|
PR TX ANAL FSTL TRANS/SUPRA/XTRASPHNCTRC INCL SETON
|
Professional
|
Both
|
$1,465.00
|
|
|
Service Code
|
HCPCS 46280
|
| Min. Negotiated Rate |
$312.47 |
| Max. Negotiated Rate |
$84,883.00 |
| Rate for Payer: Aetna Commercial |
$616.75
|
| Rate for Payer: Aetna Medicare |
$478.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$662.77
|
| Rate for Payer: BCBS Complete |
$328.09
|
| Rate for Payer: BCBS MAPPO |
$460.26
|
| Rate for Payer: BCBS Trust/PPO |
$5,471.60
|
| Rate for Payer: BCN Commercial |
$706.14
|
| Rate for Payer: BCN Medicare Advantage |
$460.26
|
| Rate for Payer: Cash Price |
$1,172.00
|
| Rate for Payer: Cash Price |
$1,172.00
|
| Rate for Payer: Cofinity Commercial |
$616.75
|
| Rate for Payer: Cofinity Commercial |
$662.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$460.26
|
| Rate for Payer: Healthscope Commercial |
$851.48
|
| Rate for Payer: Healthscope Commercial |
$736.42
|
| Rate for Payer: Mclaren Medicaid |
$312.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$483.27
|
| Rate for Payer: Meridian Medicaid |
$328.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84,883.00
|
| Rate for Payer: Nomi Health Commercial |
$552.31
|
| Rate for Payer: PACE SWMI |
$460.26
|
| Rate for Payer: PHP Medicare Advantage |
$460.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$312.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$952.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$866.86
|
| Rate for Payer: Priority Health Medicare |
$460.26
|
| Rate for Payer: Priority Health Narrow Network |
$866.86
|
| Rate for Payer: Priority Health SBD |
$866.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$460.26
|
| Rate for Payer: UHC Exchange |
$488.20
|
| Rate for Payer: UHC Medicare Advantage |
$460.26
|
| Rate for Payer: UHCCP Medicaid |
$312.47
|
|
|
PR TX ECTOPIC PREGNANCY ABDL PREGNANCY
|
Professional
|
Both
|
$1,505.00
|
|
|
Service Code
|
HCPCS 59130
|
| Min. Negotiated Rate |
$318.04 |
| Max. Negotiated Rate |
$171,596.00 |
| Rate for Payer: Aetna Commercial |
$1,240.85
|
| Rate for Payer: Aetna Medicare |
$963.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,240.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,333.45
|
| Rate for Payer: BCBS Complete |
$640.53
|
| Rate for Payer: BCBS MAPPO |
$926.01
|
| Rate for Payer: BCBS Trust/PPO |
$318.04
|
| Rate for Payer: BCN Commercial |
$1,397.13
|
| Rate for Payer: BCN Medicare Advantage |
$926.01
|
| Rate for Payer: Cash Price |
$1,204.00
|
| Rate for Payer: Cash Price |
$1,204.00
|
| Rate for Payer: Cofinity Commercial |
$1,333.45
|
| Rate for Payer: Cofinity Commercial |
$1,240.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$926.01
|
| Rate for Payer: Healthscope Commercial |
$1,713.12
|
| Rate for Payer: Healthscope Commercial |
$1,481.62
|
| Rate for Payer: Mclaren Medicaid |
$610.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$972.31
|
| Rate for Payer: Meridian Medicaid |
$640.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171,596.00
|
| Rate for Payer: Nomi Health Commercial |
$1,111.21
|
| Rate for Payer: PACE SWMI |
$926.01
|
| Rate for Payer: PHP Medicare Advantage |
$926.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$610.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$978.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,338.13
|
| Rate for Payer: Priority Health Medicare |
$926.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,338.13
|
| Rate for Payer: Priority Health SBD |
$1,338.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$999.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$926.01
|
| Rate for Payer: UHC Exchange |
$999.10
|
| Rate for Payer: UHC Medicare Advantage |
$926.01
|
| Rate for Payer: UHCCP Medicaid |
$610.03
|
|
|
PR TX ECTOPIC PREGNANCY ABDOMINAL/VAGINAL APPR
|
Professional
|
Both
|
$1,729.00
|
|
|
Service Code
|
HCPCS 59120
|
| Min. Negotiated Rate |
$51.77 |
| Max. Negotiated Rate |
$147,492.00 |
| Rate for Payer: Aetna Commercial |
$1,067.02
|
| Rate for Payer: Aetna Medicare |
$828.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,067.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,146.64
|
| Rate for Payer: BCBS Complete |
$551.96
|
| Rate for Payer: BCBS MAPPO |
$796.28
|
| Rate for Payer: BCBS Trust/PPO |
$51.77
|
| Rate for Payer: BCN Commercial |
$1,203.12
|
| Rate for Payer: BCN Medicare Advantage |
$796.28
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cash Price |
$1,383.20
|
| Rate for Payer: Cofinity Commercial |
$1,146.64
|
| Rate for Payer: Cofinity Commercial |
$1,067.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$796.28
|
| Rate for Payer: Healthscope Commercial |
$1,473.12
|
| Rate for Payer: Healthscope Commercial |
$1,274.05
|
| Rate for Payer: Mclaren Medicaid |
$525.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$836.09
|
| Rate for Payer: Meridian Medicaid |
$551.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147,492.00
|
| Rate for Payer: Nomi Health Commercial |
$955.54
|
| Rate for Payer: PACE SWMI |
$796.28
|
| Rate for Payer: PHP Medicare Advantage |
$796.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$525.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,123.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,153.23
|
| Rate for Payer: Priority Health Medicare |
$796.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,153.23
|
| Rate for Payer: Priority Health SBD |
$1,153.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,009.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$796.28
|
| Rate for Payer: UHC Exchange |
$1,009.33
|
| Rate for Payer: UHC Medicare Advantage |
$796.28
|
| Rate for Payer: UHCCP Medicaid |
$525.68
|
|
|
PR TX ECTOPIC PREGNANCY NTRSTL PRTL RESCJ UTER
|
Professional
|
Both
|
$1,817.00
|
|
|
Service Code
|
HCPCS 59136
|
| Min. Negotiated Rate |
$101.96 |
| Max. Negotiated Rate |
$162,659.00 |
| Rate for Payer: Aetna Commercial |
$1,177.90
|
| Rate for Payer: Aetna Medicare |
$914.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,177.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,265.80
|
| Rate for Payer: BCBS Complete |
$608.11
|
| Rate for Payer: BCBS MAPPO |
$879.03
|
| Rate for Payer: BCBS Trust/PPO |
$101.96
|
| Rate for Payer: BCN Commercial |
$1,324.80
|
| Rate for Payer: BCN Medicare Advantage |
$879.03
|
| Rate for Payer: Cash Price |
$1,453.60
|
| Rate for Payer: Cash Price |
$1,453.60
|
| Rate for Payer: Cofinity Commercial |
$1,265.80
|
| Rate for Payer: Cofinity Commercial |
$1,177.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$879.03
|
| Rate for Payer: Healthscope Commercial |
$1,626.21
|
| Rate for Payer: Healthscope Commercial |
$1,406.45
|
| Rate for Payer: Mclaren Medicaid |
$579.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$922.98
|
| Rate for Payer: Meridian Medicaid |
$608.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162,659.00
|
| Rate for Payer: Nomi Health Commercial |
$1,054.84
|
| Rate for Payer: PACE SWMI |
$879.03
|
| Rate for Payer: PHP Medicare Advantage |
$879.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$579.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,181.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,269.67
|
| Rate for Payer: Priority Health Medicare |
$879.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,269.67
|
| Rate for Payer: Priority Health SBD |
$1,269.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$975.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$879.03
|
| Rate for Payer: UHC Exchange |
$975.02
|
| Rate for Payer: UHC Medicare Advantage |
$879.03
|
| Rate for Payer: UHCCP Medicaid |
$579.15
|
|
|
PR TX ECTOPIC PREGNANCY W/O SALPING&/OOPHORECTOMY
|
Professional
|
Both
|
$1,467.00
|
|
|
Service Code
|
HCPCS 59121
|
| Min. Negotiated Rate |
$286.34 |
| Max. Negotiated Rate |
$147,530.00 |
| Rate for Payer: Aetna Commercial |
$1,067.91
|
| Rate for Payer: Aetna Medicare |
$828.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,067.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,147.61
|
| Rate for Payer: BCBS Complete |
$552.20
|
| Rate for Payer: BCBS MAPPO |
$796.95
|
| Rate for Payer: BCBS Trust/PPO |
$286.34
|
| Rate for Payer: BCN Commercial |
$1,203.12
|
| Rate for Payer: BCN Medicare Advantage |
$796.95
|
| Rate for Payer: Cash Price |
$1,173.60
|
| Rate for Payer: Cash Price |
$1,173.60
|
| Rate for Payer: Cofinity Commercial |
$1,147.61
|
| Rate for Payer: Cofinity Commercial |
$1,067.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$796.95
|
| Rate for Payer: Healthscope Commercial |
$1,474.36
|
| Rate for Payer: Healthscope Commercial |
$1,275.12
|
| Rate for Payer: Mclaren Medicaid |
$525.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$836.80
|
| Rate for Payer: Meridian Medicaid |
$552.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147,530.00
|
| Rate for Payer: Nomi Health Commercial |
$956.34
|
| Rate for Payer: PACE SWMI |
$796.95
|
| Rate for Payer: PHP Medicare Advantage |
$796.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$525.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$953.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,153.69
|
| Rate for Payer: Priority Health Medicare |
$796.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,153.69
|
| Rate for Payer: Priority Health SBD |
$1,153.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$876.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$796.95
|
| Rate for Payer: UHC Exchange |
$876.73
|
| Rate for Payer: UHC Medicare Advantage |
$796.95
|
| Rate for Payer: UHCCP Medicaid |
$525.90
|
|
|
PR TX HUMRAL SHAFT FX W/INSJ IMED IMPLT W/W CERCLGE
|
Professional
|
Both
|
$3,514.00
|
|
|
Service Code
|
HCPCS 24516
|
| Min. Negotiated Rate |
$345.51 |
| Max. Negotiated Rate |
$152,698.00 |
| Rate for Payer: Aetna Commercial |
$1,110.47
|
| Rate for Payer: Aetna Medicare |
$861.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,110.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,193.34
|
| Rate for Payer: BCBS Complete |
$586.64
|
| Rate for Payer: BCBS MAPPO |
$828.71
|
| Rate for Payer: BCBS Trust/PPO |
$345.51
|
| Rate for Payer: BCN Commercial |
$1,263.24
|
| Rate for Payer: BCN Medicare Advantage |
$828.71
|
| Rate for Payer: Cash Price |
$2,811.20
|
| Rate for Payer: Cash Price |
$2,811.20
|
| Rate for Payer: Cofinity Commercial |
$1,193.34
|
| Rate for Payer: Cofinity Commercial |
$1,110.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$828.71
|
| Rate for Payer: Healthscope Commercial |
$1,533.11
|
| Rate for Payer: Healthscope Commercial |
$1,325.94
|
| Rate for Payer: Mclaren Medicaid |
$558.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$870.15
|
| Rate for Payer: Meridian Medicaid |
$586.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152,698.00
|
| Rate for Payer: Nomi Health Commercial |
$994.45
|
| Rate for Payer: PACE SWMI |
$828.71
|
| Rate for Payer: PHP Medicare Advantage |
$828.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$558.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,284.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,324.56
|
| Rate for Payer: Priority Health Medicare |
$828.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,324.56
|
| Rate for Payer: Priority Health SBD |
$1,324.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$996.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$828.71
|
| Rate for Payer: UHC Exchange |
$996.77
|
| Rate for Payer: UHC Medicare Advantage |
$828.71
|
| Rate for Payer: UHCCP Medicaid |
$558.70
|
|
|
PR TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 59812
|
| Min. Negotiated Rate |
$198.73 |
| Max. Negotiated Rate |
$55,231.00 |
| Rate for Payer: Aetna Commercial |
$400.75
|
| Rate for Payer: Aetna Medicare |
$311.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$400.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.66
|
| Rate for Payer: BCBS Complete |
$208.67
|
| Rate for Payer: BCBS MAPPO |
$299.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,118.94
|
| Rate for Payer: BCN Commercial |
$536.56
|
| Rate for Payer: BCN Medicare Advantage |
$299.07
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$430.66
|
| Rate for Payer: Cofinity Commercial |
$400.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.07
|
| Rate for Payer: Healthscope Commercial |
$553.28
|
| Rate for Payer: Healthscope Commercial |
$478.51
|
| Rate for Payer: Mclaren Medicaid |
$198.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.02
|
| Rate for Payer: Meridian Medicaid |
$208.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55,231.00
|
| Rate for Payer: Nomi Health Commercial |
$358.88
|
| Rate for Payer: PACE SWMI |
$299.07
|
| Rate for Payer: PHP Medicare Advantage |
$299.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$435.49
|
| Rate for Payer: Priority Health Medicare |
$299.07
|
| Rate for Payer: Priority Health Narrow Network |
$435.49
|
| Rate for Payer: Priority Health SBD |
$435.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$434.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$299.07
|
| Rate for Payer: UHC Exchange |
$434.09
|
| Rate for Payer: UHC Medicare Advantage |
$299.07
|
| Rate for Payer: UHCCP Medicaid |
$198.73
|
|
|
PR TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW
|
Professional
|
Both
|
$4,106.00
|
|
|
Service Code
|
HCPCS 27245
|
| Min. Negotiated Rate |
$793.43 |
| Max. Negotiated Rate |
$217,372.00 |
| Rate for Payer: Aetna Commercial |
$1,582.58
|
| Rate for Payer: Aetna Medicare |
$1,228.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,582.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,700.68
|
| Rate for Payer: BCBS Complete |
$833.10
|
| Rate for Payer: BCBS MAPPO |
$1,181.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,447.01
|
| Rate for Payer: BCN Commercial |
$1,792.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,181.03
|
| Rate for Payer: Cash Price |
$3,284.80
|
| Rate for Payer: Cash Price |
$3,284.80
|
| Rate for Payer: Cofinity Commercial |
$1,700.68
|
| Rate for Payer: Cofinity Commercial |
$1,582.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,181.03
|
| Rate for Payer: Healthscope Commercial |
$2,184.91
|
| Rate for Payer: Healthscope Commercial |
$1,889.65
|
| Rate for Payer: Mclaren Medicaid |
$793.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,240.08
|
| Rate for Payer: Meridian Medicaid |
$833.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217,372.00
|
| Rate for Payer: Nomi Health Commercial |
$1,417.24
|
| Rate for Payer: PACE SWMI |
$1,181.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,181.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$793.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,668.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,880.24
|
| Rate for Payer: Priority Health Medicare |
$1,181.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,880.24
|
| Rate for Payer: Priority Health SBD |
$1,880.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,666.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,181.03
|
| Rate for Payer: UHC Exchange |
$1,666.61
|
| Rate for Payer: UHC Medicare Advantage |
$1,181.03
|
| Rate for Payer: UHCCP Medicaid |
$793.43
|
|
|
PR TX INTER/PR/SUBTRCHNTRIC FEMORAL FX SCREW IMPLT
|
Professional
|
Both
|
$3,471.00
|
|
|
Service Code
|
HCPCS 27244
|
| Min. Negotiated Rate |
$794.49 |
| Max. Negotiated Rate |
$217,625.00 |
| Rate for Payer: Aetna Commercial |
$1,584.78
|
| Rate for Payer: Aetna Medicare |
$1,229.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,584.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,703.04
|
| Rate for Payer: BCBS Complete |
$834.21
|
| Rate for Payer: BCBS MAPPO |
$1,182.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,189.73
|
| Rate for Payer: BCN Commercial |
$1,976.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,182.67
|
| Rate for Payer: Cash Price |
$2,776.80
|
| Rate for Payer: Cash Price |
$2,776.80
|
| Rate for Payer: Cofinity Commercial |
$1,703.04
|
| Rate for Payer: Cofinity Commercial |
$1,584.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,182.67
|
| Rate for Payer: Healthscope Commercial |
$2,187.94
|
| Rate for Payer: Healthscope Commercial |
$1,892.27
|
| Rate for Payer: Mclaren Medicaid |
$794.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,241.80
|
| Rate for Payer: Meridian Medicaid |
$834.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217,625.00
|
| Rate for Payer: Nomi Health Commercial |
$1,419.20
|
| Rate for Payer: PACE SWMI |
$1,182.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,182.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$794.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,256.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,882.79
|
| Rate for Payer: Priority Health Medicare |
$1,182.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,882.79
|
| Rate for Payer: Priority Health SBD |
$1,882.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,345.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,182.67
|
| Rate for Payer: UHC Exchange |
$1,345.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,182.67
|
| Rate for Payer: UHCCP Medicaid |
$794.49
|
|
|
PR TX MISSED ABORTION FIRST TRIMESTER SURGICAL
|
Professional
|
Both
|
$816.00
|
|
|
Service Code
|
HCPCS 59820
|
| Min. Negotiated Rate |
$249.85 |
| Max. Negotiated Rate |
$68,926.00 |
| Rate for Payer: Aetna Commercial |
$498.55
|
| Rate for Payer: Aetna Medicare |
$386.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$498.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$535.75
|
| Rate for Payer: BCBS Complete |
$262.34
|
| Rate for Payer: BCBS MAPPO |
$372.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,022.79
|
| Rate for Payer: BCN Commercial |
$650.43
|
| Rate for Payer: BCN Medicare Advantage |
$372.05
|
| Rate for Payer: Cash Price |
$652.80
|
| Rate for Payer: Cash Price |
$652.80
|
| Rate for Payer: Cofinity Commercial |
$535.75
|
| Rate for Payer: Cofinity Commercial |
$498.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.05
|
| Rate for Payer: Healthscope Commercial |
$688.29
|
| Rate for Payer: Healthscope Commercial |
$595.28
|
| Rate for Payer: Mclaren Medicaid |
$249.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.65
|
| Rate for Payer: Meridian Medicaid |
$262.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68,926.00
|
| Rate for Payer: Nomi Health Commercial |
$446.46
|
| Rate for Payer: PACE SWMI |
$372.05
|
| Rate for Payer: PHP Medicare Advantage |
$372.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.20
|
| Rate for Payer: Priority Health Medicare |
$372.05
|
| Rate for Payer: Priority Health Narrow Network |
$548.20
|
| Rate for Payer: Priority Health SBD |
$548.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$372.05
|
| Rate for Payer: UHC Exchange |
$405.00
|
| Rate for Payer: UHC Medicare Advantage |
$372.05
|
| Rate for Payer: UHCCP Medicaid |
$249.85
|
|
|
PR TX MISSED ABORTION SECOND TRIMESTER SURGICAL
|
Professional
|
Both
|
$816.00
|
|
|
Service Code
|
HCPCS 59821
|
| Min. Negotiated Rate |
$244.10 |
| Max. Negotiated Rate |
$67,707.00 |
| Rate for Payer: Aetna Commercial |
$489.76
|
| Rate for Payer: Aetna Medicare |
$380.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$489.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$526.31
|
| Rate for Payer: BCBS Complete |
$256.30
|
| Rate for Payer: BCBS MAPPO |
$365.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,210.41
|
| Rate for Payer: BCN Commercial |
$641.15
|
| Rate for Payer: BCN Medicare Advantage |
$365.49
|
| Rate for Payer: Cash Price |
$652.80
|
| Rate for Payer: Cash Price |
$652.80
|
| Rate for Payer: Cofinity Commercial |
$526.31
|
| Rate for Payer: Cofinity Commercial |
$489.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$365.49
|
| Rate for Payer: Healthscope Commercial |
$676.16
|
| Rate for Payer: Healthscope Commercial |
$584.78
|
| Rate for Payer: Mclaren Medicaid |
$244.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$383.76
|
| Rate for Payer: Meridian Medicaid |
$256.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67,707.00
|
| Rate for Payer: Nomi Health Commercial |
$438.59
|
| Rate for Payer: PACE SWMI |
$365.49
|
| Rate for Payer: PHP Medicare Advantage |
$365.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$535.63
|
| Rate for Payer: Priority Health Medicare |
$365.49
|
| Rate for Payer: Priority Health Narrow Network |
$535.63
|
| Rate for Payer: Priority Health SBD |
$535.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$365.49
|
| Rate for Payer: UHC Exchange |
$392.08
|
| Rate for Payer: UHC Medicare Advantage |
$365.49
|
| Rate for Payer: UHCCP Medicaid |
$244.10
|
|
|
PR TX OPEN TENDON FLEXOR TOE 1 TENDON SPX
|
Professional
|
Both
|
$635.00
|
|
|
Service Code
|
HCPCS 28232
|
| Min. Negotiated Rate |
$156.77 |
| Max. Negotiated Rate |
$41,994.00 |
| Rate for Payer: Aetna Commercial |
$307.57
|
| Rate for Payer: Aetna Medicare |
$238.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.52
|
| Rate for Payer: BCBS Complete |
$164.61
|
| Rate for Payer: BCBS MAPPO |
$229.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,182.86
|
| Rate for Payer: BCN Commercial |
$547.32
|
| Rate for Payer: BCN Medicare Advantage |
$229.53
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cofinity Commercial |
$330.52
|
| Rate for Payer: Cofinity Commercial |
$307.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.53
|
| Rate for Payer: Healthscope Commercial |
$424.63
|
| Rate for Payer: Healthscope Commercial |
$367.25
|
| Rate for Payer: Mclaren Medicaid |
$156.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$241.01
|
| Rate for Payer: Meridian Medicaid |
$164.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41,994.00
|
| Rate for Payer: Nomi Health Commercial |
$275.44
|
| Rate for Payer: PACE SWMI |
$229.53
|
| Rate for Payer: PHP Medicare Advantage |
$229.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$372.48
|
| Rate for Payer: Priority Health Medicare |
$229.53
|
| Rate for Payer: Priority Health Narrow Network |
$372.48
|
| Rate for Payer: Priority Health SBD |
$372.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$458.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$229.53
|
| Rate for Payer: UHC Exchange |
$458.92
|
| Rate for Payer: UHC Medicare Advantage |
$229.53
|
| Rate for Payer: UHCCP Medicaid |
$156.77
|
|
|
PR TX OPN TENDON FLEXOR FOOT SINGLE/MULT TENDON SPX
|
Professional
|
Both
|
$621.00
|
|
|
Service Code
|
HCPCS 28230
|
| Min. Negotiated Rate |
$185.95 |
| Max. Negotiated Rate |
$50,022.00 |
| Rate for Payer: Aetna Commercial |
$366.42
|
| Rate for Payer: Aetna Medicare |
$284.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$393.77
|
| Rate for Payer: BCBS Complete |
$195.25
|
| Rate for Payer: BCBS MAPPO |
$273.45
|
| Rate for Payer: BCBS Trust/PPO |
$920.30
|
| Rate for Payer: BCN Commercial |
$630.40
|
| Rate for Payer: BCN Medicare Advantage |
$273.45
|
| Rate for Payer: Cash Price |
$496.80
|
| Rate for Payer: Cash Price |
$496.80
|
| Rate for Payer: Cofinity Commercial |
$393.77
|
| Rate for Payer: Cofinity Commercial |
$366.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.45
|
| Rate for Payer: Healthscope Commercial |
$505.88
|
| Rate for Payer: Healthscope Commercial |
$437.52
|
| Rate for Payer: Mclaren Medicaid |
$185.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$287.12
|
| Rate for Payer: Meridian Medicaid |
$195.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50,022.00
|
| Rate for Payer: Nomi Health Commercial |
$328.14
|
| Rate for Payer: PACE SWMI |
$273.45
|
| Rate for Payer: PHP Medicare Advantage |
$273.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$185.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$403.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$439.15
|
| Rate for Payer: Priority Health Medicare |
$273.45
|
| Rate for Payer: Priority Health Narrow Network |
$439.15
|
| Rate for Payer: Priority Health SBD |
$439.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$497.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$273.45
|
| Rate for Payer: UHC Exchange |
$497.24
|
| Rate for Payer: UHC Medicare Advantage |
$273.45
|
| Rate for Payer: UHCCP Medicaid |
$185.95
|
|
|
PR TX SEPTIC ABORTION SURGICAL
|
Professional
|
Both
|
$1,000.00
|
|
|
Service Code
|
HCPCS 59830
|
| Min. Negotiated Rate |
$298.84 |
| Max. Negotiated Rate |
$83,522.00 |
| Rate for Payer: Aetna Commercial |
$602.02
|
| Rate for Payer: Aetna Medicare |
$467.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$602.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.95
|
| Rate for Payer: BCBS Complete |
$313.78
|
| Rate for Payer: BCBS MAPPO |
$449.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,227.77
|
| Rate for Payer: BCN Commercial |
$685.61
|
| Rate for Payer: BCN Medicare Advantage |
$449.27
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cofinity Commercial |
$646.95
|
| Rate for Payer: Cofinity Commercial |
$602.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$449.27
|
| Rate for Payer: Healthscope Commercial |
$831.15
|
| Rate for Payer: Healthscope Commercial |
$718.83
|
| Rate for Payer: Mclaren Medicaid |
$298.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$471.73
|
| Rate for Payer: Meridian Medicaid |
$313.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83,522.00
|
| Rate for Payer: Nomi Health Commercial |
$539.12
|
| Rate for Payer: PACE SWMI |
$449.27
|
| Rate for Payer: PHP Medicare Advantage |
$449.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$650.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$657.19
|
| Rate for Payer: Priority Health Medicare |
$449.27
|
| Rate for Payer: Priority Health Narrow Network |
$657.19
|
| Rate for Payer: Priority Health SBD |
$657.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$487.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$449.27
|
| Rate for Payer: UHC Exchange |
$487.14
|
| Rate for Payer: UHC Medicare Advantage |
$449.27
|
| Rate for Payer: UHCCP Medicaid |
$298.84
|
|
|
PR TX SLP FEM EPIPHYSIS SINGLE/MULTIPL PINNING SITU
|
Professional
|
Both
|
$6,455.00
|
|
|
Service Code
|
HCPCS 27176
|
| Min. Negotiated Rate |
$600.23 |
| Max. Negotiated Rate |
$163,732.00 |
| Rate for Payer: Aetna Commercial |
$1,192.67
|
| Rate for Payer: Aetna Medicare |
$925.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,192.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,281.67
|
| Rate for Payer: BCBS Complete |
$630.24
|
| Rate for Payer: BCBS MAPPO |
$890.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,365.66
|
| Rate for Payer: BCN Commercial |
$1,355.11
|
| Rate for Payer: BCN Medicare Advantage |
$890.05
|
| Rate for Payer: Cash Price |
$5,164.00
|
| Rate for Payer: Cash Price |
$5,164.00
|
| Rate for Payer: Cofinity Commercial |
$1,281.67
|
| Rate for Payer: Cofinity Commercial |
$1,192.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$890.05
|
| Rate for Payer: Healthscope Commercial |
$1,646.59
|
| Rate for Payer: Healthscope Commercial |
$1,424.08
|
| Rate for Payer: Mclaren Medicaid |
$600.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$934.55
|
| Rate for Payer: Meridian Medicaid |
$630.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$163,732.00
|
| Rate for Payer: Nomi Health Commercial |
$1,068.06
|
| Rate for Payer: PACE SWMI |
$890.05
|
| Rate for Payer: PHP Medicare Advantage |
$890.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$600.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,195.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,421.75
|
| Rate for Payer: Priority Health Medicare |
$890.05
|
| Rate for Payer: Priority Health Narrow Network |
$1,421.75
|
| Rate for Payer: Priority Health SBD |
$1,421.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,108.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$890.05
|
| Rate for Payer: UHC Exchange |
$1,108.59
|
| Rate for Payer: UHC Medicare Advantage |
$890.05
|
| Rate for Payer: UHCCP Medicaid |
$600.23
|
|
|
PR TX SPON HIP DISLC ABDCT SPLNT/TRCJ W/MANJ ANES
|
Professional
|
Both
|
$873.00
|
|
|
Service Code
|
HCPCS 27257
|
| Min. Negotiated Rate |
$234.30 |
| Max. Negotiated Rate |
$64,132.00 |
| Rate for Payer: Aetna Commercial |
$467.71
|
| Rate for Payer: Aetna Medicare |
$363.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$502.62
|
| Rate for Payer: BCBS Complete |
$246.02
|
| Rate for Payer: BCBS MAPPO |
$349.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,684.82
|
| Rate for Payer: BCN Commercial |
$528.75
|
| Rate for Payer: BCN Medicare Advantage |
$349.04
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cofinity Commercial |
$502.62
|
| Rate for Payer: Cofinity Commercial |
$467.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.04
|
| Rate for Payer: Healthscope Commercial |
$645.72
|
| Rate for Payer: Healthscope Commercial |
$558.46
|
| Rate for Payer: Mclaren Medicaid |
$234.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$366.49
|
| Rate for Payer: Meridian Medicaid |
$246.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64,132.00
|
| Rate for Payer: Nomi Health Commercial |
$418.85
|
| Rate for Payer: PACE SWMI |
$349.04
|
| Rate for Payer: PHP Medicare Advantage |
$349.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$567.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$555.68
|
| Rate for Payer: Priority Health Medicare |
$349.04
|
| Rate for Payer: Priority Health Narrow Network |
$555.68
|
| Rate for Payer: Priority Health SBD |
$555.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$490.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.04
|
| Rate for Payer: UHC Exchange |
$490.01
|
| Rate for Payer: UHC Medicare Advantage |
$349.04
|
| Rate for Payer: UHCCP Medicaid |
$234.30
|
|
|
PR TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE
|
Facility
|
IP
|
$470.00
|
|
|
Service Code
|
CPT 12020
|
| Hospital Charge Code |
12020
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$296.10 |
| Max. Negotiated Rate |
$423.00 |
| Rate for Payer: Aetna Commercial |
$399.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.50
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cofinity Commercial |
$329.00
|
| Rate for Payer: Cofinity Commercial |
$404.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$329.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.00
|
| Rate for Payer: Healthscope Commercial |
$423.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$399.50
|
| Rate for Payer: PHP Commercial |
$399.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.50
|
| Rate for Payer: Priority Health SBD |
$296.10
|
|
|
PR TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE
|
Facility
|
OP
|
$470.00
|
|
|
Service Code
|
CPT 12020
|
| Hospital Charge Code |
12020
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$198.24 |
| Max. Negotiated Rate |
$1,885.01 |
| Rate for Payer: Aetna Commercial |
$399.50
|
| Rate for Payer: Aetna Medicare |
$623.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$305.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$749.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$749.69
|
| Rate for Payer: BCBS Complete |
$337.54
|
| Rate for Payer: BCBS MAPPO |
$599.75
|
| Rate for Payer: BCBS Trust/PPO |
$373.96
|
| Rate for Payer: BCN Commercial |
$373.96
|
| Rate for Payer: BCN Medicare Advantage |
$599.75
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cofinity Commercial |
$404.20
|
| Rate for Payer: Cofinity Commercial |
$329.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$329.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.75
|
| Rate for Payer: Healthscope Commercial |
$423.00
|
| Rate for Payer: Mclaren Medicaid |
$321.47
|
| Rate for Payer: Mclaren Medicare |
$599.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.74
|
| Rate for Payer: Meridian Medicaid |
$337.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$689.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$399.50
|
| Rate for Payer: Nomi Health Commercial |
$1,259.48
|
| Rate for Payer: PACE Medicare |
$569.76
|
| Rate for Payer: PACE SWMI |
$599.75
|
| Rate for Payer: PHP Commercial |
$399.50
|
| Rate for Payer: PHP Medicare Advantage |
$599.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,885.01
|
| Rate for Payer: Priority Health Medicare |
$599.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,508.01
|
| Rate for Payer: Priority Health SBD |
$296.10
|
| Rate for Payer: Railroad Medicare Medicare |
$599.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.24
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.75
|
| Rate for Payer: UHC Medicare Advantage |
$599.75
|
| Rate for Payer: UHCCP Medicaid |
$337.66
|
| Rate for Payer: VA VA |
$599.75
|
|
|
PR TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE
|
Professional
|
Both
|
$470.00
|
|
|
Service Code
|
HCPCS 12020
|
| Hospital Charge Code |
12020
|
| Min. Negotiated Rate |
$85.82 |
| Max. Negotiated Rate |
$33,111.00 |
| Rate for Payer: Aetna Commercial |
$241.05
|
| Rate for Payer: Aetna Medicare |
$187.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.04
|
| Rate for Payer: BCBS Complete |
$127.93
|
| Rate for Payer: BCBS MAPPO |
$179.89
|
| Rate for Payer: BCBS Trust/PPO |
$85.82
|
| Rate for Payer: BCN Commercial |
$441.27
|
| Rate for Payer: BCN Medicare Advantage |
$179.89
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cofinity Commercial |
$259.04
|
| Rate for Payer: Cofinity Commercial |
$241.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.89
|
| Rate for Payer: Healthscope Commercial |
$332.80
|
| Rate for Payer: Healthscope Commercial |
$287.82
|
| Rate for Payer: Mclaren Medicaid |
$121.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.88
|
| Rate for Payer: Meridian Medicaid |
$127.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33,111.00
|
| Rate for Payer: Nomi Health Commercial |
$215.87
|
| Rate for Payer: PACE SWMI |
$179.89
|
| Rate for Payer: PHP Medicare Advantage |
$179.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$255.56
|
| Rate for Payer: Priority Health Medicare |
$179.89
|
| Rate for Payer: Priority Health Narrow Network |
$255.56
|
| Rate for Payer: Priority Health SBD |
$255.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.89
|
| Rate for Payer: UHC Exchange |
$220.06
|
| Rate for Payer: UHC Medicare Advantage |
$179.89
|
| Rate for Payer: UHCCP Medicaid |
$121.84
|
|
|
PR TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE
|
Professional
|
Both
|
$470.00
|
|
|
Service Code
|
HCPCS 12020
|
| Min. Negotiated Rate |
$85.82 |
| Max. Negotiated Rate |
$33,111.00 |
| Rate for Payer: Aetna Commercial |
$241.05
|
| Rate for Payer: Aetna Medicare |
$187.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.04
|
| Rate for Payer: BCBS Complete |
$127.93
|
| Rate for Payer: BCBS MAPPO |
$179.89
|
| Rate for Payer: BCBS Trust/PPO |
$85.82
|
| Rate for Payer: BCN Commercial |
$441.27
|
| Rate for Payer: BCN Medicare Advantage |
$179.89
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cofinity Commercial |
$259.04
|
| Rate for Payer: Cofinity Commercial |
$241.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.89
|
| Rate for Payer: Healthscope Commercial |
$332.80
|
| Rate for Payer: Healthscope Commercial |
$287.82
|
| Rate for Payer: Mclaren Medicaid |
$121.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.88
|
| Rate for Payer: Meridian Medicaid |
$127.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33,111.00
|
| Rate for Payer: Nomi Health Commercial |
$215.87
|
| Rate for Payer: PACE SWMI |
$179.89
|
| Rate for Payer: PHP Medicare Advantage |
$179.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$255.56
|
| Rate for Payer: Priority Health Medicare |
$179.89
|
| Rate for Payer: Priority Health Narrow Network |
$255.56
|
| Rate for Payer: Priority Health SBD |
$255.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.89
|
| Rate for Payer: UHC Exchange |
$220.06
|
| Rate for Payer: UHC Medicare Advantage |
$179.89
|
| Rate for Payer: UHCCP Medicaid |
$121.84
|
|
|
PR TX SUPERFICIAL WOUND DEHISCENCE W/PACKING
|
Professional
|
Both
|
$349.00
|
|
|
Service Code
|
HCPCS 12021
|
| Min. Negotiated Rate |
$85.82 |
| Max. Negotiated Rate |
$24,723.00 |
| Rate for Payer: Aetna Commercial |
$178.51
|
| Rate for Payer: Aetna Medicare |
$138.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.84
|
| Rate for Payer: BCBS Complete |
$95.06
|
| Rate for Payer: BCBS MAPPO |
$133.22
|
| Rate for Payer: BCBS Trust/PPO |
$85.82
|
| Rate for Payer: BCN Commercial |
$259.98
|
| Rate for Payer: BCN Medicare Advantage |
$133.22
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cofinity Commercial |
$191.84
|
| Rate for Payer: Cofinity Commercial |
$178.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.22
|
| Rate for Payer: Healthscope Commercial |
$246.46
|
| Rate for Payer: Healthscope Commercial |
$213.15
|
| Rate for Payer: Mclaren Medicaid |
$90.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.88
|
| Rate for Payer: Meridian Medicaid |
$95.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,723.00
|
| Rate for Payer: Nomi Health Commercial |
$159.86
|
| Rate for Payer: PACE SWMI |
$133.22
|
| Rate for Payer: PHP Medicare Advantage |
$133.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$226.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$191.89
|
| Rate for Payer: Priority Health Medicare |
$133.22
|
| Rate for Payer: Priority Health Narrow Network |
$191.89
|
| Rate for Payer: Priority Health SBD |
$191.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.22
|
| Rate for Payer: UHC Exchange |
$150.80
|
| Rate for Payer: UHC Medicare Advantage |
$133.22
|
| Rate for Payer: UHCCP Medicaid |
$90.53
|
|
|
PR TX TARSAL BONE FX XCP TALUS&CALCN W/MANJ
|
Professional
|
Both
|
$808.00
|
|
|
Service Code
|
HCPCS 28455
|
| Min. Negotiated Rate |
$151.02 |
| Max. Negotiated Rate |
$46,141.00 |
| Rate for Payer: Aetna Commercial |
$295.30
|
| Rate for Payer: Aetna Medicare |
$229.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$295.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$317.33
|
| Rate for Payer: BCBS Complete |
$158.57
|
| Rate for Payer: BCBS MAPPO |
$220.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,001.66
|
| Rate for Payer: BCN Commercial |
$434.44
|
| Rate for Payer: BCN Medicare Advantage |
$220.37
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cofinity Commercial |
$317.33
|
| Rate for Payer: Cofinity Commercial |
$295.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$220.37
|
| Rate for Payer: Healthscope Commercial |
$407.68
|
| Rate for Payer: Healthscope Commercial |
$352.59
|
| Rate for Payer: Mclaren Medicaid |
$151.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$231.39
|
| Rate for Payer: Meridian Medicaid |
$158.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46,141.00
|
| Rate for Payer: Nomi Health Commercial |
$264.44
|
| Rate for Payer: PACE SWMI |
$220.37
|
| Rate for Payer: PHP Medicare Advantage |
$220.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$151.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.22
|
| Rate for Payer: Priority Health Medicare |
$220.37
|
| Rate for Payer: Priority Health Narrow Network |
$357.22
|
| Rate for Payer: Priority Health SBD |
$357.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$375.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$220.37
|
| Rate for Payer: UHC Exchange |
$375.56
|
| Rate for Payer: UHC Medicare Advantage |
$220.37
|
| Rate for Payer: UHCCP Medicaid |
$151.02
|
|
|
PR TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ
|
Professional
|
Both
|
$583.00
|
|
|
Service Code
|
HCPCS 28450
|
| Min. Negotiated Rate |
$127.80 |
| Max. Negotiated Rate |
$33,604.00 |
| Rate for Payer: Aetna Commercial |
$247.93
|
| Rate for Payer: Aetna Medicare |
$192.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.43
|
| Rate for Payer: BCBS Complete |
$134.19
|
| Rate for Payer: BCBS MAPPO |
$185.02
|
| Rate for Payer: BCBS Trust/PPO |
$921.88
|
| Rate for Payer: BCN Commercial |
$313.24
|
| Rate for Payer: BCN Medicare Advantage |
$185.02
|
| Rate for Payer: Cash Price |
$466.40
|
| Rate for Payer: Cash Price |
$466.40
|
| Rate for Payer: Cofinity Commercial |
$266.43
|
| Rate for Payer: Cofinity Commercial |
$247.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.02
|
| Rate for Payer: Healthscope Commercial |
$342.29
|
| Rate for Payer: Healthscope Commercial |
$296.03
|
| Rate for Payer: Mclaren Medicaid |
$127.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.27
|
| Rate for Payer: Meridian Medicaid |
$134.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33,604.00
|
| Rate for Payer: Nomi Health Commercial |
$222.02
|
| Rate for Payer: PACE SWMI |
$185.02
|
| Rate for Payer: PHP Medicare Advantage |
$185.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$378.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$302.27
|
| Rate for Payer: Priority Health Medicare |
$185.02
|
| Rate for Payer: Priority Health Narrow Network |
$302.27
|
| Rate for Payer: Priority Health SBD |
$302.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.02
|
| Rate for Payer: UHC Exchange |
$316.18
|
| Rate for Payer: UHC Medicare Advantage |
$185.02
|
| Rate for Payer: UHCCP Medicaid |
$127.80
|
|
|
PR TX TIBL SHFT FX IMED IMPLT W/WO SCREWS&/CERCLA
|
Professional
|
Both
|
$4,265.00
|
|
|
Service Code
|
HCPCS 27759
|
| Min. Negotiated Rate |
$647.31 |
| Max. Negotiated Rate |
$176,938.00 |
| Rate for Payer: Aetna Commercial |
$1,288.91
|
| Rate for Payer: Aetna Medicare |
$1,000.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,288.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,385.09
|
| Rate for Payer: BCBS Complete |
$679.68
|
| Rate for Payer: BCBS MAPPO |
$961.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,209.30
|
| Rate for Payer: BCN Commercial |
$1,609.37
|
| Rate for Payer: BCN Medicare Advantage |
$961.87
|
| Rate for Payer: Cash Price |
$3,412.00
|
| Rate for Payer: Cash Price |
$3,412.00
|
| Rate for Payer: Cofinity Commercial |
$1,385.09
|
| Rate for Payer: Cofinity Commercial |
$1,288.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$961.87
|
| Rate for Payer: Healthscope Commercial |
$1,779.46
|
| Rate for Payer: Healthscope Commercial |
$1,538.99
|
| Rate for Payer: Mclaren Medicaid |
$647.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,009.96
|
| Rate for Payer: Meridian Medicaid |
$679.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176,938.00
|
| Rate for Payer: Nomi Health Commercial |
$1,154.24
|
| Rate for Payer: PACE SWMI |
$961.87
|
| Rate for Payer: PHP Medicare Advantage |
$961.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$647.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,772.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,533.19
|
| Rate for Payer: Priority Health Medicare |
$961.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,533.19
|
| Rate for Payer: Priority Health SBD |
$1,533.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,253.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$961.87
|
| Rate for Payer: UHC Exchange |
$1,253.82
|
| Rate for Payer: UHC Medicare Advantage |
$961.87
|
| Rate for Payer: UHCCP Medicaid |
$647.31
|
|
|
PR TYMPANIC MEMB RPR W/WO PREPJ PERFOR PATCH
|
Professional
|
Both
|
$668.00
|
|
|
Service Code
|
HCPCS 69610
|
| Min. Negotiated Rate |
$184.67 |
| Max. Negotiated Rate |
$51,035.00 |
| Rate for Payer: Aetna Commercial |
$366.87
|
| Rate for Payer: Aetna Medicare |
$284.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$394.24
|
| Rate for Payer: BCBS Complete |
$193.90
|
| Rate for Payer: BCBS MAPPO |
$273.78
|
| Rate for Payer: BCBS Trust/PPO |
$4,016.66
|
| Rate for Payer: BCN Commercial |
$565.40
|
| Rate for Payer: BCN Medicare Advantage |
$273.78
|
| Rate for Payer: Cash Price |
$534.40
|
| Rate for Payer: Cash Price |
$534.40
|
| Rate for Payer: Cofinity Commercial |
$394.24
|
| Rate for Payer: Cofinity Commercial |
$366.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.78
|
| Rate for Payer: Healthscope Commercial |
$506.49
|
| Rate for Payer: Healthscope Commercial |
$438.05
|
| Rate for Payer: Mclaren Medicaid |
$184.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$287.47
|
| Rate for Payer: Meridian Medicaid |
$193.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51,035.00
|
| Rate for Payer: Nomi Health Commercial |
$328.54
|
| Rate for Payer: PACE SWMI |
$273.78
|
| Rate for Payer: PHP Medicare Advantage |
$273.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$184.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$434.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$421.68
|
| Rate for Payer: Priority Health Medicare |
$273.78
|
| Rate for Payer: Priority Health Narrow Network |
$421.68
|
| Rate for Payer: Priority Health SBD |
$421.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$402.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$273.78
|
| Rate for Payer: UHC Exchange |
$402.90
|
| Rate for Payer: UHC Medicare Advantage |
$273.78
|
| Rate for Payer: UHCCP Medicaid |
$184.67
|
|
