|
PR APPLICATION LONG LEG CAST BRACE
|
Professional
|
Both
|
$285.00
|
|
|
Service Code
|
HCPCS 29358
|
| Min. Negotiated Rate |
$61.13 |
| Max. Negotiated Rate |
$213.75 |
| Rate for Payer: Molina Medicare/Medicaid |
$103.02
|
| Rate for Payer: Aetna Commercial |
$125.49
|
| Rate for Payer: Aetna Medicare |
$97.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.86
|
| Rate for Payer: BCBS Complete |
$64.19
|
| Rate for Payer: BCBS MAPPO |
$93.65
|
| Rate for Payer: BCN Commercial |
$156.37
|
| Rate for Payer: BCN Medicare Advantage |
$93.65
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$134.86
|
| Rate for Payer: Cofinity Commercial |
$125.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.65
|
| Rate for Payer: Healthscope Commercial |
$173.25
|
| Rate for Payer: Healthscope Commercial |
$149.84
|
| Rate for Payer: Mclaren Medicaid |
$61.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.33
|
| Rate for Payer: Meridian Medicaid |
$64.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.28
|
| Rate for Payer: Nomi Health Commercial |
$112.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.75
|
| Rate for Payer: PACE SWMI |
$93.65
|
| Rate for Payer: PHP Medicare Advantage |
$93.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$167.15
|
| Rate for Payer: Priority Health Medicare |
$93.65
|
| Rate for Payer: Priority Health SBD |
$167.15
|
| Rate for Payer: Priority Health Tiered Network |
$167.15
|
| Rate for Payer: Railroad Medicare Medicare |
$93.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.19
|
| Rate for Payer: UHC Core |
$179.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$93.65
|
| Rate for Payer: UHC Exchange |
$179.19
|
| Rate for Payer: UHC Medicaid |
$61.13
|
| Rate for Payer: UHCCP Medicaid |
$61.13
|
|
|
PR APPLICATION LONG LEG CAST THIGH-TOE
|
Professional
|
Both
|
$290.00
|
|
|
Service Code
|
HCPCS 29345
|
| Min. Negotiated Rate |
$58.36 |
| Max. Negotiated Rate |
$217.50 |
| Rate for Payer: Aetna Commercial |
$119.81
|
| Rate for Payer: Aetna Medicare |
$92.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.75
|
| Rate for Payer: BCBS Complete |
$61.28
|
| Rate for Payer: BCBS MAPPO |
$89.41
|
| Rate for Payer: BCN Commercial |
$150.39
|
| Rate for Payer: BCN Medicare Advantage |
$89.41
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cofinity Commercial |
$128.75
|
| Rate for Payer: Cofinity Commercial |
$119.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.41
|
| Rate for Payer: Healthscope Commercial |
$165.41
|
| Rate for Payer: Healthscope Commercial |
$143.06
|
| Rate for Payer: Mclaren Medicaid |
$58.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.88
|
| Rate for Payer: Meridian Medicaid |
$61.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.36
|
| Rate for Payer: Nomi Health Commercial |
$107.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$217.50
|
| Rate for Payer: PACE SWMI |
$89.41
|
| Rate for Payer: PHP Medicare Advantage |
$89.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$160.77
|
| Rate for Payer: Priority Health Medicare |
$89.41
|
| Rate for Payer: Priority Health SBD |
$160.77
|
| Rate for Payer: Priority Health Tiered Network |
$160.77
|
| Rate for Payer: Railroad Medicare Medicare |
$89.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.81
|
| Rate for Payer: UHC Core |
$173.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$89.41
|
| Rate for Payer: UHC Exchange |
$173.81
|
| Rate for Payer: UHC Medicaid |
$58.36
|
| Rate for Payer: UHCCP Medicaid |
$58.36
|
|
|
PR APPLICATION LONG LEG CAST WALKER/AMBULATORY TYPE
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
HCPCS 29355
|
| Min. Negotiated Rate |
$61.77 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$127.02
|
| Rate for Payer: Aetna Medicare |
$98.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.50
|
| Rate for Payer: BCBS Complete |
$64.86
|
| Rate for Payer: BCBS MAPPO |
$94.79
|
| Rate for Payer: BCN Commercial |
$159.85
|
| Rate for Payer: BCN Medicare Advantage |
$94.79
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Commercial |
$136.50
|
| Rate for Payer: Cofinity Commercial |
$127.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.79
|
| Rate for Payer: Healthscope Commercial |
$175.36
|
| Rate for Payer: Healthscope Commercial |
$151.66
|
| Rate for Payer: Mclaren Medicaid |
$61.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.53
|
| Rate for Payer: Meridian Medicaid |
$64.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.38
|
| Rate for Payer: Nomi Health Commercial |
$113.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.00
|
| Rate for Payer: PACE SWMI |
$94.79
|
| Rate for Payer: PHP Medicare Advantage |
$94.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$170.87
|
| Rate for Payer: Priority Health Medicare |
$94.79
|
| Rate for Payer: Priority Health SBD |
$170.87
|
| Rate for Payer: Priority Health Tiered Network |
$170.87
|
| Rate for Payer: Railroad Medicare Medicare |
$94.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.04
|
| Rate for Payer: UHC Core |
$186.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$94.79
|
| Rate for Payer: UHC Exchange |
$186.04
|
| Rate for Payer: UHC Medicaid |
$61.77
|
| Rate for Payer: UHCCP Medicaid |
$61.77
|
|
|
PR APPLICATION LONG LEG SPLINT THIGH TO ANKLE/TOES
|
Professional
|
Both
|
$141.00
|
|
|
Service Code
|
HCPCS 29505
|
| Min. Negotiated Rate |
$34.93 |
| Max. Negotiated Rate |
$105.75 |
| Rate for Payer: Aetna Commercial |
$70.89
|
| Rate for Payer: Aetna Medicare |
$55.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.18
|
| Rate for Payer: BCBS Complete |
$36.68
|
| Rate for Payer: BCBS MAPPO |
$52.90
|
| Rate for Payer: BCN Commercial |
$80.18
|
| Rate for Payer: BCN Medicare Advantage |
$52.90
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cofinity Commercial |
$76.18
|
| Rate for Payer: Cofinity Commercial |
$70.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.90
|
| Rate for Payer: Healthscope Commercial |
$97.86
|
| Rate for Payer: Healthscope Commercial |
$84.64
|
| Rate for Payer: Mclaren Medicaid |
$34.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.55
|
| Rate for Payer: Meridian Medicaid |
$36.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.08
|
| Rate for Payer: Nomi Health Commercial |
$63.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.75
|
| Rate for Payer: PACE SWMI |
$52.90
|
| Rate for Payer: PHP Medicare Advantage |
$52.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$85.71
|
| Rate for Payer: Priority Health Medicare |
$52.90
|
| Rate for Payer: Priority Health SBD |
$85.71
|
| Rate for Payer: Priority Health Tiered Network |
$85.71
|
| Rate for Payer: Railroad Medicare Medicare |
$52.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.57
|
| Rate for Payer: UHC Core |
$87.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.90
|
| Rate for Payer: UHC Exchange |
$87.57
|
| Rate for Payer: UHC Medicaid |
$34.93
|
| Rate for Payer: UHCCP Medicaid |
$34.93
|
|
|
PR APPLICATION MODALITY 1/> AREAS HOT/COLD PACKS
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS 97010
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$89.48 |
| Rate for Payer: Aetna Commercial |
$4.45
|
| Rate for Payer: Aetna Medicare |
$4.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.45
|
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: BCN Commercial |
$6.68
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$89.48
|
| Rate for Payer: Priority Health SBD |
$89.48
|
| Rate for Payer: Priority Health Tiered Network |
$89.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.54
|
| Rate for Payer: UHC Core |
$5.54
|
| Rate for Payer: UHC Exchange |
$5.54
|
|
|
PR APPLICATION MODALITY 1/> AREAS WHIRLPOOL
|
Professional
|
Both
|
$35.00
|
|
|
Service Code
|
HCPCS 97022
|
| Min. Negotiated Rate |
$14.90 |
| Max. Negotiated Rate |
$89.48 |
| Rate for Payer: Aetna Commercial |
$19.97
|
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.46
|
| Rate for Payer: BCBS MAPPO |
$14.90
|
| Rate for Payer: BCN Commercial |
$16.03
|
| Rate for Payer: BCN Medicare Advantage |
$14.90
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cofinity Commercial |
$21.46
|
| Rate for Payer: Cofinity Commercial |
$19.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.90
|
| Rate for Payer: Healthscope Commercial |
$27.57
|
| Rate for Payer: Healthscope Commercial |
$23.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.47
|
| Rate for Payer: Nomi Health Commercial |
$17.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.25
|
| Rate for Payer: PACE SWMI |
$14.90
|
| Rate for Payer: PHP Medicare Advantage |
$14.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$89.48
|
| Rate for Payer: Priority Health Medicare |
$14.90
|
| Rate for Payer: Priority Health SBD |
$89.48
|
| Rate for Payer: Priority Health Tiered Network |
$89.48
|
| Rate for Payer: Railroad Medicare Medicare |
$14.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.65
|
| Rate for Payer: UHC Core |
$15.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.90
|
| Rate for Payer: UHC Exchange |
$15.65
|
|
|
PR APPLICATION MULTIPLANE EXTERNAL FIXATION SYSTEM
|
Professional
|
Both
|
$1,983.00
|
|
|
Service Code
|
HCPCS 20692
|
| Min. Negotiated Rate |
$667.76 |
| Max. Negotiated Rate |
$1,985.47 |
| Rate for Payer: Aetna Commercial |
$1,371.14
|
| Rate for Payer: Aetna Medicare |
$1,064.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,371.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,473.47
|
| Rate for Payer: BCBS Complete |
$701.15
|
| Rate for Payer: BCBS MAPPO |
$1,023.24
|
| Rate for Payer: BCN Commercial |
$1,715.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,023.24
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cash Price |
$1,586.40
|
| Rate for Payer: Cofinity Commercial |
$1,473.47
|
| Rate for Payer: Cofinity Commercial |
$1,371.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,023.24
|
| Rate for Payer: Healthscope Commercial |
$1,892.99
|
| Rate for Payer: Healthscope Commercial |
$1,637.18
|
| Rate for Payer: Mclaren Medicaid |
$667.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,074.40
|
| Rate for Payer: Meridian Medicaid |
$701.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,125.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,985.47
|
| Rate for Payer: Nomi Health Commercial |
$1,227.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,487.25
|
| Rate for Payer: PACE SWMI |
$1,023.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,023.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$667.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,833.87
|
| Rate for Payer: Priority Health Medicare |
$1,023.24
|
| Rate for Payer: Priority Health SBD |
$1,833.87
|
| Rate for Payer: Priority Health Tiered Network |
$1,833.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,023.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,956.37
|
| Rate for Payer: UHC Core |
$1,956.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,023.24
|
| Rate for Payer: UHC Exchange |
$1,956.37
|
| Rate for Payer: UHC Medicaid |
$667.76
|
| Rate for Payer: UHCCP Medicaid |
$667.76
|
|
|
PR APPLICATION OF SURFACE NEUROSTIMULATOR
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 64550
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Aetna Medicare |
$17.00
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
|
|
PR APPLICATION PATELLAR TENDON BEARING CAST
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
HCPCS 29435
|
| Min. Negotiated Rate |
$51.76 |
| Max. Negotiated Rate |
$269.25 |
| Rate for Payer: Aetna Commercial |
$106.10
|
| Rate for Payer: Aetna Medicare |
$82.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.02
|
| Rate for Payer: BCBS Complete |
$54.35
|
| Rate for Payer: BCBS MAPPO |
$79.18
|
| Rate for Payer: BCN Commercial |
$131.47
|
| Rate for Payer: BCN Medicare Advantage |
$79.18
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$114.02
|
| Rate for Payer: Cofinity Commercial |
$106.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.18
|
| Rate for Payer: Healthscope Commercial |
$126.69
|
| Rate for Payer: Healthscope Commercial |
$146.48
|
| Rate for Payer: Mclaren Medicaid |
$51.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.14
|
| Rate for Payer: Meridian Medicaid |
$54.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$87.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.34
|
| Rate for Payer: Nomi Health Commercial |
$95.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$269.25
|
| Rate for Payer: PACE SWMI |
$79.18
|
| Rate for Payer: PHP Medicare Advantage |
$79.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$140.53
|
| Rate for Payer: Priority Health Medicare |
$79.18
|
| Rate for Payer: Priority Health SBD |
$140.53
|
| Rate for Payer: Priority Health Tiered Network |
$140.53
|
| Rate for Payer: Railroad Medicare Medicare |
$79.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.44
|
| Rate for Payer: UHC Core |
$142.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$79.18
|
| Rate for Payer: UHC Exchange |
$142.44
|
| Rate for Payer: UHC Medicaid |
$51.76
|
| Rate for Payer: UHCCP Medicaid |
$51.76
|
|
|
PR APPLICATION RIGHT & LEFT PULMONARY ARTERY BAND
|
Professional
|
Both
|
$3,462.00
|
|
|
Service Code
|
HCPCS 33620
|
| Min. Negotiated Rate |
$980.44 |
| Max. Negotiated Rate |
$2,940.98 |
| Rate for Payer: Aetna Commercial |
$2,066.19
|
| Rate for Payer: Aetna Medicare |
$1,603.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,066.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,220.38
|
| Rate for Payer: BCBS Complete |
$1,029.46
|
| Rate for Payer: BCBS MAPPO |
$1,541.93
|
| Rate for Payer: BCN Commercial |
$2,423.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,541.93
|
| Rate for Payer: Cash Price |
$2,769.60
|
| Rate for Payer: Cash Price |
$2,769.60
|
| Rate for Payer: Cofinity Commercial |
$2,220.38
|
| Rate for Payer: Cofinity Commercial |
$2,066.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,541.93
|
| Rate for Payer: Healthscope Commercial |
$2,852.57
|
| Rate for Payer: Healthscope Commercial |
$2,467.09
|
| Rate for Payer: Mclaren Medicaid |
$980.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,619.03
|
| Rate for Payer: Meridian Medicaid |
$1,029.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,696.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,922.25
|
| Rate for Payer: Nomi Health Commercial |
$1,850.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,596.50
|
| Rate for Payer: PACE SWMI |
$1,541.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,541.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$980.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,606.35
|
| Rate for Payer: Priority Health Medicare |
$1,541.93
|
| Rate for Payer: Priority Health SBD |
$2,606.35
|
| Rate for Payer: Priority Health Tiered Network |
$2,606.35
|
| Rate for Payer: Railroad Medicare Medicare |
$1,541.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,940.98
|
| Rate for Payer: UHC Core |
$2,940.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,541.93
|
| Rate for Payer: UHC Exchange |
$2,940.98
|
| Rate for Payer: UHC Medicaid |
$980.44
|
| Rate for Payer: UHCCP Medicaid |
$980.44
|
|
|
PR APPLICATION RIGID TOTAL CONTACT LEG CAST
|
Professional
|
Both
|
$388.00
|
|
|
Service Code
|
HCPCS 29445
|
| Min. Negotiated Rate |
$57.72 |
| Max. Negotiated Rate |
$291.00 |
| Rate for Payer: Aetna Commercial |
$119.45
|
| Rate for Payer: Aetna Medicare |
$92.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.36
|
| Rate for Payer: BCBS Complete |
$60.61
|
| Rate for Payer: BCBS MAPPO |
$89.14
|
| Rate for Payer: BCN Commercial |
$115.85
|
| Rate for Payer: BCN Medicare Advantage |
$89.14
|
| Rate for Payer: Cash Price |
$310.40
|
| Rate for Payer: Cash Price |
$310.40
|
| Rate for Payer: Cofinity Commercial |
$128.36
|
| Rate for Payer: Cofinity Commercial |
$119.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.14
|
| Rate for Payer: Healthscope Commercial |
$164.91
|
| Rate for Payer: Healthscope Commercial |
$142.62
|
| Rate for Payer: Mclaren Medicaid |
$57.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.60
|
| Rate for Payer: Meridian Medicaid |
$60.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.29
|
| Rate for Payer: Nomi Health Commercial |
$106.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$291.00
|
| Rate for Payer: PACE SWMI |
$89.14
|
| Rate for Payer: PHP Medicare Advantage |
$89.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$157.03
|
| Rate for Payer: Priority Health Medicare |
$89.14
|
| Rate for Payer: Priority Health SBD |
$157.03
|
| Rate for Payer: Priority Health Tiered Network |
$157.03
|
| Rate for Payer: Railroad Medicare Medicare |
$89.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.59
|
| Rate for Payer: UHC Core |
$179.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$89.14
|
| Rate for Payer: UHC Exchange |
$179.59
|
| Rate for Payer: UHC Medicaid |
$57.72
|
| Rate for Payer: UHCCP Medicaid |
$57.72
|
|
|
PR APPLICATION SHORT ARM SPLINT DYNAMIC
|
Professional
|
Both
|
$198.00
|
|
|
Service Code
|
HCPCS 29126
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$148.50 |
| Rate for Payer: Aetna Commercial |
$59.01
|
| Rate for Payer: Aetna Medicare |
$45.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.42
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS MAPPO |
$44.04
|
| Rate for Payer: BCN Commercial |
$75.19
|
| Rate for Payer: BCN Medicare Advantage |
$44.04
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$63.42
|
| Rate for Payer: Cofinity Commercial |
$59.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.04
|
| Rate for Payer: Healthscope Commercial |
$81.47
|
| Rate for Payer: Healthscope Commercial |
$70.46
|
| Rate for Payer: Mclaren Medicaid |
$28.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.24
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.38
|
| Rate for Payer: Nomi Health Commercial |
$52.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.50
|
| Rate for Payer: PACE SWMI |
$44.04
|
| Rate for Payer: PHP Medicare Advantage |
$44.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$80.38
|
| Rate for Payer: Priority Health Medicare |
$44.04
|
| Rate for Payer: Priority Health SBD |
$80.38
|
| Rate for Payer: Priority Health Tiered Network |
$80.38
|
| Rate for Payer: Railroad Medicare Medicare |
$44.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.55
|
| Rate for Payer: UHC Core |
$84.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.04
|
| Rate for Payer: UHC Exchange |
$84.55
|
| Rate for Payer: UHC Medicaid |
$28.97
|
| Rate for Payer: UHCCP Medicaid |
$28.97
|
|
|
PR APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC
|
Professional
|
Both
|
$146.00
|
|
|
Service Code
|
HCPCS 29125
|
| Min. Negotiated Rate |
$26.20 |
| Max. Negotiated Rate |
$109.50 |
| Rate for Payer: Aetna Commercial |
$53.04
|
| Rate for Payer: Aetna Medicare |
$41.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.00
|
| Rate for Payer: BCBS Complete |
$27.51
|
| Rate for Payer: BCBS MAPPO |
$39.58
|
| Rate for Payer: BCN Commercial |
$61.25
|
| Rate for Payer: BCN Medicare Advantage |
$39.58
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cofinity Commercial |
$57.00
|
| Rate for Payer: Cofinity Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.58
|
| Rate for Payer: Healthscope Commercial |
$73.22
|
| Rate for Payer: Healthscope Commercial |
$63.33
|
| Rate for Payer: Mclaren Medicaid |
$26.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.56
|
| Rate for Payer: Meridian Medicaid |
$27.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.96
|
| Rate for Payer: Nomi Health Commercial |
$47.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.50
|
| Rate for Payer: PACE SWMI |
$39.58
|
| Rate for Payer: PHP Medicare Advantage |
$39.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$65.48
|
| Rate for Payer: Priority Health Medicare |
$39.58
|
| Rate for Payer: Priority Health SBD |
$65.48
|
| Rate for Payer: Priority Health Tiered Network |
$65.48
|
| Rate for Payer: Railroad Medicare Medicare |
$39.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.07
|
| Rate for Payer: UHC Core |
$68.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.58
|
| Rate for Payer: UHC Exchange |
$68.07
|
| Rate for Payer: UHC Medicaid |
$26.20
|
| Rate for Payer: UHCCP Medicaid |
$26.20
|
|
|
PR APPLICATION SHORT LEG CAST BELOW KNEE-TOE
|
Professional
|
Both
|
$240.00
|
|
|
Service Code
|
HCPCS 29405
|
| Min. Negotiated Rate |
$35.57 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Priority Health SBD |
$95.29
|
| Rate for Payer: Aetna Commercial |
$72.53
|
| Rate for Payer: Aetna Medicare |
$56.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.95
|
| Rate for Payer: BCBS Complete |
$37.35
|
| Rate for Payer: BCBS MAPPO |
$54.13
|
| Rate for Payer: BCN Commercial |
$70.29
|
| Rate for Payer: BCN Medicare Advantage |
$54.13
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$77.95
|
| Rate for Payer: Cofinity Commercial |
$72.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.13
|
| Rate for Payer: Healthscope Commercial |
$86.61
|
| Rate for Payer: Healthscope Commercial |
$100.14
|
| Rate for Payer: Mclaren Medicaid |
$35.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.84
|
| Rate for Payer: Meridian Medicaid |
$37.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.24
|
| Rate for Payer: Nomi Health Commercial |
$64.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.00
|
| Rate for Payer: PACE SWMI |
$54.13
|
| Rate for Payer: PHP Medicare Advantage |
$54.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$95.29
|
| Rate for Payer: Priority Health Medicare |
$54.13
|
| Rate for Payer: Priority Health Tiered Network |
$95.29
|
| Rate for Payer: Railroad Medicare Medicare |
$54.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.02
|
| Rate for Payer: UHC Core |
$102.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$54.13
|
| Rate for Payer: UHC Exchange |
$102.02
|
| Rate for Payer: UHC Medicaid |
$35.57
|
| Rate for Payer: UHCCP Medicaid |
$35.57
|
|
|
PR APPLICATION SHORT LEG CAST WALKING/AMBULATORY
|
Professional
|
Both
|
$279.00
|
|
|
Service Code
|
HCPCS 29425
|
| Min. Negotiated Rate |
$32.59 |
| Max. Negotiated Rate |
$209.25 |
| Rate for Payer: Aetna Commercial |
$66.42
|
| Rate for Payer: Aetna Medicare |
$51.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.38
|
| Rate for Payer: BCBS Complete |
$34.22
|
| Rate for Payer: BCBS MAPPO |
$49.57
|
| Rate for Payer: BCN Commercial |
$64.80
|
| Rate for Payer: BCN Medicare Advantage |
$49.57
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cofinity Commercial |
$71.38
|
| Rate for Payer: Cofinity Commercial |
$66.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.57
|
| Rate for Payer: Healthscope Commercial |
$91.70
|
| Rate for Payer: Healthscope Commercial |
$79.31
|
| Rate for Payer: Mclaren Medicaid |
$32.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.05
|
| Rate for Payer: Meridian Medicaid |
$34.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.81
|
| Rate for Payer: Nomi Health Commercial |
$59.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$209.25
|
| Rate for Payer: PACE SWMI |
$49.57
|
| Rate for Payer: PHP Medicare Advantage |
$49.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$87.83
|
| Rate for Payer: Priority Health Medicare |
$49.57
|
| Rate for Payer: Priority Health SBD |
$87.83
|
| Rate for Payer: Priority Health Tiered Network |
$87.83
|
| Rate for Payer: Railroad Medicare Medicare |
$49.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.20
|
| Rate for Payer: UHC Core |
$96.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.57
|
| Rate for Payer: UHC Exchange |
$96.20
|
| Rate for Payer: UHC Medicaid |
$32.59
|
| Rate for Payer: UHCCP Medicaid |
$32.59
|
|
|
PR APPLICATION SHORT LEG SPLINT CALF TO FOOT
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS 29515
|
| Min. Negotiated Rate |
$31.74 |
| Max. Negotiated Rate |
$97.50 |
| Rate for Payer: Aetna Commercial |
$64.82
|
| Rate for Payer: Aetna Medicare |
$50.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.65
|
| Rate for Payer: BCBS Complete |
$33.33
|
| Rate for Payer: BCBS MAPPO |
$48.37
|
| Rate for Payer: BCN Commercial |
$75.70
|
| Rate for Payer: BCN Medicare Advantage |
$48.37
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cofinity Commercial |
$69.65
|
| Rate for Payer: Cofinity Commercial |
$64.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.37
|
| Rate for Payer: Healthscope Commercial |
$89.48
|
| Rate for Payer: Healthscope Commercial |
$77.39
|
| Rate for Payer: Mclaren Medicaid |
$31.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.79
|
| Rate for Payer: Meridian Medicaid |
$33.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.76
|
| Rate for Payer: Nomi Health Commercial |
$58.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.50
|
| Rate for Payer: PACE SWMI |
$48.37
|
| Rate for Payer: PHP Medicare Advantage |
$48.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$80.92
|
| Rate for Payer: Priority Health Medicare |
$48.37
|
| Rate for Payer: Priority Health SBD |
$80.92
|
| Rate for Payer: Priority Health Tiered Network |
$80.92
|
| Rate for Payer: Railroad Medicare Medicare |
$48.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.06
|
| Rate for Payer: UHC Core |
$86.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$48.37
|
| Rate for Payer: UHC Exchange |
$86.06
|
| Rate for Payer: UHC Medicaid |
$31.74
|
| Rate for Payer: UHCCP Medicaid |
$31.74
|
|
|
PR APPLICATION TOPICAL FLUORIDE VARNISH BY PHS/QHP
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 99188
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna Commercial |
$11.43
|
| Rate for Payer: Aetna Medicare |
$18.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.43
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCN Commercial |
$14.45
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Mclaren Medicaid |
$5.33
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.32
|
| Rate for Payer: Priority Health SBD |
$13.32
|
| Rate for Payer: Priority Health Tiered Network |
$13.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.03
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: UHC Exchange |
$17.03
|
| Rate for Payer: UHC Medicaid |
$5.33
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
|
|
PR APPLICATION UNIPLANE EXTERNAL FIXATION SYSTEM
|
Professional
|
Both
|
$1,056.00
|
|
|
Service Code
|
HCPCS 20690
|
| Min. Negotiated Rate |
$348.04 |
| Max. Negotiated Rate |
$1,058.58 |
| Rate for Payer: Aetna Commercial |
$717.76
|
| Rate for Payer: Aetna Medicare |
$557.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$771.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$717.76
|
| Rate for Payer: BCBS Complete |
$365.44
|
| Rate for Payer: BCBS MAPPO |
$535.64
|
| Rate for Payer: BCN Commercial |
$906.82
|
| Rate for Payer: BCN Medicare Advantage |
$535.64
|
| Rate for Payer: Cash Price |
$844.80
|
| Rate for Payer: Cash Price |
$844.80
|
| Rate for Payer: Cofinity Commercial |
$771.32
|
| Rate for Payer: Cofinity Commercial |
$717.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$535.64
|
| Rate for Payer: Healthscope Commercial |
$990.93
|
| Rate for Payer: Healthscope Commercial |
$857.02
|
| Rate for Payer: Mclaren Medicaid |
$348.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$562.42
|
| Rate for Payer: Meridian Medicaid |
$365.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$589.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,058.58
|
| Rate for Payer: Nomi Health Commercial |
$642.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$792.00
|
| Rate for Payer: PACE SWMI |
$535.64
|
| Rate for Payer: PHP Medicare Advantage |
$535.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$969.37
|
| Rate for Payer: Priority Health Medicare |
$535.64
|
| Rate for Payer: Priority Health SBD |
$969.37
|
| Rate for Payer: Priority Health Tiered Network |
$969.37
|
| Rate for Payer: Railroad Medicare Medicare |
$535.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,044.99
|
| Rate for Payer: UHC Core |
$1,044.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$535.64
|
| Rate for Payer: UHC Exchange |
$1,044.99
|
| Rate for Payer: UHC Medicaid |
$348.04
|
| Rate for Payer: UHCCP Medicaid |
$348.04
|
|
|
PR APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC
|
Professional
|
Both
|
$1,857.00
|
|
|
Service Code
|
HCPCS 21110
|
| Min. Negotiated Rate |
$638.09 |
| Max. Negotiated Rate |
$1,392.75 |
| Rate for Payer: Aetna Commercial |
$855.04
|
| Rate for Payer: Aetna Medicare |
$663.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$855.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$918.85
|
| Rate for Payer: BCBS Complete |
$742.80
|
| Rate for Payer: BCBS MAPPO |
$638.09
|
| Rate for Payer: BCN Commercial |
$1,055.72
|
| Rate for Payer: BCN Medicare Advantage |
$638.09
|
| Rate for Payer: Cash Price |
$1,485.60
|
| Rate for Payer: Cash Price |
$1,485.60
|
| Rate for Payer: Cofinity Commercial |
$918.85
|
| Rate for Payer: Cofinity Commercial |
$855.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$638.09
|
| Rate for Payer: Healthscope Commercial |
$1,180.47
|
| Rate for Payer: Healthscope Commercial |
$1,020.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$669.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$701.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,234.75
|
| Rate for Payer: Nomi Health Commercial |
$765.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,392.75
|
| Rate for Payer: PACE SWMI |
$638.09
|
| Rate for Payer: PHP Medicare Advantage |
$638.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,128.54
|
| Rate for Payer: Priority Health Medicare |
$638.09
|
| Rate for Payer: Priority Health SBD |
$1,128.54
|
| Rate for Payer: Priority Health Tiered Network |
$1,128.54
|
| Rate for Payer: Railroad Medicare Medicare |
$638.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,164.96
|
| Rate for Payer: UHC Core |
$1,164.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$638.09
|
| Rate for Payer: UHC Exchange |
$1,164.96
|
|
|
PR APPL MLTLAYR CMPRN SYS LEG BELW KNE W/ANKLE&FOOT
|
Professional
|
Both
|
$201.00
|
|
|
Service Code
|
HCPCS 29581
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$150.75 |
| Rate for Payer: Aetna Commercial |
$30.59
|
| Rate for Payer: Aetna Medicare |
$23.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.88
|
| Rate for Payer: BCBS Complete |
$15.44
|
| Rate for Payer: BCBS MAPPO |
$22.83
|
| Rate for Payer: BCN Commercial |
$39.34
|
| Rate for Payer: BCN Medicare Advantage |
$22.83
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cofinity Commercial |
$32.88
|
| Rate for Payer: Cofinity Commercial |
$30.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.83
|
| Rate for Payer: Healthscope Commercial |
$42.24
|
| Rate for Payer: Healthscope Commercial |
$36.53
|
| Rate for Payer: Mclaren Medicaid |
$14.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.97
|
| Rate for Payer: Meridian Medicaid |
$15.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.25
|
| Rate for Payer: Nomi Health Commercial |
$27.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.75
|
| Rate for Payer: PACE SWMI |
$22.83
|
| Rate for Payer: PHP Medicare Advantage |
$22.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$42.05
|
| Rate for Payer: Priority Health Medicare |
$22.83
|
| Rate for Payer: Priority Health SBD |
$42.05
|
| Rate for Payer: Priority Health Tiered Network |
$42.05
|
| Rate for Payer: Railroad Medicare Medicare |
$22.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.28
|
| Rate for Payer: UHC Core |
$49.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.83
|
| Rate for Payer: UHC Exchange |
$49.28
|
| Rate for Payer: UHC Medicaid |
$14.70
|
| Rate for Payer: UHCCP Medicaid |
$14.70
|
|
|
PR APPL MLTLAYR COMPRES SYSTEM UPPER & LOWER ARM
|
Professional
|
Both
|
$85.00
|
|
|
Service Code
|
HCPCS 29583
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Aetna Medicare |
$42.50
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.75
|
|
|
PR APPL MLTLAYR COMPRES THGH LEG ANKLE FT WHEN DONE
|
Professional
|
Both
|
$136.00
|
|
|
Service Code
|
HCPCS 29582
|
| Min. Negotiated Rate |
$54.40 |
| Max. Negotiated Rate |
$102.00 |
| Rate for Payer: Aetna Medicare |
$68.00
|
| Rate for Payer: BCBS Complete |
$54.40
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.00
|
|
|
PR APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 97014
|
| Min. Negotiated Rate |
$9.73 |
| Max. Negotiated Rate |
$89.48 |
| Rate for Payer: Aetna Commercial |
$9.73
|
| Rate for Payer: Aetna Medicare |
$13.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.73
|
| Rate for Payer: BCN Commercial |
$12.69
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$89.48
|
| Rate for Payer: Priority Health SBD |
$89.48
|
| Rate for Payer: Priority Health Tiered Network |
$89.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.71
|
| Rate for Payer: UHC Core |
$12.71
|
| Rate for Payer: UHC Exchange |
$12.71
|
|
|
PR APPL MODALITY 1+ AREAS ESTIM EA 15 MIN
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 97032
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$89.48 |
| Rate for Payer: Aetna Commercial |
$19.05
|
| Rate for Payer: Aetna Medicare |
$14.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.05
|
| Rate for Payer: BCBS MAPPO |
$14.22
|
| Rate for Payer: BCN Commercial |
$14.69
|
| Rate for Payer: BCN Medicare Advantage |
$14.22
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$20.48
|
| Rate for Payer: Cofinity Commercial |
$19.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.22
|
| Rate for Payer: Healthscope Commercial |
$26.31
|
| Rate for Payer: Healthscope Commercial |
$22.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.12
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
| Rate for Payer: PACE SWMI |
$14.22
|
| Rate for Payer: PHP Medicare Advantage |
$14.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$89.48
|
| Rate for Payer: Priority Health Medicare |
$14.22
|
| Rate for Payer: Priority Health SBD |
$89.48
|
| Rate for Payer: Priority Health Tiered Network |
$89.48
|
| Rate for Payer: Railroad Medicare Medicare |
$14.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.20
|
| Rate for Payer: UHC Core |
$13.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.22
|
| Rate for Payer: UHC Exchange |
$13.20
|
|
|
PR APPL MODALITY 1+ AREAS IONTOPHORESIS EA 15 MIN
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 97033
|
| Min. Negotiated Rate |
$18.21 |
| Max. Negotiated Rate |
$89.48 |
| Rate for Payer: Aetna Commercial |
$24.40
|
| Rate for Payer: Aetna Medicare |
$18.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.40
|
| Rate for Payer: BCBS MAPPO |
$18.21
|
| Rate for Payer: BCN Commercial |
$19.36
|
| Rate for Payer: BCN Medicare Advantage |
$18.21
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$26.22
|
| Rate for Payer: Cofinity Commercial |
$24.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.21
|
| Rate for Payer: Healthscope Commercial |
$33.69
|
| Rate for Payer: Healthscope Commercial |
$29.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.58
|
| Rate for Payer: Nomi Health Commercial |
$21.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.00
|
| Rate for Payer: PACE SWMI |
$18.21
|
| Rate for Payer: PHP Medicare Advantage |
$18.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$89.48
|
| Rate for Payer: Priority Health Medicare |
$18.21
|
| Rate for Payer: Priority Health SBD |
$89.48
|
| Rate for Payer: Priority Health Tiered Network |
$89.48
|
| Rate for Payer: Railroad Medicare Medicare |
$18.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.28
|
| Rate for Payer: UHC Core |
$18.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.21
|
| Rate for Payer: UHC Exchange |
$18.28
|
|
