
| Rate for Payer: Priority Health Medicare |
$139.20
|
| Rate for Payer: Priority Health Narrow Network |
$186.48
|
| Rate for Payer: Priority Health SBD |
$186.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.20
|
| Rate for Payer: UHC Exchange |
$179.49
|
| Rate for Payer: UHC Medicare Advantage |
$139.20
|
| Rate for Payer: UHCCP Medicaid |
$92.23
|
|
|
PR TISS CLTR SKIN AUTOGRAFT T/A/L 1ST 25 SQ CM/<
|
Professional
|
Both
|
$1,205.00
|
|
|
Service Code
|
HCPCS 15150
|
| Min. Negotiated Rate |
$212.16 |
| Max. Negotiated Rate |
$113,774.00 |
| Rate for Payer: Aetna Commercial |
$828.23
|
| Rate for Payer: Aetna Medicare |
$642.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$828.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$890.04
|
| Rate for Payer: BCBS Complete |
$433.21
|
| Rate for Payer: BCBS MAPPO |
$618.08
|
| Rate for Payer: BCBS Trust/PPO |
$212.16
|
| Rate for Payer: BCN Commercial |
$1,035.02
|
| Rate for Payer: BCN Medicare Advantage |
$618.08
|
| Rate for Payer: Cash Price |
$964.00
|
| Rate for Payer: Cash Price |
$964.00
|
| Rate for Payer: Cofinity Commercial |
$890.04
|
| Rate for Payer: Cofinity Commercial |
$828.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$618.08
|
| Rate for Payer: Healthscope Commercial |
$988.93
|
| Rate for Payer: Healthscope Commercial |
$1,143.45
|
| Rate for Payer: Mclaren Medicaid |
$412.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$648.98
|
| Rate for Payer: Meridian Medicaid |
$433.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113,774.00
|
| Rate for Payer: Nomi Health Commercial |
$741.70
|
| Rate for Payer: PACE SWMI |
$618.08
|
| Rate for Payer: PHP Medicare Advantage |
$618.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$869.16
|
| Rate for Payer: Priority Health Medicare |
$618.08
|
| Rate for Payer: Priority Health Narrow Network |
$869.16
|
| Rate for Payer: Priority Health SBD |
$869.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$714.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$618.08
|
| Rate for Payer: UHC Exchange |
$714.67
|
| Rate for Payer: UHC Medicare Advantage |
$618.08
|
| Rate for Payer: UHCCP Medicaid |
$412.58
|
|
|
PR TISS CLTR SKIN AUTOGRAFT T/A/L ADDL 1-75 SQCM
|
Professional
|
Both
|
$230.00
|
|
|
Service Code
|
HCPCS 15151
|
| Min. Negotiated Rate |
$69.44 |
| Max. Negotiated Rate |
$19,660.00 |
| Rate for Payer: Aetna Commercial |
$142.23
|
| Rate for Payer: Aetna Medicare |
$110.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.84
|
| Rate for Payer: BCBS Complete |
$72.91
|
| Rate for Payer: BCBS MAPPO |
$106.14
|
| Rate for Payer: BCBS Trust/PPO |
$206.12
|
| Rate for Payer: BCN Commercial |
$172.50
|
| Rate for Payer: BCN Medicare Advantage |
$106.14
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Cofinity Commercial |
$152.84
|
| Rate for Payer: Cofinity Commercial |
$142.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.14
|
| Rate for Payer: Healthscope Commercial |
$196.36
|
| Rate for Payer: Healthscope Commercial |
$169.82
|
| Rate for Payer: Mclaren Medicaid |
$69.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.45
|
| Rate for Payer: Meridian Medicaid |
$72.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,660.00
|
| Rate for Payer: Nomi Health Commercial |
$127.37
|
| Rate for Payer: PACE SWMI |
$106.14
|
| Rate for Payer: PHP Medicare Advantage |
$106.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$146.29
|
| Rate for Payer: Priority Health Medicare |
$106.14
|
| Rate for Payer: Priority Health Narrow Network |
$146.29
|
| Rate for Payer: Priority Health SBD |
$146.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.14
|
| Rate for Payer: UHC Exchange |
$145.89
|
| Rate for Payer: UHC Medicare Advantage |
$106.14
|
| Rate for Payer: UHCCP Medicaid |
$69.44
|
|
|
PR TISSUE EXPANDER PLACEMENT BREAST RECONSTRUCTION
|
Professional
|
Both
|
$2,448.00
|
|
|
Service Code
|
HCPCS 19357
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$203,767.00 |
| Rate for Payer: Aetna Commercial |
$1,480.78
|
| Rate for Payer: Aetna Medicare |
$1,149.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,480.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,591.29
|
| Rate for Payer: BCBS Complete |
$788.59
|
| Rate for Payer: BCBS MAPPO |
$1,105.06
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$1,696.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,105.06
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cofinity Commercial |
$1,591.29
|
| Rate for Payer: Cofinity Commercial |
$1,480.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,105.06
|
| Rate for Payer: Healthscope Commercial |
$2,044.36
|
| Rate for Payer: Healthscope Commercial |
$1,768.10
|
| Rate for Payer: Mclaren Medicaid |
$751.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,160.31
|
| Rate for Payer: Meridian Medicaid |
$788.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$203,767.00
|
| Rate for Payer: Nomi Health Commercial |
$1,326.07
|
| Rate for Payer: PACE SWMI |
$1,105.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,105.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$751.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,591.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,576.25
|
| Rate for Payer: Priority Health Medicare |
$1,105.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,576.25
|
| Rate for Payer: Priority Health SBD |
$1,576.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,453.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,105.06
|
| Rate for Payer: UHC Exchange |
$1,453.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,105.06
|
| Rate for Payer: UHCCP Medicaid |
$751.04
|
|
|
PR TIXAGEV AND CILGAV INJ
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS M0220
|
| Min. Negotiated Rate |
$81.60 |
| Max. Negotiated Rate |
$21,740.00 |
| Rate for Payer: Aetna Commercial |
$150.50
|
| Rate for Payer: Aetna Medicare |
$102.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.50
|
| Rate for Payer: BCBS Complete |
$81.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,507.84
|
| Rate for Payer: BCN Commercial |
$99.03
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,740.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.93
|
| Rate for Payer: Priority Health Narrow Network |
$144.93
|
| Rate for Payer: Priority Health SBD |
$144.93
|
|
|
PR TMPP ANTRT/MASTOIDOTOMY PROSTHESIS TORP
|
Professional
|
Both
|
$3,605.00
|
|
|
Service Code
|
HCPCS 69637
|
| Min. Negotiated Rate |
$896.94 |
| Max. Negotiated Rate |
$246,211.00 |
| Rate for Payer: Aetna Commercial |
$1,747.09
|
| Rate for Payer: Aetna Medicare |
$1,355.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,747.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,877.47
|
| Rate for Payer: BCBS Complete |
$941.79
|
| Rate for Payer: BCBS MAPPO |
$1,303.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,372.93
|
| Rate for Payer: BCN Commercial |
$2,072.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,303.80
|
| Rate for Payer: Cash Price |
$2,884.00
|
| Rate for Payer: Cash Price |
$2,884.00
|
| Rate for Payer: Cofinity Commercial |
$1,747.09
|
| Rate for Payer: Cofinity Commercial |
$1,877.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,303.80
|
| Rate for Payer: Healthscope Commercial |
$2,412.03
|
| Rate for Payer: Healthscope Commercial |
$2,086.08
|
| Rate for Payer: Mclaren Medicaid |
$896.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,368.99
|
| Rate for Payer: Meridian Medicaid |
$941.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$246,211.00
|
| Rate for Payer: Nomi Health Commercial |
$1,564.56
|
| Rate for Payer: PACE SWMI |
$1,303.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,303.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$896.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,343.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,052.99
|
| Rate for Payer: Priority Health Medicare |
$1,303.80
|
| Rate for Payer: Priority Health Narrow Network |
$2,052.99
|
| Rate for Payer: Priority Health SBD |
$2,052.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,708.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,303.80
|
| Rate for Payer: UHC Exchange |
$1,708.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,303.80
|
| Rate for Payer: UHCCP Medicaid |
$896.94
|
|
|
PR TMPP MASTOIDECT NTC/RCNSTED CANAL WALL OCR
|
Professional
|
Both
|
$4,310.00
|
|
|
Service Code
|
HCPCS 69644
|
| Min. Negotiated Rate |
$964.89 |
| Max. Negotiated Rate |
$265,019.00 |
| Rate for Payer: Aetna Commercial |
$1,884.17
|
| Rate for Payer: Aetna Medicare |
$1,462.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,884.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,024.78
|
| Rate for Payer: BCBS Complete |
$1,013.13
|
| Rate for Payer: BCBS MAPPO |
$1,406.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,406.93
|
| Rate for Payer: BCN Commercial |
$2,226.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,406.10
|
| Rate for Payer: Cash Price |
$3,448.00
|
| Rate for Payer: Cash Price |
$3,448.00
|
| Rate for Payer: Cofinity Commercial |
$2,024.78
|
| Rate for Payer: Cofinity Commercial |
$1,884.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,406.10
|
| Rate for Payer: Healthscope Commercial |
$2,601.28
|
| Rate for Payer: Healthscope Commercial |
$2,249.76
|
| Rate for Payer: Mclaren Medicaid |
$964.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,476.40
|
| Rate for Payer: Meridian Medicaid |
$1,013.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265,019.00
|
| Rate for Payer: Nomi Health Commercial |
$1,687.32
|
| Rate for Payer: PACE SWMI |
$1,406.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,406.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$964.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,801.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,203.27
|
| Rate for Payer: Priority Health Medicare |
$1,406.10
|
| Rate for Payer: Priority Health Narrow Network |
$2,203.27
|
| Rate for Payer: Priority Health SBD |
$2,203.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,758.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,406.10
|
| Rate for Payer: UHC Exchange |
$1,758.23
|
| Rate for Payer: UHC Medicare Advantage |
$1,406.10
|
| Rate for Payer: UHCCP Medicaid |
$964.89
|
|
|
PR TMPP MASTOIDECT NTC/RCNSTED WALL W/O OCR
|
Professional
|
Both
|
$4,076.00
|
|
|
Service Code
|
HCPCS 69643
|
| Min. Negotiated Rate |
$780.01 |
| Max. Negotiated Rate |
$216,385.00 |
| Rate for Payer: Aetna Commercial |
$1,531.70
|
| Rate for Payer: Aetna Medicare |
$1,188.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,531.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,646.01
|
| Rate for Payer: BCBS Complete |
$819.01
|
| Rate for Payer: BCBS MAPPO |
$1,143.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,123.77
|
| Rate for Payer: BCN Commercial |
$1,808.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,143.06
|
| Rate for Payer: Cash Price |
$3,260.80
|
| Rate for Payer: Cash Price |
$3,260.80
|
| Rate for Payer: Cofinity Commercial |
$1,646.01
|
| Rate for Payer: Cofinity Commercial |
$1,531.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,143.06
|
| Rate for Payer: Healthscope Commercial |
$2,114.66
|
| Rate for Payer: Healthscope Commercial |
$1,828.90
|
| Rate for Payer: Mclaren Medicaid |
$780.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,200.21
|
| Rate for Payer: Meridian Medicaid |
$819.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216,385.00
|
| Rate for Payer: Nomi Health Commercial |
$1,371.67
|
| Rate for Payer: PACE SWMI |
$1,143.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,143.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$780.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,649.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,792.78
|
| Rate for Payer: Priority Health Medicare |
$1,143.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,792.78
|
| Rate for Payer: Priority Health SBD |
$1,792.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,609.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,143.06
|
| Rate for Payer: UHC Exchange |
$1,609.79
|
| Rate for Payer: UHC Medicare Advantage |
$1,143.06
|
| Rate for Payer: UHCCP Medicaid |
$780.01
|
|
|
PR TMPP MASTOIDECTOMY W/O OSSICULAR CHAIN RECNSTJ
|
Professional
|
Both
|
$3,931.00
|
|
|
Service Code
|
HCPCS 69641
|
| Min. Negotiated Rate |
$664.77 |
| Max. Negotiated Rate |
$184,122.00 |
| Rate for Payer: Aetna Commercial |
$1,303.57
|
| Rate for Payer: Aetna Medicare |
$1,011.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,303.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,400.85
|
| Rate for Payer: BCBS Complete |
$698.01
|
| Rate for Payer: BCBS MAPPO |
$972.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,242.56
|
| Rate for Payer: BCN Commercial |
$1,541.29
|
| Rate for Payer: BCN Medicare Advantage |
$972.81
|
| Rate for Payer: Cash Price |
$3,144.80
|
| Rate for Payer: Cash Price |
$3,144.80
|
| Rate for Payer: Cofinity Commercial |
$1,400.85
|
| Rate for Payer: Cofinity Commercial |
$1,303.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$972.81
|
| Rate for Payer: Healthscope Commercial |
$1,799.70
|
| Rate for Payer: Healthscope Commercial |
$1,556.50
|
| Rate for Payer: Mclaren Medicaid |
$664.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,021.45
|
| Rate for Payer: Meridian Medicaid |
$698.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184,122.00
|
| Rate for Payer: Nomi Health Commercial |
$1,167.37
|
| Rate for Payer: PACE SWMI |
$972.81
|
| Rate for Payer: PHP Medicare Advantage |
$972.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$664.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,555.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,528.68
|
| Rate for Payer: Priority Health Medicare |
$972.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,528.68
|
| Rate for Payer: Priority Health SBD |
$1,528.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,338.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$972.81
|
| Rate for Payer: UHC Exchange |
$1,338.96
|
| Rate for Payer: UHC Medicare Advantage |
$972.81
|
| Rate for Payer: UHCCP Medicaid |
$664.77
|
|
|
PR TMPP MASTOIDECTOMY W/OSSICULAR CHAIN RECNSTJ
|
Professional
|
Both
|
$2,684.00
|
|
|
Service Code
|
HCPCS 69642
|
| Min. Negotiated Rate |
$852.64 |
| Max. Negotiated Rate |
$236,360.00 |
| Rate for Payer: Aetna Commercial |
$1,674.29
|
| Rate for Payer: Aetna Medicare |
$1,299.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,674.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,799.24
|
| Rate for Payer: BCBS Complete |
$895.27
|
| Rate for Payer: BCBS MAPPO |
$1,249.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,237.81
|
| Rate for Payer: BCN Commercial |
$1,975.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,249.47
|
| Rate for Payer: Cash Price |
$2,147.20
|
| Rate for Payer: Cash Price |
$2,147.20
|
| Rate for Payer: Cofinity Commercial |
$1,799.24
|
| Rate for Payer: Cofinity Commercial |
$1,674.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,249.47
|
| Rate for Payer: Healthscope Commercial |
$2,311.52
|
| Rate for Payer: Healthscope Commercial |
$1,999.15
|
| Rate for Payer: Mclaren Medicaid |
$852.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,311.94
|
| Rate for Payer: Meridian Medicaid |
$895.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236,360.00
|
| Rate for Payer: Nomi Health Commercial |
$1,499.36
|
| Rate for Payer: PACE SWMI |
$1,249.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,249.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$852.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,962.04
|
| Rate for Payer: Priority Health Medicare |
$1,249.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,962.04
|
| Rate for Payer: Priority Health SBD |
$1,962.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,746.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,249.47
|
| Rate for Payer: UHC Exchange |
$1,746.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,249.47
|
| Rate for Payer: UHCCP Medicaid |
$852.64
|
|
|
PR TMVI W/PROSTHETIC VALVE PERCUTANEOUS APPROACH
|
Professional
|
Both
|
$3,759.00
|
|
|
Service Code
|
HCPCS 0483T
|
| Min. Negotiated Rate |
$131.11 |
| Max. Negotiated Rate |
$238,014.00 |
| Rate for Payer: Aetna Commercial |
$1,415.73
|
| Rate for Payer: Aetna Medicare |
$1,879.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,415.73
|
| Rate for Payer: BCBS Complete |
$1,503.60
|
| Rate for Payer: BCBS Trust/PPO |
$131.11
|
| Rate for Payer: Cash Price |
$3,007.20
|
| Rate for Payer: Cash Price |
$3,007.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238,014.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,443.35
|
|
|
PR TNOLS FLXR/XTNSR TDN LEG&/ANKLE MLT TDN
|
Professional
|
Both
|
$1,735.00
|
|
|
Service Code
|
HCPCS 27681
|
| Min. Negotiated Rate |
$332.49 |
| Max. Negotiated Rate |
$89,352.00 |
| Rate for Payer: Aetna Commercial |
$656.76
|
| Rate for Payer: Aetna Medicare |
$509.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$656.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$705.77
|
| Rate for Payer: BCBS Complete |
$349.11
|
| Rate for Payer: BCBS MAPPO |
$490.12
|
| Rate for Payer: BCBS Trust/PPO |
$924.00
|
| Rate for Payer: BCN Commercial |
$742.30
|
| Rate for Payer: BCN Medicare Advantage |
$490.12
|
| Rate for Payer: Cash Price |
$1,388.00
|
| Rate for Payer: Cash Price |
$1,388.00
|
| Rate for Payer: Cofinity Commercial |
$656.76
|
| Rate for Payer: Cofinity Commercial |
$705.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$490.12
|
| Rate for Payer: Healthscope Commercial |
$784.19
|
| Rate for Payer: Healthscope Commercial |
$906.72
|
| Rate for Payer: Mclaren Medicaid |
$332.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$514.63
|
| Rate for Payer: Meridian Medicaid |
$349.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89,352.00
|
| Rate for Payer: Nomi Health Commercial |
$588.14
|
| Rate for Payer: PACE SWMI |
$490.12
|
| Rate for Payer: PHP Medicare Advantage |
$490.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$785.68
|
| Rate for Payer: Priority Health Medicare |
$490.12
|
| Rate for Payer: Priority Health Narrow Network |
$785.68
|
| Rate for Payer: Priority Health SBD |
$785.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$705.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$490.12
|
| Rate for Payer: UHC Exchange |
$705.12
|
| Rate for Payer: UHC Medicare Advantage |
$490.12
|
| Rate for Payer: UHCCP Medicaid |
$332.49
|
|
|
PR TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Facility
|
OP
|
$1,474.00
|
|
|
Service Code
|
CPT 25295
|
| Hospital Charge Code |
25295
|
| Min. Negotiated Rate |
$563.12 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna Commercial |
$1,252.90
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$958.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,298.77
|
| Rate for Payer: BCN Commercial |
$1,298.77
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,179.20
|
| Rate for Payer: Cash Price |
$1,179.20
|
| Rate for Payer: Cash Price |
$1,179.20
|
| Rate for Payer: Cofinity Commercial |
$1,267.64
|
| Rate for Payer: Cofinity Commercial |
$1,031.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,031.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,179.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$1,326.60
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,252.90
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$1,252.90
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$958.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Priority Health SBD |
$928.62
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$563.12
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,789.78
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
PR TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Professional
|
Both
|
$1,474.00
|
|
|
Service Code
|
HCPCS 25295
|
| Min. Negotiated Rate |
$347.40 |
| Max. Negotiated Rate |
$93,760.00 |
| Rate for Payer: Aetna Commercial |
$684.38
|
| Rate for Payer: Aetna Medicare |
$531.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$735.45
|
| Rate for Payer: BCBS Complete |
$364.77
|
| Rate for Payer: BCBS MAPPO |
$510.73
|
| Rate for Payer: BCBS Trust/PPO |
$803.02
|
| Rate for Payer: BCN Commercial |
$781.39
|
| Rate for Payer: BCN Medicare Advantage |
$510.73
|
| Rate for Payer: Cash Price |
$1,179.20
|
| Rate for Payer: Cash Price |
$1,179.20
|
| Rate for Payer: Cofinity Commercial |
$735.45
|
| Rate for Payer: Cofinity Commercial |
$684.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.73
|
| Rate for Payer: Healthscope Commercial |
$944.85
|
| Rate for Payer: Healthscope Commercial |
$817.17
|
| Rate for Payer: Mclaren Medicaid |
$347.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.27
|
| Rate for Payer: Meridian Medicaid |
$364.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93,760.00
|
| Rate for Payer: Nomi Health Commercial |
$612.88
|
| Rate for Payer: PACE SWMI |
$510.73
|
| Rate for Payer: PHP Medicare Advantage |
$510.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$958.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$821.30
|
| Rate for Payer: Priority Health Medicare |
$510.73
|
| Rate for Payer: Priority Health Narrow Network |
$821.30
|
| Rate for Payer: Priority Health SBD |
$821.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$889.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$510.73
|
| Rate for Payer: UHC Exchange |
$889.97
|
| Rate for Payer: UHC Medicare Advantage |
$510.73
|
| Rate for Payer: UHCCP Medicaid |
$347.40
|
|
|
PR TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Professional
|
Both
|
$1,474.00
|
|
|
Service Code
|
HCPCS 25295
|
| Hospital Charge Code |
25295
|
| Min. Negotiated Rate |
$347.40 |
| Max. Negotiated Rate |
$93,760.00 |
| Rate for Payer: Aetna Commercial |
$684.38
|
| Rate for Payer: Aetna Medicare |
$531.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$735.45
|
| Rate for Payer: BCBS Complete |
$364.77
|
| Rate for Payer: BCBS MAPPO |
$510.73
|
| Rate for Payer: BCBS Trust/PPO |
$803.02
|
| Rate for Payer: BCN Commercial |
$781.39
|
| Rate for Payer: BCN Medicare Advantage |
$510.73
|
| Rate for Payer: Cash Price |
$1,179.20
|
| Rate for Payer: Cash Price |
$1,179.20
|
| Rate for Payer: Cofinity Commercial |
$735.45
|
| Rate for Payer: Cofinity Commercial |
$684.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.73
|
| Rate for Payer: Healthscope Commercial |
$944.85
|
| Rate for Payer: Healthscope Commercial |
$817.17
|
| Rate for Payer: Mclaren Medicaid |
$347.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.27
|
| Rate for Payer: Meridian Medicaid |
$364.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93,760.00
|
| Rate for Payer: Nomi Health Commercial |
$612.88
|
| Rate for Payer: PACE SWMI |
$510.73
|
| Rate for Payer: PHP Medicare Advantage |
$510.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$958.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$821.30
|
| Rate for Payer: Priority Health Medicare |
$510.73
|
| Rate for Payer: Priority Health Narrow Network |
$821.30
|
| Rate for Payer: Priority Health SBD |
$821.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$889.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$510.73
|
| Rate for Payer: UHC Exchange |
$889.97
|
| Rate for Payer: UHC Medicare Advantage |
$510.73
|
| Rate for Payer: UHCCP Medicaid |
$347.40
|
|
|
PR TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Facility
|
IP
|
$1,474.00
|
|
|
Service Code
|
CPT 25295
|
| Hospital Charge Code |
25295
|
| Min. Negotiated Rate |
$928.62 |
| Max. Negotiated Rate |
$1,326.60 |
| Rate for Payer: Aetna Commercial |
$1,252.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$958.10
|
| Rate for Payer: Cash Price |
$1,179.20
|
| Rate for Payer: Cofinity Commercial |
$1,031.80
|
| Rate for Payer: Cofinity Commercial |
$1,267.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,031.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,179.20
|
| Rate for Payer: Healthscope Commercial |
$1,326.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,252.90
|
| Rate for Payer: PHP Commercial |
$1,252.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$958.10
|
| Rate for Payer: Priority Health SBD |
$928.62
|
|
|
PR TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN
|
Professional
|
Both
|
$1,557.00
|
|
|
Service Code
|
HCPCS 24358
|
| Min. Negotiated Rate |
$222.41 |
| Max. Negotiated Rate |
$93,960.00 |
| Rate for Payer: Aetna Commercial |
$688.60
|
| Rate for Payer: Aetna Medicare |
$534.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$688.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$739.99
|
| Rate for Payer: BCBS Complete |
$367.24
|
| Rate for Payer: BCBS MAPPO |
$513.88
|
| Rate for Payer: BCBS Trust/PPO |
$222.41
|
| Rate for Payer: BCN Commercial |
$783.35
|
| Rate for Payer: BCN Medicare Advantage |
$513.88
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cofinity Commercial |
$739.99
|
| Rate for Payer: Cofinity Commercial |
$688.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$513.88
|
| Rate for Payer: Healthscope Commercial |
$822.21
|
| Rate for Payer: Healthscope Commercial |
$950.68
|
| Rate for Payer: Mclaren Medicaid |
$349.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$539.57
|
| Rate for Payer: Meridian Medicaid |
$367.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93,960.00
|
| Rate for Payer: Nomi Health Commercial |
$616.66
|
| Rate for Payer: PACE SWMI |
$513.88
|
| Rate for Payer: PHP Medicare Advantage |
$513.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$825.89
|
| Rate for Payer: Priority Health Medicare |
$513.88
|
| Rate for Payer: Priority Health Narrow Network |
$825.89
|
| Rate for Payer: Priority Health SBD |
$825.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$513.88
|
| Rate for Payer: UHC Medicare Advantage |
$513.88
|
| Rate for Payer: UHCCP Medicaid |
$349.75
|
|
|
PR TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR
|
Professional
|
Both
|
$1,853.00
|
|
|
Service Code
|
HCPCS 24359
|
| Min. Negotiated Rate |
$191.45 |
| Max. Negotiated Rate |
$117,900.00 |
| Rate for Payer: Aetna Commercial |
$860.21
|
| Rate for Payer: Aetna Medicare |
$667.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$860.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$924.41
|
| Rate for Payer: BCBS Complete |
$456.47
|
| Rate for Payer: BCBS MAPPO |
$641.95
|
| Rate for Payer: BCBS Trust/PPO |
$191.45
|
| Rate for Payer: BCN Commercial |
$978.82
|
| Rate for Payer: BCN Medicare Advantage |
$641.95
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cofinity Commercial |
$924.41
|
| Rate for Payer: Cofinity Commercial |
$860.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.95
|
| Rate for Payer: Healthscope Commercial |
$1,027.12
|
| Rate for Payer: Healthscope Commercial |
$1,187.61
|
| Rate for Payer: Mclaren Medicaid |
$434.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$674.05
|
| Rate for Payer: Meridian Medicaid |
$456.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117,900.00
|
| Rate for Payer: Nomi Health Commercial |
$770.34
|
| Rate for Payer: PACE SWMI |
$641.95
|
| Rate for Payer: PHP Medicare Advantage |
$641.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$434.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,204.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,029.94
|
| Rate for Payer: Priority Health Medicare |
$641.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,029.94
|
| Rate for Payer: Priority Health SBD |
$1,029.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$641.95
|
| Rate for Payer: UHC Medicare Advantage |
$641.95
|
| Rate for Payer: UHCCP Medicaid |
$434.73
|
|
|
PR TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR
|
Facility
|
IP
|
$1,853.00
|
|
|
Service Code
|
CPT 24359
|
| Hospital Charge Code |
24359
|
| Min. Negotiated Rate |
$1,167.39 |
| Max. Negotiated Rate |
$1,667.70 |
| Rate for Payer: Aetna Commercial |
$1,575.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,204.45
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cofinity Commercial |
$1,297.10
|
| Rate for Payer: Cofinity Commercial |
$1,593.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,297.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,482.40
|
| Rate for Payer: Healthscope Commercial |
$1,667.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,575.05
|
| Rate for Payer: PHP Commercial |
$1,575.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,204.45
|
| Rate for Payer: Priority Health SBD |
$1,167.39
|
|
|
PR TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR
|
Facility
|
OP
|
$1,853.00
|
|
|
Service Code
|
CPT 24359
|
| Hospital Charge Code |
24359
|
| Min. Negotiated Rate |
$709.43 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna Commercial |
$1,575.05
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,204.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,949.48
|
| Rate for Payer: BCN Commercial |
$1,949.48
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cofinity Commercial |
$1,593.58
|
| Rate for Payer: Cofinity Commercial |
$1,297.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,297.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,482.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$1,667.70
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,575.05
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$1,575.05
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,204.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Priority Health SBD |
$1,167.39
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$709.43
|
| Rate for Payer: UHC Core |
$5,427.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,789.78
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
PR TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR
|
Professional
|
Both
|
$1,853.00
|
|
|
Service Code
|
HCPCS 24359
|
| Hospital Charge Code |
24359
|
| Min. Negotiated Rate |
$191.45 |
| Max. Negotiated Rate |
$117,900.00 |
| Rate for Payer: Aetna Commercial |
$860.21
|
| Rate for Payer: Aetna Medicare |
$667.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$860.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$924.41
|
| Rate for Payer: BCBS Complete |
$456.47
|
| Rate for Payer: BCBS MAPPO |
$641.95
|
| Rate for Payer: BCBS Trust/PPO |
$191.45
|
| Rate for Payer: BCN Commercial |
$978.82
|
| Rate for Payer: BCN Medicare Advantage |
$641.95
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cash Price |
$1,482.40
|
| Rate for Payer: Cofinity Commercial |
$924.41
|
| Rate for Payer: Cofinity Commercial |
$860.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.95
|
| Rate for Payer: Healthscope Commercial |
$1,027.12
|
| Rate for Payer: Healthscope Commercial |
$1,187.61
|
| Rate for Payer: Mclaren Medicaid |
$434.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$674.05
|
| Rate for Payer: Meridian Medicaid |
$456.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117,900.00
|
| Rate for Payer: Nomi Health Commercial |
$770.34
|
| Rate for Payer: PACE SWMI |
$641.95
|
| Rate for Payer: PHP Medicare Advantage |
$641.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$434.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,204.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,029.94
|
| Rate for Payer: Priority Health Medicare |
$641.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,029.94
|
| Rate for Payer: Priority Health SBD |
$1,029.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$641.95
|
| Rate for Payer: UHC Medicare Advantage |
$641.95
|
| Rate for Payer: UHCCP Medicaid |
$434.73
|
|
|
PR TNOT FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Professional
|
Both
|
$1,276.00
|
|
|
Service Code
|
HCPCS 25290
|
| Min. Negotiated Rate |
$288.62 |
| Max. Negotiated Rate |
$77,450.00 |
| Rate for Payer: Aetna Commercial |
$567.46
|
| Rate for Payer: Aetna Medicare |
$440.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$567.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$609.81
|
| Rate for Payer: BCBS Complete |
$303.05
|
| Rate for Payer: BCBS MAPPO |
$423.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,061.88
|
| Rate for Payer: BCN Commercial |
$646.52
|
| Rate for Payer: BCN Medicare Advantage |
$423.48
|
| Rate for Payer: Cash Price |
$1,020.80
|
| Rate for Payer: Cash Price |
$1,020.80
|
| Rate for Payer: Cofinity Commercial |
$609.81
|
| Rate for Payer: Cofinity Commercial |
$567.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$423.48
|
| Rate for Payer: Healthscope Commercial |
$783.44
|
| Rate for Payer: Healthscope Commercial |
$677.57
|
| Rate for Payer: Mclaren Medicaid |
$288.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$444.65
|
| Rate for Payer: Meridian Medicaid |
$303.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77,450.00
|
| Rate for Payer: Nomi Health Commercial |
$508.18
|
| Rate for Payer: PACE SWMI |
$423.48
|
| Rate for Payer: PHP Medicare Advantage |
$423.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$829.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$681.87
|
| Rate for Payer: Priority Health Medicare |
$423.48
|
| Rate for Payer: Priority Health Narrow Network |
$681.87
|
| Rate for Payer: Priority Health SBD |
$681.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$927.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$423.48
|
| Rate for Payer: UHC Exchange |
$927.11
|
| Rate for Payer: UHC Medicare Advantage |
$423.48
|
| Rate for Payer: UHCCP Medicaid |
$288.62
|
|
