|
PR APPL MODALITY 1+ AREAS ULTRASOUND EA 15 MIN
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 97035
|
| Min. Negotiated Rate |
$12.79 |
| Max. Negotiated Rate |
$89.48 |
| Rate for Payer: Aetna Commercial |
$18.49
|
| Rate for Payer: Aetna Medicare |
$14.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.87
|
| Rate for Payer: BCBS MAPPO |
$13.80
|
| Rate for Payer: BCN Commercial |
$14.35
|
| Rate for Payer: BCN Medicare Advantage |
$13.80
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cofinity Commercial |
$19.87
|
| Rate for Payer: Cofinity Commercial |
$18.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.80
|
| Rate for Payer: Healthscope Commercial |
$25.53
|
| Rate for Payer: Healthscope Commercial |
$22.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.94
|
| Rate for Payer: Nomi Health Commercial |
$16.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.25
|
| Rate for Payer: PACE SWMI |
$13.80
|
| Rate for Payer: PHP Medicare Advantage |
$13.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$89.48
|
| Rate for Payer: Priority Health Medicare |
$13.80
|
| Rate for Payer: Priority Health SBD |
$89.48
|
| Rate for Payer: Priority Health Tiered Network |
$89.48
|
| Rate for Payer: Railroad Medicare Medicare |
$13.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.79
|
| Rate for Payer: UHC Core |
$12.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.80
|
| Rate for Payer: UHC Exchange |
$12.79
|
|
|
PR APPL MULTILAYR CMPRN SYS UPR ARM F/ARM HAND&FNGR
|
Professional
|
Both
|
$136.00
|
|
|
Service Code
|
HCPCS 29584
|
| Min. Negotiated Rate |
$8.52 |
| Max. Negotiated Rate |
$102.00 |
| Rate for Payer: Aetna Commercial |
$17.77
|
| Rate for Payer: Aetna Medicare |
$13.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.09
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS MAPPO |
$13.26
|
| Rate for Payer: BCN Commercial |
$23.40
|
| Rate for Payer: BCN Medicare Advantage |
$13.26
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cofinity Commercial |
$19.09
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.26
|
| Rate for Payer: Healthscope Commercial |
$24.53
|
| Rate for Payer: Healthscope Commercial |
$21.22
|
| Rate for Payer: Mclaren Medicaid |
$8.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.92
|
| Rate for Payer: Meridian Medicaid |
$8.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.12
|
| Rate for Payer: Nomi Health Commercial |
$15.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.00
|
| Rate for Payer: PACE SWMI |
$13.26
|
| Rate for Payer: PHP Medicare Advantage |
$13.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25.01
|
| Rate for Payer: Priority Health Medicare |
$13.26
|
| Rate for Payer: Priority Health SBD |
$25.01
|
| Rate for Payer: Priority Health Tiered Network |
$25.01
|
| Rate for Payer: Railroad Medicare Medicare |
$13.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.92
|
| Rate for Payer: UHC Core |
$28.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.26
|
| Rate for Payer: UHC Exchange |
$28.92
|
| Rate for Payer: UHC Medicaid |
$8.52
|
| Rate for Payer: UHCCP Medicaid |
$8.52
|
|
|
PR APPL SKIN CELL SSP AGRFT T/A/L 1ST 480 SQ CM/<
|
Professional
|
Both
|
$2,449.00
|
|
|
Service Code
|
HCPCS 15015
|
| Min. Negotiated Rate |
$360.51 |
| Max. Negotiated Rate |
$2,744.01 |
| Rate for Payer: Aetna Medicare |
$1,224.50
|
| Rate for Payer: BCBS Complete |
$378.54
|
| Rate for Payer: BCN Commercial |
$1,710.33
|
| Rate for Payer: Cash Price |
$1,959.20
|
| Rate for Payer: Cash Price |
$1,959.20
|
| Rate for Payer: Mclaren Medicaid |
$360.51
|
| Rate for Payer: Meridian Medicaid |
$378.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,591.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,836.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$360.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,744.01
|
| Rate for Payer: Priority Health SBD |
$2,744.01
|
| Rate for Payer: Priority Health Tiered Network |
$2,744.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,338.43
|
| Rate for Payer: UHC Core |
$1,338.43
|
| Rate for Payer: UHC Exchange |
$1,338.43
|
| Rate for Payer: UHC Medicaid |
$360.51
|
| Rate for Payer: UHCCP Medicaid |
$360.51
|
|
|
PR APPL SKIN CELL SSP AGRFT T/A/L EA ADDL 480 SQ CM
|
Professional
|
Both
|
$2,449.00
|
|
|
Service Code
|
HCPCS 15016
|
| Min. Negotiated Rate |
$58.34 |
| Max. Negotiated Rate |
$1,836.75 |
| Rate for Payer: Aetna Medicare |
$1,224.50
|
| Rate for Payer: BCBS Complete |
$61.26
|
| Rate for Payer: Cash Price |
$1,959.20
|
| Rate for Payer: Cash Price |
$1,959.20
|
| Rate for Payer: Mclaren Medicaid |
$58.34
|
| Rate for Payer: Meridian Medicaid |
$61.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,591.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,836.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.80
|
| Rate for Payer: UHC Core |
$227.80
|
| Rate for Payer: UHC Exchange |
$227.80
|
| Rate for Payer: UHC Medicaid |
$58.34
|
| Rate for Payer: UHCCP Medicaid |
$58.34
|
|
|
PR APPL SKN CLL SSP AGRFT F/S/N/H/F/G/M/DGT 1ST 480
|
Professional
|
Both
|
$2,449.00
|
|
|
Service Code
|
HCPCS 15017
|
| Min. Negotiated Rate |
$380.83 |
| Max. Negotiated Rate |
$2,744.01 |
| Rate for Payer: Aetna Medicare |
$1,224.50
|
| Rate for Payer: BCBS Complete |
$399.87
|
| Rate for Payer: BCN Commercial |
$1,710.33
|
| Rate for Payer: Cash Price |
$1,959.20
|
| Rate for Payer: Cash Price |
$1,959.20
|
| Rate for Payer: Mclaren Medicaid |
$380.83
|
| Rate for Payer: Meridian Medicaid |
$399.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,591.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,836.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,744.01
|
| Rate for Payer: Priority Health SBD |
$2,744.01
|
| Rate for Payer: Priority Health Tiered Network |
$2,744.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,542.08
|
| Rate for Payer: UHC Core |
$1,542.08
|
| Rate for Payer: UHC Exchange |
$1,542.08
|
| Rate for Payer: UHC Medicaid |
$380.83
|
| Rate for Payer: UHCCP Medicaid |
$380.83
|
|
|
PR APPL SKN CLL SSP AGRFT F/S/N/H/F/G/M/DGT EA ADDL
|
Professional
|
Both
|
$2,449.00
|
|
|
Service Code
|
HCPCS 15018
|
| Min. Negotiated Rate |
$80.77 |
| Max. Negotiated Rate |
$1,836.75 |
| Rate for Payer: Aetna Medicare |
$1,224.50
|
| Rate for Payer: BCBS Complete |
$84.81
|
| Rate for Payer: Cash Price |
$1,959.20
|
| Rate for Payer: Cash Price |
$1,959.20
|
| Rate for Payer: Mclaren Medicaid |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$84.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,591.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,836.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.23
|
| Rate for Payer: UHC Core |
$314.23
|
| Rate for Payer: UHC Exchange |
$314.23
|
| Rate for Payer: UHC Medicaid |
$80.77
|
| Rate for Payer: UHCCP Medicaid |
$80.77
|
|
|
PR APP MLTPLN UNI XTRNL FIX STRTCTC ADJMT EXCHANGE
|
Professional
|
Both
|
$4,012.00
|
|
|
Service Code
|
HCPCS 20697
|
| Min. Negotiated Rate |
$1,744.53 |
| Max. Negotiated Rate |
$3,321.82 |
| Rate for Payer: Aetna Commercial |
$2,337.67
|
| Rate for Payer: Aetna Medicare |
$1,814.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,512.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,337.67
|
| Rate for Payer: BCBS MAPPO |
$1,744.53
|
| Rate for Payer: BCN Commercial |
$2,527.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,744.53
|
| Rate for Payer: Cash Price |
$3,209.60
|
| Rate for Payer: Cash Price |
$3,209.60
|
| Rate for Payer: Cofinity Commercial |
$2,512.12
|
| Rate for Payer: Cofinity Commercial |
$2,337.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,744.53
|
| Rate for Payer: Healthscope Commercial |
$2,791.25
|
| Rate for Payer: Healthscope Commercial |
$3,227.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,831.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,918.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,051.09
|
| Rate for Payer: Nomi Health Commercial |
$2,093.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,009.00
|
| Rate for Payer: PACE SWMI |
$1,744.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,744.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,702.10
|
| Rate for Payer: Priority Health Medicare |
$1,744.53
|
| Rate for Payer: Priority Health SBD |
$2,702.10
|
| Rate for Payer: Priority Health Tiered Network |
$2,702.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,744.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,321.82
|
| Rate for Payer: UHC Core |
$3,321.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,744.53
|
| Rate for Payer: UHC Exchange |
$3,321.82
|
|
|
PR APP SKN SUB GRFT T/A/L AREA>=100SCM ADL 100SQCM
|
Professional
|
Both
|
$145.00
|
|
|
Service Code
|
HCPCS 15274
|
| Min. Negotiated Rate |
$24.92 |
| Max. Negotiated Rate |
$108.75 |
| Rate for Payer: Aetna Commercial |
$52.49
|
| Rate for Payer: Aetna Medicare |
$40.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.40
|
| Rate for Payer: BCBS Complete |
$26.17
|
| Rate for Payer: BCBS MAPPO |
$39.17
|
| Rate for Payer: BCN Commercial |
$65.23
|
| Rate for Payer: BCN Medicare Advantage |
$39.17
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Cofinity Commercial |
$56.40
|
| Rate for Payer: Cofinity Commercial |
$52.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.17
|
| Rate for Payer: Healthscope Commercial |
$72.46
|
| Rate for Payer: Healthscope Commercial |
$62.67
|
| Rate for Payer: Mclaren Medicaid |
$24.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.13
|
| Rate for Payer: Meridian Medicaid |
$26.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.06
|
| Rate for Payer: Nomi Health Commercial |
$47.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$108.75
|
| Rate for Payer: PACE SWMI |
$39.17
|
| Rate for Payer: PHP Medicare Advantage |
$39.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$59.70
|
| Rate for Payer: Priority Health Medicare |
$39.17
|
| Rate for Payer: Priority Health SBD |
$59.70
|
| Rate for Payer: Priority Health Tiered Network |
$59.70
|
| Rate for Payer: Railroad Medicare Medicare |
$39.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.96
|
| Rate for Payer: UHC Core |
$80.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.17
|
| Rate for Payer: UHC Exchange |
$80.96
|
| Rate for Payer: UHC Medicaid |
$24.92
|
| Rate for Payer: UHCCP Medicaid |
$24.92
|
|
|
PR APP SKN SUBGRFT T/A/L AREA/100SQ CM 1ST 100SQ CM
|
Professional
|
Both
|
$634.00
|
|
|
Service Code
|
HCPCS 15273
|
| Min. Negotiated Rate |
$109.48 |
| Max. Negotiated Rate |
$475.50 |
| Rate for Payer: Aetna Commercial |
$229.31
|
| Rate for Payer: Aetna Medicare |
$177.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.43
|
| Rate for Payer: BCBS Complete |
$114.95
|
| Rate for Payer: BCBS MAPPO |
$171.13
|
| Rate for Payer: BCN Commercial |
$288.34
|
| Rate for Payer: BCN Medicare Advantage |
$171.13
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cofinity Commercial |
$246.43
|
| Rate for Payer: Cofinity Commercial |
$229.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.13
|
| Rate for Payer: Healthscope Commercial |
$316.59
|
| Rate for Payer: Healthscope Commercial |
$273.81
|
| Rate for Payer: Mclaren Medicaid |
$109.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.69
|
| Rate for Payer: Meridian Medicaid |
$114.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$188.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$347.83
|
| Rate for Payer: Nomi Health Commercial |
$205.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$475.50
|
| Rate for Payer: PACE SWMI |
$171.13
|
| Rate for Payer: PHP Medicare Advantage |
$171.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$263.90
|
| Rate for Payer: Priority Health Medicare |
$171.13
|
| Rate for Payer: Priority Health SBD |
$263.90
|
| Rate for Payer: Priority Health Tiered Network |
$263.90
|
| Rate for Payer: Railroad Medicare Medicare |
$171.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.40
|
| Rate for Payer: UHC Core |
$356.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$171.13
|
| Rate for Payer: UHC Exchange |
$356.40
|
| Rate for Payer: UHC Medicaid |
$109.48
|
| Rate for Payer: UHCCP Medicaid |
$109.48
|
|
|
PR APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1ST 25
|
Professional
|
Both
|
$286.00
|
|
|
Service Code
|
HCPCS 15271
|
| Min. Negotiated Rate |
$47.93 |
| Max. Negotiated Rate |
$214.50 |
| Rate for Payer: Aetna Commercial |
$99.66
|
| Rate for Payer: Aetna Medicare |
$77.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.66
|
| Rate for Payer: BCBS Complete |
$50.33
|
| Rate for Payer: BCBS MAPPO |
$74.37
|
| Rate for Payer: BCN Commercial |
$125.50
|
| Rate for Payer: BCN Medicare Advantage |
$74.37
|
| Rate for Payer: Cash Price |
$228.80
|
| Rate for Payer: Cash Price |
$228.80
|
| Rate for Payer: Cofinity Commercial |
$99.66
|
| Rate for Payer: Cofinity Commercial |
$107.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.37
|
| Rate for Payer: Healthscope Commercial |
$137.58
|
| Rate for Payer: Healthscope Commercial |
$118.99
|
| Rate for Payer: Mclaren Medicaid |
$47.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.09
|
| Rate for Payer: Meridian Medicaid |
$50.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$81.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.62
|
| Rate for Payer: Nomi Health Commercial |
$89.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.50
|
| Rate for Payer: PACE SWMI |
$74.37
|
| Rate for Payer: PHP Medicare Advantage |
$74.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$114.85
|
| Rate for Payer: Priority Health Medicare |
$74.37
|
| Rate for Payer: Priority Health SBD |
$114.85
|
| Rate for Payer: Priority Health Tiered Network |
$114.85
|
| Rate for Payer: Railroad Medicare Medicare |
$74.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.99
|
| Rate for Payer: UHC Core |
$149.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$74.37
|
| Rate for Payer: UHC Exchange |
$149.99
|
| Rate for Payer: UHC Medicaid |
$47.93
|
| Rate for Payer: UHCCP Medicaid |
$47.93
|
|
|
PR APP SKN SUB GRFT T/A/L AREA/100SQ CM EA ADL 25SC
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 15272
|
| Min. Negotiated Rate |
$9.37 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Aetna Commercial |
$19.71
|
| Rate for Payer: Aetna Medicare |
$15.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.18
|
| Rate for Payer: BCBS Complete |
$9.84
|
| Rate for Payer: BCBS MAPPO |
$14.71
|
| Rate for Payer: BCN Commercial |
$24.90
|
| Rate for Payer: BCN Medicare Advantage |
$14.71
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$21.18
|
| Rate for Payer: Cofinity Commercial |
$19.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.71
|
| Rate for Payer: Healthscope Commercial |
$27.21
|
| Rate for Payer: Healthscope Commercial |
$23.54
|
| Rate for Payer: Mclaren Medicaid |
$9.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.45
|
| Rate for Payer: Meridian Medicaid |
$9.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.43
|
| Rate for Payer: Nomi Health Commercial |
$17.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.50
|
| Rate for Payer: PACE SWMI |
$14.71
|
| Rate for Payer: PHP Medicare Advantage |
$14.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$22.78
|
| Rate for Payer: Priority Health Medicare |
$14.71
|
| Rate for Payer: Priority Health SBD |
$22.78
|
| Rate for Payer: Priority Health Tiered Network |
$22.78
|
| Rate for Payer: Railroad Medicare Medicare |
$14.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.39
|
| Rate for Payer: UHC Core |
$31.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.71
|
| Rate for Payer: UHC Exchange |
$31.39
|
| Rate for Payer: UHC Medicaid |
$9.37
|
| Rate for Payer: UHCCP Medicaid |
$9.37
|
|
|
PR ARREST EPIPHYSEAL DISTAL FEMUR
|
Professional
|
Both
|
$1,749.00
|
|
|
Service Code
|
HCPCS 27475
|
| Min. Negotiated Rate |
$400.01 |
| Max. Negotiated Rate |
$1,311.75 |
| Rate for Payer: Aetna Commercial |
$819.21
|
| Rate for Payer: Aetna Medicare |
$635.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$819.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$880.34
|
| Rate for Payer: BCBS Complete |
$420.01
|
| Rate for Payer: BCBS MAPPO |
$611.35
|
| Rate for Payer: BCN Commercial |
$1,015.38
|
| Rate for Payer: BCN Medicare Advantage |
$611.35
|
| Rate for Payer: Cash Price |
$1,399.20
|
| Rate for Payer: Cash Price |
$1,399.20
|
| Rate for Payer: Cofinity Commercial |
$880.34
|
| Rate for Payer: Cofinity Commercial |
$819.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$611.35
|
| Rate for Payer: Healthscope Commercial |
$978.16
|
| Rate for Payer: Healthscope Commercial |
$1,131.00
|
| Rate for Payer: Mclaren Medicaid |
$400.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$641.92
|
| Rate for Payer: Meridian Medicaid |
$420.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$672.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,179.52
|
| Rate for Payer: Nomi Health Commercial |
$733.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,311.75
|
| Rate for Payer: PACE SWMI |
$611.35
|
| Rate for Payer: PHP Medicare Advantage |
$611.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,085.42
|
| Rate for Payer: Priority Health Medicare |
$611.35
|
| Rate for Payer: Priority Health SBD |
$1,085.42
|
| Rate for Payer: Priority Health Tiered Network |
$1,085.42
|
| Rate for Payer: Railroad Medicare Medicare |
$611.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,155.60
|
| Rate for Payer: UHC Core |
$1,155.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$611.35
|
| Rate for Payer: UHC Exchange |
$1,155.60
|
| Rate for Payer: UHC Medicaid |
$400.01
|
| Rate for Payer: UHCCP Medicaid |
$400.01
|
|
|
PR ARREST EPIPHYSEAL OPEN DISTAL FIBULA
|
Professional
|
Both
|
$1,568.00
|
|
|
Service Code
|
HCPCS 27732
|
| Min. Negotiated Rate |
$281.80 |
| Max. Negotiated Rate |
$1,176.00 |
| Rate for Payer: Aetna Commercial |
$572.35
|
| Rate for Payer: Aetna Medicare |
$444.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$572.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$615.07
|
| Rate for Payer: BCBS Complete |
$295.89
|
| Rate for Payer: BCBS MAPPO |
$427.13
|
| Rate for Payer: BCN Commercial |
$700.66
|
| Rate for Payer: BCN Medicare Advantage |
$427.13
|
| Rate for Payer: Cash Price |
$1,254.40
|
| Rate for Payer: Cash Price |
$1,254.40
|
| Rate for Payer: Cofinity Commercial |
$615.07
|
| Rate for Payer: Cofinity Commercial |
$572.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$427.13
|
| Rate for Payer: Healthscope Commercial |
$790.19
|
| Rate for Payer: Healthscope Commercial |
$683.41
|
| Rate for Payer: Mclaren Medicaid |
$281.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$448.49
|
| Rate for Payer: Meridian Medicaid |
$295.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$469.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$806.54
|
| Rate for Payer: Nomi Health Commercial |
$512.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,176.00
|
| Rate for Payer: PACE SWMI |
$427.13
|
| Rate for Payer: PHP Medicare Advantage |
$427.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$748.99
|
| Rate for Payer: Priority Health Medicare |
$427.13
|
| Rate for Payer: Priority Health SBD |
$748.99
|
| Rate for Payer: Priority Health Tiered Network |
$748.99
|
| Rate for Payer: Railroad Medicare Medicare |
$427.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$780.08
|
| Rate for Payer: UHC Core |
$780.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$427.13
|
| Rate for Payer: UHC Exchange |
$780.08
|
| Rate for Payer: UHC Medicaid |
$281.80
|
| Rate for Payer: UHCCP Medicaid |
$281.80
|
|
|
PR ARREST EPIPHYSEAL OPEN DISTAL TIBIA
|
Professional
|
Both
|
$1,473.00
|
|
|
Service Code
|
HCPCS 27730
|
| Min. Negotiated Rate |
$357.84 |
| Max. Negotiated Rate |
$1,104.75 |
| Rate for Payer: Aetna Commercial |
$731.32
|
| Rate for Payer: Aetna Medicare |
$567.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$785.89
|
| Rate for Payer: BCBS Complete |
$375.73
|
| Rate for Payer: BCBS MAPPO |
$545.76
|
| Rate for Payer: BCN Commercial |
$902.84
|
| Rate for Payer: BCN Medicare Advantage |
$545.76
|
| Rate for Payer: Cash Price |
$1,178.40
|
| Rate for Payer: Cash Price |
$1,178.40
|
| Rate for Payer: Cofinity Commercial |
$785.89
|
| Rate for Payer: Cofinity Commercial |
$731.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$545.76
|
| Rate for Payer: Healthscope Commercial |
$873.22
|
| Rate for Payer: Healthscope Commercial |
$1,009.66
|
| Rate for Payer: Mclaren Medicaid |
$357.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$573.05
|
| Rate for Payer: Meridian Medicaid |
$375.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$600.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,045.96
|
| Rate for Payer: Nomi Health Commercial |
$654.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,104.75
|
| Rate for Payer: PACE SWMI |
$545.76
|
| Rate for Payer: PHP Medicare Advantage |
$545.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$965.11
|
| Rate for Payer: Priority Health Medicare |
$545.76
|
| Rate for Payer: Priority Health SBD |
$965.11
|
| Rate for Payer: Priority Health Tiered Network |
$965.11
|
| Rate for Payer: Railroad Medicare Medicare |
$545.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,021.88
|
| Rate for Payer: UHC Core |
$1,021.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$545.76
|
| Rate for Payer: UHC Exchange |
$1,021.88
|
| Rate for Payer: UHC Medicaid |
$357.84
|
| Rate for Payer: UHCCP Medicaid |
$357.84
|
|
|
PR ARREST EPIPHYSEAL OPEN DISTAL TIBIA&FIBULA
|
Professional
|
Both
|
$3,046.00
|
|
|
Service Code
|
HCPCS 27734
|
| Min. Negotiated Rate |
$396.82 |
| Max. Negotiated Rate |
$2,284.50 |
| Rate for Payer: Aetna Commercial |
$812.50
|
| Rate for Payer: Aetna Medicare |
$630.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$812.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$873.13
|
| Rate for Payer: BCBS Complete |
$416.66
|
| Rate for Payer: BCBS MAPPO |
$606.34
|
| Rate for Payer: BCN Commercial |
$1,007.91
|
| Rate for Payer: BCN Medicare Advantage |
$606.34
|
| Rate for Payer: Cash Price |
$2,436.80
|
| Rate for Payer: Cash Price |
$2,436.80
|
| Rate for Payer: Cofinity Commercial |
$873.13
|
| Rate for Payer: Cofinity Commercial |
$812.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.34
|
| Rate for Payer: Healthscope Commercial |
$970.14
|
| Rate for Payer: Healthscope Commercial |
$1,121.73
|
| Rate for Payer: Mclaren Medicaid |
$396.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.66
|
| Rate for Payer: Meridian Medicaid |
$416.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$666.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,169.89
|
| Rate for Payer: Nomi Health Commercial |
$727.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,284.50
|
| Rate for Payer: PACE SWMI |
$606.34
|
| Rate for Payer: PHP Medicare Advantage |
$606.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,077.43
|
| Rate for Payer: Priority Health Medicare |
$606.34
|
| Rate for Payer: Priority Health SBD |
$1,077.43
|
| Rate for Payer: Priority Health Tiered Network |
$1,077.43
|
| Rate for Payer: Railroad Medicare Medicare |
$606.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,145.15
|
| Rate for Payer: UHC Core |
$1,145.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$606.34
|
| Rate for Payer: UHC Exchange |
$1,145.15
|
| Rate for Payer: UHC Medicaid |
$396.82
|
| Rate for Payer: UHCCP Medicaid |
$396.82
|
|
|
PR ARRST EPIPHYSL ANY METH TIBFIB&DSTL FEMUR
|
Professional
|
Both
|
$1,394.00
|
|
|
Service Code
|
HCPCS 27742
|
| Min. Negotiated Rate |
$465.83 |
| Max. Negotiated Rate |
$1,380.65 |
| Rate for Payer: Aetna Commercial |
$955.29
|
| Rate for Payer: Aetna Medicare |
$741.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,026.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$955.29
|
| Rate for Payer: BCBS Complete |
$489.12
|
| Rate for Payer: BCBS MAPPO |
$712.90
|
| Rate for Payer: BCN Commercial |
$1,187.19
|
| Rate for Payer: BCN Medicare Advantage |
$712.90
|
| Rate for Payer: Cash Price |
$1,115.20
|
| Rate for Payer: Cash Price |
$1,115.20
|
| Rate for Payer: Cofinity Commercial |
$955.29
|
| Rate for Payer: Cofinity Commercial |
$1,026.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$712.90
|
| Rate for Payer: Healthscope Commercial |
$1,318.87
|
| Rate for Payer: Healthscope Commercial |
$1,140.64
|
| Rate for Payer: Mclaren Medicaid |
$465.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$748.54
|
| Rate for Payer: Meridian Medicaid |
$489.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$784.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,380.65
|
| Rate for Payer: Nomi Health Commercial |
$855.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,045.50
|
| Rate for Payer: PACE SWMI |
$712.90
|
| Rate for Payer: PHP Medicare Advantage |
$712.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,269.07
|
| Rate for Payer: Priority Health Medicare |
$712.90
|
| Rate for Payer: Priority Health SBD |
$1,269.07
|
| Rate for Payer: Priority Health Tiered Network |
$1,269.07
|
| Rate for Payer: Railroad Medicare Medicare |
$712.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,357.18
|
| Rate for Payer: UHC Core |
$1,357.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$712.90
|
| Rate for Payer: UHC Exchange |
$1,357.18
|
| Rate for Payer: UHC Medicaid |
$465.83
|
| Rate for Payer: UHCCP Medicaid |
$465.83
|
|
|
PR ARRST EPIPHYSL CMBN DSTL FEMUR PROX TIBFIB
|
Professional
|
Both
|
$3,192.00
|
|
|
Service Code
|
HCPCS 27479
|
| Min. Negotiated Rate |
$541.66 |
| Max. Negotiated Rate |
$2,394.00 |
| Rate for Payer: Aetna Commercial |
$1,115.51
|
| Rate for Payer: Aetna Medicare |
$865.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,115.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,198.76
|
| Rate for Payer: BCBS Complete |
$568.74
|
| Rate for Payer: BCBS MAPPO |
$832.47
|
| Rate for Payer: BCN Commercial |
$1,396.34
|
| Rate for Payer: BCN Medicare Advantage |
$832.47
|
| Rate for Payer: Cash Price |
$2,553.60
|
| Rate for Payer: Cash Price |
$2,553.60
|
| Rate for Payer: Cofinity Commercial |
$1,198.76
|
| Rate for Payer: Cofinity Commercial |
$1,115.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$832.47
|
| Rate for Payer: Healthscope Commercial |
$1,540.07
|
| Rate for Payer: Healthscope Commercial |
$1,331.95
|
| Rate for Payer: Mclaren Medicaid |
$541.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$874.09
|
| Rate for Payer: Meridian Medicaid |
$568.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$915.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,631.79
|
| Rate for Payer: Nomi Health Commercial |
$998.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,394.00
|
| Rate for Payer: PACE SWMI |
$832.47
|
| Rate for Payer: PHP Medicare Advantage |
$832.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$541.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,492.65
|
| Rate for Payer: Priority Health Medicare |
$832.47
|
| Rate for Payer: Priority Health SBD |
$1,492.65
|
| Rate for Payer: Priority Health Tiered Network |
$1,492.65
|
| Rate for Payer: Railroad Medicare Medicare |
$832.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,609.48
|
| Rate for Payer: UHC Core |
$1,609.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$832.47
|
| Rate for Payer: UHC Exchange |
$1,609.48
|
| Rate for Payer: UHC Medicaid |
$541.66
|
| Rate for Payer: UHCCP Medicaid |
$541.66
|
|
|
PR ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX
|
Professional
|
Both
|
$144.00
|
|
|
Service Code
|
HCPCS 36600
|
| Min. Negotiated Rate |
$8.31 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$13.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.63
|
| Rate for Payer: BCBS Complete |
$8.73
|
| Rate for Payer: BCBS MAPPO |
$12.94
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: BCN Medicare Advantage |
$12.94
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cofinity Commercial |
$18.63
|
| Rate for Payer: Cofinity Commercial |
$17.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.94
|
| Rate for Payer: Healthscope Commercial |
$23.94
|
| Rate for Payer: Healthscope Commercial |
$20.70
|
| Rate for Payer: Mclaren Medicaid |
$8.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.59
|
| Rate for Payer: Meridian Medicaid |
$8.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.39
|
| Rate for Payer: Nomi Health Commercial |
$15.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$108.00
|
| Rate for Payer: PACE SWMI |
$12.94
|
| Rate for Payer: PHP Medicare Advantage |
$12.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23.56
|
| Rate for Payer: Priority Health Medicare |
$12.94
|
| Rate for Payer: Priority Health SBD |
$23.56
|
| Rate for Payer: Priority Health Tiered Network |
$23.56
|
| Rate for Payer: Railroad Medicare Medicare |
$12.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.72
|
| Rate for Payer: UHC Core |
$27.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.94
|
| Rate for Payer: UHC Exchange |
$27.72
|
| Rate for Payer: UHC Medicaid |
$8.31
|
| Rate for Payer: UHCCP Medicaid |
$8.31
|
|
|
PR ARTERIOVENOUS ANASTOMOSIS OPEN DIRECT
|
Professional
|
Both
|
$2,305.00
|
|
|
Service Code
|
HCPCS 36821
|
| Min. Negotiated Rate |
$383.19 |
| Max. Negotiated Rate |
$1,728.75 |
| Rate for Payer: Aetna Commercial |
$808.82
|
| Rate for Payer: Aetna Medicare |
$627.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$869.18
|
| Rate for Payer: BCBS Complete |
$402.35
|
| Rate for Payer: BCBS MAPPO |
$603.60
|
| Rate for Payer: BCN Commercial |
$966.58
|
| Rate for Payer: BCN Medicare Advantage |
$603.60
|
| Rate for Payer: Cash Price |
$1,844.00
|
| Rate for Payer: Cash Price |
$1,844.00
|
| Rate for Payer: Cofinity Commercial |
$869.18
|
| Rate for Payer: Cofinity Commercial |
$808.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$603.60
|
| Rate for Payer: Healthscope Commercial |
$965.76
|
| Rate for Payer: Healthscope Commercial |
$1,116.66
|
| Rate for Payer: Mclaren Medicaid |
$383.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.78
|
| Rate for Payer: Meridian Medicaid |
$402.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$663.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,169.28
|
| Rate for Payer: Nomi Health Commercial |
$724.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,728.75
|
| Rate for Payer: PACE SWMI |
$603.60
|
| Rate for Payer: PHP Medicare Advantage |
$603.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,039.44
|
| Rate for Payer: Priority Health Medicare |
$603.60
|
| Rate for Payer: Priority Health SBD |
$1,039.44
|
| Rate for Payer: Priority Health Tiered Network |
$1,039.44
|
| Rate for Payer: Railroad Medicare Medicare |
$603.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,187.97
|
| Rate for Payer: UHC Core |
$1,187.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$603.60
|
| Rate for Payer: UHC Exchange |
$1,187.97
|
| Rate for Payer: UHC Medicaid |
$383.19
|
| Rate for Payer: UHCCP Medicaid |
$383.19
|
|
|
PR ARTERY EXPOS/GRAFT ARTERY PERFUSION ECMO/ECLS
|
Professional
|
Both
|
$455.00
|
|
|
Service Code
|
HCPCS 33987
|
| Min. Negotiated Rate |
$121.41 |
| Max. Negotiated Rate |
$373.35 |
| Rate for Payer: Aetna Commercial |
$257.44
|
| Rate for Payer: Aetna Medicare |
$199.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.65
|
| Rate for Payer: BCBS Complete |
$127.48
|
| Rate for Payer: BCBS MAPPO |
$192.12
|
| Rate for Payer: BCN Commercial |
$301.78
|
| Rate for Payer: BCN Medicare Advantage |
$192.12
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Cofinity Commercial |
$276.65
|
| Rate for Payer: Cofinity Commercial |
$257.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.12
|
| Rate for Payer: Healthscope Commercial |
$355.42
|
| Rate for Payer: Healthscope Commercial |
$307.39
|
| Rate for Payer: Mclaren Medicaid |
$121.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.73
|
| Rate for Payer: Meridian Medicaid |
$127.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$211.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.27
|
| Rate for Payer: Nomi Health Commercial |
$230.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$341.25
|
| Rate for Payer: PACE SWMI |
$192.12
|
| Rate for Payer: PHP Medicare Advantage |
$192.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$324.52
|
| Rate for Payer: Priority Health Medicare |
$192.12
|
| Rate for Payer: Priority Health SBD |
$324.52
|
| Rate for Payer: Priority Health Tiered Network |
$324.52
|
| Rate for Payer: Railroad Medicare Medicare |
$192.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$373.35
|
| Rate for Payer: UHC Core |
$373.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$192.12
|
| Rate for Payer: UHC Exchange |
$373.35
|
| Rate for Payer: UHC Medicaid |
$121.41
|
| Rate for Payer: UHCCP Medicaid |
$121.41
|
|
|
PR ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2
|
Professional
|
Both
|
$4,548.00
|
|
|
Service Code
|
HCPCS 22551
|
| Min. Negotiated Rate |
$1,023.47 |
| Max. Negotiated Rate |
$3,411.00 |
| Rate for Payer: Aetna Commercial |
$2,138.08
|
| Rate for Payer: Aetna Medicare |
$1,659.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,138.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,297.64
|
| Rate for Payer: BCBS Complete |
$1,074.64
|
| Rate for Payer: BCBS MAPPO |
$1,595.58
|
| Rate for Payer: BCN Commercial |
$2,576.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,595.58
|
| Rate for Payer: Cash Price |
$3,638.40
|
| Rate for Payer: Cash Price |
$3,638.40
|
| Rate for Payer: Cofinity Commercial |
$2,297.64
|
| Rate for Payer: Cofinity Commercial |
$2,138.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,595.58
|
| Rate for Payer: Healthscope Commercial |
$2,951.82
|
| Rate for Payer: Healthscope Commercial |
$2,552.93
|
| Rate for Payer: Mclaren Medicaid |
$1,023.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,675.36
|
| Rate for Payer: Meridian Medicaid |
$1,074.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,755.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,058.74
|
| Rate for Payer: Nomi Health Commercial |
$1,914.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,411.00
|
| Rate for Payer: PACE SWMI |
$1,595.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,595.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,023.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,754.27
|
| Rate for Payer: Priority Health Medicare |
$1,595.58
|
| Rate for Payer: Priority Health SBD |
$2,754.27
|
| Rate for Payer: Priority Health Tiered Network |
$2,754.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,595.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,011.14
|
| Rate for Payer: UHC Core |
$3,011.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,595.58
|
| Rate for Payer: UHC Exchange |
$3,011.14
|
| Rate for Payer: UHC Medicaid |
$1,023.47
|
| Rate for Payer: UHCCP Medicaid |
$1,023.47
|
|
|
PR ARTHRD ANT INTERBODY MIN DSC CRV BELOW C2
|
Professional
|
Both
|
$5,063.00
|
|
|
Service Code
|
HCPCS 22554
|
| Min. Negotiated Rate |
$775.32 |
| Max. Negotiated Rate |
$3,797.25 |
| Rate for Payer: Aetna Commercial |
$1,610.67
|
| Rate for Payer: Aetna Medicare |
$1,250.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,610.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,730.87
|
| Rate for Payer: BCBS Complete |
$814.09
|
| Rate for Payer: BCBS MAPPO |
$1,201.99
|
| Rate for Payer: BCN Commercial |
$2,109.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,201.99
|
| Rate for Payer: Cash Price |
$4,050.40
|
| Rate for Payer: Cash Price |
$4,050.40
|
| Rate for Payer: Cofinity Commercial |
$1,730.87
|
| Rate for Payer: Cofinity Commercial |
$1,610.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,201.99
|
| Rate for Payer: Healthscope Commercial |
$2,223.68
|
| Rate for Payer: Healthscope Commercial |
$1,923.18
|
| Rate for Payer: Mclaren Medicaid |
$775.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,262.09
|
| Rate for Payer: Meridian Medicaid |
$814.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,322.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,263.68
|
| Rate for Payer: Nomi Health Commercial |
$1,442.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,797.25
|
| Rate for Payer: PACE SWMI |
$1,201.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,201.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$775.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,052.65
|
| Rate for Payer: Priority Health Medicare |
$1,201.99
|
| Rate for Payer: Priority Health SBD |
$2,052.65
|
| Rate for Payer: Priority Health Tiered Network |
$2,052.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,201.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,209.57
|
| Rate for Payer: UHC Core |
$2,209.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,201.99
|
| Rate for Payer: UHC Exchange |
$2,209.57
|
| Rate for Payer: UHC Medicaid |
$775.32
|
| Rate for Payer: UHCCP Medicaid |
$775.32
|
|
|
PR ARTHRD ANT INTERBODY MIN DSC LUMBAR
|
Professional
|
Both
|
$3,286.00
|
|
|
Service Code
|
HCPCS 22558
|
| Min. Negotiated Rate |
$908.02 |
| Max. Negotiated Rate |
$2,734.34 |
| Rate for Payer: Aetna Commercial |
$1,894.08
|
| Rate for Payer: Aetna Medicare |
$1,470.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,894.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,035.43
|
| Rate for Payer: BCBS Complete |
$953.42
|
| Rate for Payer: BCBS MAPPO |
$1,413.49
|
| Rate for Payer: BCN Commercial |
$2,532.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,413.49
|
| Rate for Payer: Cash Price |
$2,628.80
|
| Rate for Payer: Cash Price |
$2,628.80
|
| Rate for Payer: Cofinity Commercial |
$2,035.43
|
| Rate for Payer: Cofinity Commercial |
$1,894.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,413.49
|
| Rate for Payer: Healthscope Commercial |
$2,614.96
|
| Rate for Payer: Healthscope Commercial |
$2,261.58
|
| Rate for Payer: Mclaren Medicaid |
$908.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,484.16
|
| Rate for Payer: Meridian Medicaid |
$953.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,554.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,734.34
|
| Rate for Payer: Nomi Health Commercial |
$1,696.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,464.50
|
| Rate for Payer: PACE SWMI |
$1,413.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,413.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$908.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,464.67
|
| Rate for Payer: Priority Health Medicare |
$1,413.49
|
| Rate for Payer: Priority Health SBD |
$2,464.67
|
| Rate for Payer: Priority Health Tiered Network |
$2,464.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,413.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,707.54
|
| Rate for Payer: UHC Core |
$2,707.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,413.49
|
| Rate for Payer: UHC Exchange |
$2,707.54
|
| Rate for Payer: UHC Medicaid |
$908.02
|
| Rate for Payer: UHCCP Medicaid |
$908.02
|
|
|
PR ARTHRD ANT INTERBODY MIN DSC THORACIC
|
Professional
|
Both
|
$6,162.00
|
|
|
Service Code
|
HCPCS 22556
|
| Min. Negotiated Rate |
$1,019.63 |
| Max. Negotiated Rate |
$4,621.50 |
| Rate for Payer: Aetna Commercial |
$2,124.42
|
| Rate for Payer: Aetna Medicare |
$1,648.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,124.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,282.96
|
| Rate for Payer: BCBS Complete |
$1,070.61
|
| Rate for Payer: BCBS MAPPO |
$1,585.39
|
| Rate for Payer: BCN Commercial |
$2,807.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,585.39
|
| Rate for Payer: Cash Price |
$4,929.60
|
| Rate for Payer: Cash Price |
$4,929.60
|
| Rate for Payer: Cofinity Commercial |
$2,282.96
|
| Rate for Payer: Cofinity Commercial |
$2,124.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,585.39
|
| Rate for Payer: Healthscope Commercial |
$2,932.97
|
| Rate for Payer: Healthscope Commercial |
$2,536.62
|
| Rate for Payer: Mclaren Medicaid |
$1,019.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,664.66
|
| Rate for Payer: Meridian Medicaid |
$1,070.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,743.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,996.84
|
| Rate for Payer: Nomi Health Commercial |
$1,902.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,621.50
|
| Rate for Payer: PACE SWMI |
$1,585.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,585.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,019.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,731.38
|
| Rate for Payer: Priority Health Medicare |
$1,585.39
|
| Rate for Payer: Priority Health SBD |
$2,731.38
|
| Rate for Payer: Priority Health Tiered Network |
$2,731.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,585.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,936.20
|
| Rate for Payer: UHC Core |
$2,936.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,585.39
|
| Rate for Payer: UHC Exchange |
$2,936.20
|
| Rate for Payer: UHC Medicaid |
$1,019.63
|
| Rate for Payer: UHCCP Medicaid |
$1,019.63
|
|
|
PR ARTHRD ANT INTERDY CERVCL BELW C2 EA ADDL NTRSPC
|
Professional
|
Both
|
$1,062.00
|
|
|
Service Code
|
HCPCS 22552
|
| Min. Negotiated Rate |
$225.14 |
| Max. Negotiated Rate |
$796.50 |
| Rate for Payer: Aetna Commercial |
$476.92
|
| Rate for Payer: Aetna Medicare |
$370.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$476.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.51
|
| Rate for Payer: BCBS Complete |
$236.40
|
| Rate for Payer: BCBS MAPPO |
$355.91
|
| Rate for Payer: BCN Commercial |
$593.10
|
| Rate for Payer: BCN Medicare Advantage |
$355.91
|
| Rate for Payer: Cash Price |
$849.60
|
| Rate for Payer: Cash Price |
$849.60
|
| Rate for Payer: Cofinity Commercial |
$512.51
|
| Rate for Payer: Cofinity Commercial |
$476.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$355.91
|
| Rate for Payer: Healthscope Commercial |
$658.43
|
| Rate for Payer: Healthscope Commercial |
$569.46
|
| Rate for Payer: Mclaren Medicaid |
$225.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.71
|
| Rate for Payer: Meridian Medicaid |
$236.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$391.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$711.92
|
| Rate for Payer: Nomi Health Commercial |
$427.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$796.50
|
| Rate for Payer: PACE SWMI |
$355.91
|
| Rate for Payer: PHP Medicare Advantage |
$355.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$634.01
|
| Rate for Payer: Priority Health Medicare |
$355.91
|
| Rate for Payer: Priority Health SBD |
$634.01
|
| Rate for Payer: Priority Health Tiered Network |
$634.01
|
| Rate for Payer: Railroad Medicare Medicare |
$355.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$708.68
|
| Rate for Payer: UHC Core |
$708.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$355.91
|
| Rate for Payer: UHC Exchange |
$708.68
|
| Rate for Payer: UHC Medicaid |
$225.14
|
| Rate for Payer: UHCCP Medicaid |
$225.14
|
|
