|
PR ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX
|
Professional
|
Both
|
$2,125.00
|
|
|
Service Code
|
HCPCS 24006
|
| Min. Negotiated Rate |
$423.66 |
| Max. Negotiated Rate |
$1,593.75 |
| Rate for Payer: Aetna Commercial |
$868.43
|
| Rate for Payer: Aetna Medicare |
$674.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$868.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$933.24
|
| Rate for Payer: BCBS Complete |
$444.84
|
| Rate for Payer: BCBS MAPPO |
$648.08
|
| Rate for Payer: BCN Commercial |
$1,094.06
|
| Rate for Payer: BCN Medicare Advantage |
$648.08
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cash Price |
$1,700.00
|
| Rate for Payer: Cofinity Commercial |
$933.24
|
| Rate for Payer: Cofinity Commercial |
$868.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$648.08
|
| Rate for Payer: Healthscope Commercial |
$1,198.95
|
| Rate for Payer: Healthscope Commercial |
$1,036.93
|
| Rate for Payer: Mclaren Medicaid |
$423.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$680.48
|
| Rate for Payer: Meridian Medicaid |
$444.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$712.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,265.85
|
| Rate for Payer: Nomi Health Commercial |
$777.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,593.75
|
| Rate for Payer: PACE SWMI |
$648.08
|
| Rate for Payer: PHP Medicare Advantage |
$648.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,169.52
|
| Rate for Payer: Priority Health Medicare |
$648.08
|
| Rate for Payer: Priority Health SBD |
$1,169.52
|
| Rate for Payer: Priority Health Tiered Network |
$1,169.52
|
| Rate for Payer: Railroad Medicare Medicare |
$648.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,241.11
|
| Rate for Payer: UHC Core |
$1,241.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$648.08
|
| Rate for Payer: UHC Exchange |
$1,241.11
|
| Rate for Payer: UHC Medicaid |
$423.66
|
| Rate for Payer: UHCCP Medicaid |
$423.66
|
|
|
PR ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB
|
Professional
|
Both
|
$2,099.00
|
|
|
Service Code
|
HCPCS 24000
|
| Min. Negotiated Rate |
$294.15 |
| Max. Negotiated Rate |
$1,574.25 |
| Rate for Payer: Aetna Commercial |
$599.21
|
| Rate for Payer: Aetna Medicare |
$465.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$599.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$643.92
|
| Rate for Payer: BCBS Complete |
$308.86
|
| Rate for Payer: BCBS MAPPO |
$447.17
|
| Rate for Payer: BCN Commercial |
$738.51
|
| Rate for Payer: BCN Medicare Advantage |
$447.17
|
| Rate for Payer: Cash Price |
$1,679.20
|
| Rate for Payer: Cash Price |
$1,679.20
|
| Rate for Payer: Cofinity Commercial |
$643.92
|
| Rate for Payer: Cofinity Commercial |
$599.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$447.17
|
| Rate for Payer: Healthscope Commercial |
$827.26
|
| Rate for Payer: Healthscope Commercial |
$715.47
|
| Rate for Payer: Mclaren Medicaid |
$294.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$469.53
|
| Rate for Payer: Meridian Medicaid |
$308.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$491.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$850.72
|
| Rate for Payer: Nomi Health Commercial |
$536.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,574.25
|
| Rate for Payer: PACE SWMI |
$447.17
|
| Rate for Payer: PHP Medicare Advantage |
$447.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$294.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$789.44
|
| Rate for Payer: Priority Health Medicare |
$447.17
|
| Rate for Payer: Priority Health SBD |
$789.44
|
| Rate for Payer: Priority Health Tiered Network |
$789.44
|
| Rate for Payer: Railroad Medicare Medicare |
$447.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$830.35
|
| Rate for Payer: UHC Core |
$830.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$447.17
|
| Rate for Payer: UHC Exchange |
$830.35
|
| Rate for Payer: UHC Medicaid |
$294.15
|
| Rate for Payer: UHCCP Medicaid |
$294.15
|
|
|
PR ARTHRT ELBOW W/JT EXPL W/WOBX W/O RMVL LOOSE/FB
|
Professional
|
Both
|
$1,388.00
|
|
|
Service Code
|
HCPCS 24101
|
| Min. Negotiated Rate |
$307.79 |
| Max. Negotiated Rate |
$1,041.00 |
| Rate for Payer: Priority Health SBD |
$829.37
|
| Rate for Payer: Aetna Commercial |
$626.46
|
| Rate for Payer: Aetna Medicare |
$486.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$626.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$673.21
|
| Rate for Payer: BCBS Complete |
$323.18
|
| Rate for Payer: BCBS MAPPO |
$467.51
|
| Rate for Payer: BCN Commercial |
$775.85
|
| Rate for Payer: BCN Medicare Advantage |
$467.51
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cofinity Commercial |
$673.21
|
| Rate for Payer: Cofinity Commercial |
$626.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$467.51
|
| Rate for Payer: Healthscope Commercial |
$864.89
|
| Rate for Payer: Healthscope Commercial |
$748.02
|
| Rate for Payer: Mclaren Medicaid |
$307.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$490.89
|
| Rate for Payer: Meridian Medicaid |
$323.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$514.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$896.58
|
| Rate for Payer: Nomi Health Commercial |
$561.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,041.00
|
| Rate for Payer: PACE SWMI |
$467.51
|
| Rate for Payer: PHP Medicare Advantage |
$467.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$829.37
|
| Rate for Payer: Priority Health Medicare |
$467.51
|
| Rate for Payer: Priority Health Tiered Network |
$829.37
|
| Rate for Payer: Railroad Medicare Medicare |
$467.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$870.17
|
| Rate for Payer: UHC Core |
$870.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$467.51
|
| Rate for Payer: UHC Exchange |
$870.17
|
| Rate for Payer: UHC Medicaid |
$307.79
|
| Rate for Payer: UHCCP Medicaid |
$307.79
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT
|
Professional
|
Both
|
$1,329.00
|
|
|
Service Code
|
HCPCS 26070
|
| Min. Negotiated Rate |
$199.58 |
| Max. Negotiated Rate |
$996.75 |
| Rate for Payer: Aetna Commercial |
$403.92
|
| Rate for Payer: Aetna Medicare |
$313.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$403.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.06
|
| Rate for Payer: BCBS Complete |
$209.56
|
| Rate for Payer: BCBS MAPPO |
$301.43
|
| Rate for Payer: BCN Commercial |
$500.47
|
| Rate for Payer: BCN Medicare Advantage |
$301.43
|
| Rate for Payer: Cash Price |
$1,063.20
|
| Rate for Payer: Cash Price |
$1,063.20
|
| Rate for Payer: Cofinity Commercial |
$434.06
|
| Rate for Payer: Cofinity Commercial |
$403.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.43
|
| Rate for Payer: Healthscope Commercial |
$557.65
|
| Rate for Payer: Healthscope Commercial |
$482.29
|
| Rate for Payer: Mclaren Medicaid |
$199.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.50
|
| Rate for Payer: Meridian Medicaid |
$209.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$331.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$573.01
|
| Rate for Payer: Nomi Health Commercial |
$361.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$996.75
|
| Rate for Payer: PACE SWMI |
$301.43
|
| Rate for Payer: PHP Medicare Advantage |
$301.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$534.99
|
| Rate for Payer: Priority Health Medicare |
$301.43
|
| Rate for Payer: Priority Health SBD |
$534.99
|
| Rate for Payer: Priority Health Tiered Network |
$534.99
|
| Rate for Payer: Railroad Medicare Medicare |
$301.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$554.05
|
| Rate for Payer: UHC Core |
$554.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$301.43
|
| Rate for Payer: UHC Exchange |
$554.05
|
| Rate for Payer: UHC Medicaid |
$199.58
|
| Rate for Payer: UHCCP Medicaid |
$199.58
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA
|
Professional
|
Both
|
$1,122.00
|
|
|
Service Code
|
HCPCS 26080
|
| Min. Negotiated Rate |
$247.29 |
| Max. Negotiated Rate |
$841.50 |
| Rate for Payer: Aetna Commercial |
$499.53
|
| Rate for Payer: Aetna Medicare |
$387.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$536.80
|
| Rate for Payer: BCBS Complete |
$259.65
|
| Rate for Payer: BCBS MAPPO |
$372.78
|
| Rate for Payer: BCN Commercial |
$618.49
|
| Rate for Payer: BCN Medicare Advantage |
$372.78
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$536.80
|
| Rate for Payer: Cofinity Commercial |
$499.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.78
|
| Rate for Payer: Healthscope Commercial |
$689.64
|
| Rate for Payer: Healthscope Commercial |
$596.45
|
| Rate for Payer: Mclaren Medicaid |
$247.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.42
|
| Rate for Payer: Meridian Medicaid |
$259.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$706.01
|
| Rate for Payer: Nomi Health Commercial |
$447.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$841.50
|
| Rate for Payer: PACE SWMI |
$372.78
|
| Rate for Payer: PHP Medicare Advantage |
$372.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$247.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$661.15
|
| Rate for Payer: Priority Health Medicare |
$372.78
|
| Rate for Payer: Priority Health SBD |
$661.15
|
| Rate for Payer: Priority Health Tiered Network |
$661.15
|
| Rate for Payer: Railroad Medicare Medicare |
$372.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$677.89
|
| Rate for Payer: UHC Core |
$677.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$372.78
|
| Rate for Payer: UHC Exchange |
$677.89
|
| Rate for Payer: UHC Medicaid |
$247.29
|
| Rate for Payer: UHCCP Medicaid |
$247.29
|
|
|
PR ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA
|
Professional
|
Both
|
$590.00
|
|
|
Service Code
|
HCPCS 26075
|
| Min. Negotiated Rate |
$210.44 |
| Max. Negotiated Rate |
$601.38 |
| Rate for Payer: Aetna Commercial |
$425.62
|
| Rate for Payer: Aetna Medicare |
$330.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$425.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.39
|
| Rate for Payer: BCBS Complete |
$220.96
|
| Rate for Payer: BCBS MAPPO |
$317.63
|
| Rate for Payer: BCN Commercial |
$524.87
|
| Rate for Payer: BCN Medicare Advantage |
$317.63
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Cash Price |
$472.00
|
| Rate for Payer: Cofinity Commercial |
$457.39
|
| Rate for Payer: Cofinity Commercial |
$425.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$317.63
|
| Rate for Payer: Healthscope Commercial |
$587.62
|
| Rate for Payer: Healthscope Commercial |
$508.21
|
| Rate for Payer: Mclaren Medicaid |
$210.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$333.51
|
| Rate for Payer: Meridian Medicaid |
$220.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$349.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$601.38
|
| Rate for Payer: Nomi Health Commercial |
$381.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$442.50
|
| Rate for Payer: PACE SWMI |
$317.63
|
| Rate for Payer: PHP Medicare Advantage |
$317.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$561.07
|
| Rate for Payer: Priority Health Medicare |
$317.63
|
| Rate for Payer: Priority Health SBD |
$561.07
|
| Rate for Payer: Priority Health Tiered Network |
$561.07
|
| Rate for Payer: Railroad Medicare Medicare |
$317.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$578.36
|
| Rate for Payer: UHC Core |
$578.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$317.63
|
| Rate for Payer: UHC Exchange |
$578.36
|
| Rate for Payer: UHC Medicaid |
$210.44
|
| Rate for Payer: UHCCP Medicaid |
$210.44
|
|
|
PR ARTHRT GLENOHMRL JT W/JT EXPL W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$1,293.00
|
|
|
Service Code
|
HCPCS 23107
|
| Min. Negotiated Rate |
$399.38 |
| Max. Negotiated Rate |
$1,175.92 |
| Rate for Payer: Aetna Commercial |
$817.27
|
| Rate for Payer: Aetna Medicare |
$634.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$817.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$878.26
|
| Rate for Payer: BCBS Complete |
$419.35
|
| Rate for Payer: BCBS MAPPO |
$609.90
|
| Rate for Payer: BCN Commercial |
$1,017.37
|
| Rate for Payer: BCN Medicare Advantage |
$609.90
|
| Rate for Payer: Cash Price |
$1,034.40
|
| Rate for Payer: Cash Price |
$1,034.40
|
| Rate for Payer: Cofinity Commercial |
$878.26
|
| Rate for Payer: Cofinity Commercial |
$817.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$609.90
|
| Rate for Payer: Healthscope Commercial |
$975.84
|
| Rate for Payer: Healthscope Commercial |
$1,128.32
|
| Rate for Payer: Mclaren Medicaid |
$399.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$640.39
|
| Rate for Payer: Meridian Medicaid |
$419.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$670.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,175.92
|
| Rate for Payer: Nomi Health Commercial |
$731.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.75
|
| Rate for Payer: PACE SWMI |
$609.90
|
| Rate for Payer: PHP Medicare Advantage |
$609.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$399.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,087.55
|
| Rate for Payer: Priority Health Medicare |
$609.90
|
| Rate for Payer: Priority Health SBD |
$1,087.55
|
| Rate for Payer: Priority Health Tiered Network |
$1,087.55
|
| Rate for Payer: Railroad Medicare Medicare |
$609.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,149.74
|
| Rate for Payer: UHC Core |
$1,149.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$609.90
|
| Rate for Payer: UHC Exchange |
$1,149.74
|
| Rate for Payer: UHC Medicaid |
$399.38
|
| Rate for Payer: UHCCP Medicaid |
$399.38
|
|
|
PR ARTHRT GLENOHUMRL JT STRNCLAV JT W/SYNVCT W/WOBX
|
Professional
|
Both
|
$1,031.00
|
|
|
Service Code
|
HCPCS 23106
|
| Min. Negotiated Rate |
$311.19 |
| Max. Negotiated Rate |
$892.62 |
| Rate for Payer: Aetna Commercial |
$632.67
|
| Rate for Payer: Aetna Medicare |
$491.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$632.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$679.88
|
| Rate for Payer: BCBS Complete |
$326.75
|
| Rate for Payer: BCBS MAPPO |
$472.14
|
| Rate for Payer: BCN Commercial |
$774.86
|
| Rate for Payer: BCN Medicare Advantage |
$472.14
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cofinity Commercial |
$679.88
|
| Rate for Payer: Cofinity Commercial |
$632.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$472.14
|
| Rate for Payer: Healthscope Commercial |
$873.46
|
| Rate for Payer: Healthscope Commercial |
$755.42
|
| Rate for Payer: Mclaren Medicaid |
$311.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$495.75
|
| Rate for Payer: Meridian Medicaid |
$326.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$519.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$892.62
|
| Rate for Payer: Nomi Health Commercial |
$566.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$773.25
|
| Rate for Payer: PACE SWMI |
$472.14
|
| Rate for Payer: PHP Medicare Advantage |
$472.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$311.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$828.30
|
| Rate for Payer: Priority Health Medicare |
$472.14
|
| Rate for Payer: Priority Health SBD |
$828.30
|
| Rate for Payer: Priority Health Tiered Network |
$828.30
|
| Rate for Payer: Railroad Medicare Medicare |
$472.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$865.41
|
| Rate for Payer: UHC Core |
$865.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$472.14
|
| Rate for Payer: UHC Exchange |
$865.41
|
| Rate for Payer: UHC Medicaid |
$311.19
|
| Rate for Payer: UHCCP Medicaid |
$311.19
|
|
|
PR ARTHRT GLENOHUMRL JT W/SYNOVECTOMY W/WO BIOPSY
|
Professional
|
Both
|
$1,168.00
|
|
|
Service Code
|
HCPCS 23105
|
| Min. Negotiated Rate |
$385.96 |
| Max. Negotiated Rate |
$1,135.87 |
| Rate for Payer: Aetna Commercial |
$789.27
|
| Rate for Payer: Aetna Medicare |
$612.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$789.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$848.17
|
| Rate for Payer: BCBS Complete |
$405.26
|
| Rate for Payer: BCBS MAPPO |
$589.01
|
| Rate for Payer: BCN Commercial |
$982.52
|
| Rate for Payer: BCN Medicare Advantage |
$589.01
|
| Rate for Payer: Cash Price |
$934.40
|
| Rate for Payer: Cash Price |
$934.40
|
| Rate for Payer: Cofinity Commercial |
$848.17
|
| Rate for Payer: Cofinity Commercial |
$789.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.01
|
| Rate for Payer: Healthscope Commercial |
$942.42
|
| Rate for Payer: Healthscope Commercial |
$1,089.67
|
| Rate for Payer: Mclaren Medicaid |
$385.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$618.46
|
| Rate for Payer: Meridian Medicaid |
$405.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$647.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,135.87
|
| Rate for Payer: Nomi Health Commercial |
$706.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$876.00
|
| Rate for Payer: PACE SWMI |
$589.01
|
| Rate for Payer: PHP Medicare Advantage |
$589.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,050.29
|
| Rate for Payer: Priority Health Medicare |
$589.01
|
| Rate for Payer: Priority Health SBD |
$1,050.29
|
| Rate for Payer: Priority Health Tiered Network |
$1,050.29
|
| Rate for Payer: Railroad Medicare Medicare |
$589.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,108.28
|
| Rate for Payer: UHC Core |
$1,108.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$589.01
|
| Rate for Payer: UHC Exchange |
$1,108.28
|
| Rate for Payer: UHC Medicaid |
$385.96
|
| Rate for Payer: UHCCP Medicaid |
$385.96
|
|
|
PR ARTHRT KNE W/EXPL DRG/RMVL FB
|
Professional
|
Both
|
$2,772.00
|
|
|
Service Code
|
HCPCS 27310
|
| Min. Negotiated Rate |
$439.42 |
| Max. Negotiated Rate |
$2,079.00 |
| Rate for Payer: Priority Health SBD |
$1,196.67
|
| Rate for Payer: Aetna Commercial |
$900.79
|
| Rate for Payer: Aetna Medicare |
$699.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$900.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$968.01
|
| Rate for Payer: BCBS Complete |
$461.39
|
| Rate for Payer: BCBS MAPPO |
$672.23
|
| Rate for Payer: BCN Commercial |
$1,119.46
|
| Rate for Payer: BCN Medicare Advantage |
$672.23
|
| Rate for Payer: Cash Price |
$2,217.60
|
| Rate for Payer: Cash Price |
$2,217.60
|
| Rate for Payer: Cofinity Commercial |
$968.01
|
| Rate for Payer: Cofinity Commercial |
$900.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$672.23
|
| Rate for Payer: Healthscope Commercial |
$1,243.63
|
| Rate for Payer: Healthscope Commercial |
$1,075.57
|
| Rate for Payer: Mclaren Medicaid |
$439.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$705.84
|
| Rate for Payer: Meridian Medicaid |
$461.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$739.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,301.81
|
| Rate for Payer: Nomi Health Commercial |
$806.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,079.00
|
| Rate for Payer: PACE SWMI |
$672.23
|
| Rate for Payer: PHP Medicare Advantage |
$672.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$439.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,196.67
|
| Rate for Payer: Priority Health Medicare |
$672.23
|
| Rate for Payer: Priority Health Tiered Network |
$1,196.67
|
| Rate for Payer: Railroad Medicare Medicare |
$672.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,276.66
|
| Rate for Payer: UHC Core |
$1,276.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$672.23
|
| Rate for Payer: UHC Exchange |
$1,276.66
|
| Rate for Payer: UHC Medicaid |
$439.42
|
| Rate for Payer: UHCCP Medicaid |
$439.42
|
|
|
PR ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB
|
Professional
|
Both
|
$1,801.00
|
|
|
Service Code
|
HCPCS 27331
|
| Min. Negotiated Rate |
$293.09 |
| Max. Negotiated Rate |
$1,350.75 |
| Rate for Payer: Aetna Commercial |
$597.02
|
| Rate for Payer: Aetna Medicare |
$463.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$641.58
|
| Rate for Payer: BCBS Complete |
$307.74
|
| Rate for Payer: BCBS MAPPO |
$445.54
|
| Rate for Payer: BCN Commercial |
$736.01
|
| Rate for Payer: BCN Medicare Advantage |
$445.54
|
| Rate for Payer: Cash Price |
$1,440.80
|
| Rate for Payer: Cash Price |
$1,440.80
|
| Rate for Payer: Cofinity Commercial |
$641.58
|
| Rate for Payer: Cofinity Commercial |
$597.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.54
|
| Rate for Payer: Healthscope Commercial |
$824.25
|
| Rate for Payer: Healthscope Commercial |
$712.86
|
| Rate for Payer: Mclaren Medicaid |
$293.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.82
|
| Rate for Payer: Meridian Medicaid |
$307.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$490.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$848.27
|
| Rate for Payer: Nomi Health Commercial |
$534.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,350.75
|
| Rate for Payer: PACE SWMI |
$445.54
|
| Rate for Payer: PHP Medicare Advantage |
$445.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$293.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$786.78
|
| Rate for Payer: Priority Health Medicare |
$445.54
|
| Rate for Payer: Priority Health SBD |
$786.78
|
| Rate for Payer: Priority Health Tiered Network |
$786.78
|
| Rate for Payer: Railroad Medicare Medicare |
$445.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$824.33
|
| Rate for Payer: UHC Core |
$824.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$445.54
|
| Rate for Payer: UHC Exchange |
$824.33
|
| Rate for Payer: UHC Medicaid |
$293.09
|
| Rate for Payer: UHCCP Medicaid |
$293.09
|
|
|
PR ARTHRTOMY W/BX METATARSOPHALANGEAL JOINT
|
Professional
|
Both
|
$515.00
|
|
|
Service Code
|
HCPCS 28052
|
| Min. Negotiated Rate |
$154.64 |
| Max. Negotiated Rate |
$494.16 |
| Rate for Payer: Aetna Commercial |
$315.48
|
| Rate for Payer: Aetna Medicare |
$244.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$339.02
|
| Rate for Payer: BCBS Complete |
$162.37
|
| Rate for Payer: BCBS MAPPO |
$235.43
|
| Rate for Payer: BCN Commercial |
$387.93
|
| Rate for Payer: BCN Medicare Advantage |
$235.43
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cofinity Commercial |
$339.02
|
| Rate for Payer: Cofinity Commercial |
$315.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.43
|
| Rate for Payer: Healthscope Commercial |
$435.55
|
| Rate for Payer: Healthscope Commercial |
$376.69
|
| Rate for Payer: Mclaren Medicaid |
$154.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.20
|
| Rate for Payer: Meridian Medicaid |
$162.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$258.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$446.27
|
| Rate for Payer: Nomi Health Commercial |
$282.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$386.25
|
| Rate for Payer: PACE SWMI |
$235.43
|
| Rate for Payer: PHP Medicare Advantage |
$235.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$414.68
|
| Rate for Payer: Priority Health Medicare |
$235.43
|
| Rate for Payer: Priority Health SBD |
$414.68
|
| Rate for Payer: Priority Health Tiered Network |
$414.68
|
| Rate for Payer: Railroad Medicare Medicare |
$235.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$494.16
|
| Rate for Payer: UHC Core |
$494.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$235.43
|
| Rate for Payer: UHC Exchange |
$494.16
|
| Rate for Payer: UHC Medicaid |
$154.64
|
| Rate for Payer: UHCCP Medicaid |
$154.64
|
|
|
PR ARTHRT PST CAPSUL RLS ANKLE W/WO ACHLL TDN LNGTH
|
Professional
|
Both
|
$2,234.00
|
|
|
Service Code
|
HCPCS 27612
|
| Min. Negotiated Rate |
$345.27 |
| Max. Negotiated Rate |
$1,675.50 |
| Rate for Payer: Aetna Commercial |
$705.43
|
| Rate for Payer: Aetna Medicare |
$547.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$705.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$758.07
|
| Rate for Payer: BCBS Complete |
$362.53
|
| Rate for Payer: BCBS MAPPO |
$526.44
|
| Rate for Payer: BCN Commercial |
$876.45
|
| Rate for Payer: BCN Medicare Advantage |
$526.44
|
| Rate for Payer: Cash Price |
$1,787.20
|
| Rate for Payer: Cash Price |
$1,787.20
|
| Rate for Payer: Cofinity Commercial |
$758.07
|
| Rate for Payer: Cofinity Commercial |
$705.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$526.44
|
| Rate for Payer: Healthscope Commercial |
$973.91
|
| Rate for Payer: Healthscope Commercial |
$842.30
|
| Rate for Payer: Mclaren Medicaid |
$345.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$552.76
|
| Rate for Payer: Meridian Medicaid |
$362.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$579.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,001.54
|
| Rate for Payer: Nomi Health Commercial |
$631.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,675.50
|
| Rate for Payer: PACE SWMI |
$526.44
|
| Rate for Payer: PHP Medicare Advantage |
$526.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$936.90
|
| Rate for Payer: Priority Health Medicare |
$526.44
|
| Rate for Payer: Priority Health SBD |
$936.90
|
| Rate for Payer: Priority Health Tiered Network |
$936.90
|
| Rate for Payer: Railroad Medicare Medicare |
$526.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$973.44
|
| Rate for Payer: UHC Core |
$973.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$526.44
|
| Rate for Payer: UHC Exchange |
$973.44
|
| Rate for Payer: UHC Medicaid |
$345.27
|
| Rate for Payer: UHCCP Medicaid |
$345.27
|
|
|
PR ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB
|
Professional
|
Both
|
$1,945.00
|
|
|
Service Code
|
HCPCS 25040
|
| Min. Negotiated Rate |
$334.62 |
| Max. Negotiated Rate |
$1,458.75 |
| Rate for Payer: Aetna Commercial |
$684.45
|
| Rate for Payer: Aetna Medicare |
$531.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$735.52
|
| Rate for Payer: BCBS Complete |
$351.35
|
| Rate for Payer: BCBS MAPPO |
$510.78
|
| Rate for Payer: BCN Commercial |
$859.02
|
| Rate for Payer: BCN Medicare Advantage |
$510.78
|
| Rate for Payer: Cash Price |
$1,556.00
|
| Rate for Payer: Cash Price |
$1,556.00
|
| Rate for Payer: Cofinity Commercial |
$735.52
|
| Rate for Payer: Cofinity Commercial |
$684.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.78
|
| Rate for Payer: Healthscope Commercial |
$944.94
|
| Rate for Payer: Healthscope Commercial |
$817.25
|
| Rate for Payer: Mclaren Medicaid |
$334.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.32
|
| Rate for Payer: Meridian Medicaid |
$351.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$561.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$994.36
|
| Rate for Payer: Nomi Health Commercial |
$612.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,458.75
|
| Rate for Payer: PACE SWMI |
$510.78
|
| Rate for Payer: PHP Medicare Advantage |
$510.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$334.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$918.27
|
| Rate for Payer: Priority Health Medicare |
$510.78
|
| Rate for Payer: Priority Health SBD |
$918.27
|
| Rate for Payer: Priority Health Tiered Network |
$918.27
|
| Rate for Payer: Railroad Medicare Medicare |
$510.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$976.94
|
| Rate for Payer: UHC Core |
$976.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$510.78
|
| Rate for Payer: UHC Exchange |
$976.94
|
| Rate for Payer: UHC Medicaid |
$334.62
|
| Rate for Payer: UHCCP Medicaid |
$334.62
|
|
|
PR ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL/LAT
|
Professional
|
Both
|
$2,461.00
|
|
|
Service Code
|
HCPCS 27332
|
| Min. Negotiated Rate |
$392.13 |
| Max. Negotiated Rate |
$1,845.75 |
| Rate for Payer: Aetna Commercial |
$801.33
|
| Rate for Payer: Aetna Medicare |
$621.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$801.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$861.13
|
| Rate for Payer: BCBS Complete |
$411.74
|
| Rate for Payer: BCBS MAPPO |
$598.01
|
| Rate for Payer: BCN Commercial |
$991.48
|
| Rate for Payer: BCN Medicare Advantage |
$598.01
|
| Rate for Payer: Cash Price |
$1,968.80
|
| Rate for Payer: Cash Price |
$1,968.80
|
| Rate for Payer: Cofinity Commercial |
$861.13
|
| Rate for Payer: Cofinity Commercial |
$801.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$598.01
|
| Rate for Payer: Healthscope Commercial |
$956.82
|
| Rate for Payer: Healthscope Commercial |
$1,106.32
|
| Rate for Payer: Mclaren Medicaid |
$392.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$627.91
|
| Rate for Payer: Meridian Medicaid |
$411.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$657.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,147.07
|
| Rate for Payer: Nomi Health Commercial |
$717.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,845.75
|
| Rate for Payer: PACE SWMI |
$598.01
|
| Rate for Payer: PHP Medicare Advantage |
$598.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,059.87
|
| Rate for Payer: Priority Health Medicare |
$598.01
|
| Rate for Payer: Priority Health SBD |
$1,059.87
|
| Rate for Payer: Priority Health Tiered Network |
$1,059.87
|
| Rate for Payer: Railroad Medicare Medicare |
$598.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,121.59
|
| Rate for Payer: UHC Core |
$1,121.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$598.01
|
| Rate for Payer: UHC Exchange |
$1,121.59
|
| Rate for Payer: UHC Medicaid |
$392.13
|
| Rate for Payer: UHCCP Medicaid |
$392.13
|
|
|
PR ARTHRT W/EXPL DRG/RMVL LOOSE/FB IPHAL JT
|
Professional
|
Both
|
$755.00
|
|
|
Service Code
|
HCPCS 28024
|
| Min. Negotiated Rate |
$190.00 |
| Max. Negotiated Rate |
$566.25 |
| Rate for Payer: Aetna Commercial |
$386.42
|
| Rate for Payer: Aetna Medicare |
$299.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$415.25
|
| Rate for Payer: BCBS Complete |
$199.50
|
| Rate for Payer: BCBS MAPPO |
$288.37
|
| Rate for Payer: BCN Commercial |
$473.58
|
| Rate for Payer: BCN Medicare Advantage |
$288.37
|
| Rate for Payer: Cash Price |
$604.00
|
| Rate for Payer: Cash Price |
$604.00
|
| Rate for Payer: Cofinity Commercial |
$415.25
|
| Rate for Payer: Cofinity Commercial |
$386.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.37
|
| Rate for Payer: Healthscope Commercial |
$533.48
|
| Rate for Payer: Healthscope Commercial |
$461.39
|
| Rate for Payer: Mclaren Medicaid |
$190.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.79
|
| Rate for Payer: Meridian Medicaid |
$199.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$317.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$536.87
|
| Rate for Payer: Nomi Health Commercial |
$346.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$566.25
|
| Rate for Payer: PACE SWMI |
$288.37
|
| Rate for Payer: PHP Medicare Advantage |
$288.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$506.25
|
| Rate for Payer: Priority Health Medicare |
$288.37
|
| Rate for Payer: Priority Health SBD |
$506.25
|
| Rate for Payer: Priority Health Tiered Network |
$506.25
|
| Rate for Payer: Railroad Medicare Medicare |
$288.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$526.91
|
| Rate for Payer: UHC Core |
$526.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$288.37
|
| Rate for Payer: UHC Exchange |
$526.91
|
| Rate for Payer: UHC Medicaid |
$190.00
|
| Rate for Payer: UHCCP Medicaid |
$190.00
|
|
|
PR ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT
|
Professional
|
Both
|
$861.00
|
|
|
Service Code
|
HCPCS 28022
|
| Min. Negotiated Rate |
$200.22 |
| Max. Negotiated Rate |
$645.75 |
| Rate for Payer: Priority Health SBD |
$532.86
|
| Rate for Payer: Aetna Commercial |
$407.69
|
| Rate for Payer: Aetna Medicare |
$316.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$407.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$438.12
|
| Rate for Payer: BCBS Complete |
$210.23
|
| Rate for Payer: BCBS MAPPO |
$304.25
|
| Rate for Payer: BCN Commercial |
$498.48
|
| Rate for Payer: BCN Medicare Advantage |
$304.25
|
| Rate for Payer: Cash Price |
$688.80
|
| Rate for Payer: Cash Price |
$688.80
|
| Rate for Payer: Cofinity Commercial |
$438.12
|
| Rate for Payer: Cofinity Commercial |
$407.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$304.25
|
| Rate for Payer: Healthscope Commercial |
$562.86
|
| Rate for Payer: Healthscope Commercial |
$486.80
|
| Rate for Payer: Mclaren Medicaid |
$200.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$319.46
|
| Rate for Payer: Meridian Medicaid |
$210.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$334.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$573.79
|
| Rate for Payer: Nomi Health Commercial |
$365.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$645.75
|
| Rate for Payer: PACE SWMI |
$304.25
|
| Rate for Payer: PHP Medicare Advantage |
$304.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$532.86
|
| Rate for Payer: Priority Health Medicare |
$304.25
|
| Rate for Payer: Priority Health Tiered Network |
$532.86
|
| Rate for Payer: Railroad Medicare Medicare |
$304.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$566.23
|
| Rate for Payer: UHC Core |
$566.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$304.25
|
| Rate for Payer: UHC Exchange |
$566.23
|
| Rate for Payer: UHC Medicaid |
$200.22
|
| Rate for Payer: UHCCP Medicaid |
$200.22
|
|
|
PR ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT
|
Professional
|
Both
|
$947.00
|
|
|
Service Code
|
HCPCS 28020
|
| Min. Negotiated Rate |
$223.86 |
| Max. Negotiated Rate |
$710.25 |
| Rate for Payer: Aetna Commercial |
$455.79
|
| Rate for Payer: Aetna Medicare |
$353.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$489.80
|
| Rate for Payer: BCBS Complete |
$235.05
|
| Rate for Payer: BCBS MAPPO |
$340.14
|
| Rate for Payer: BCN Commercial |
$550.77
|
| Rate for Payer: BCN Medicare Advantage |
$340.14
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cash Price |
$757.60
|
| Rate for Payer: Cofinity Commercial |
$489.80
|
| Rate for Payer: Cofinity Commercial |
$455.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.14
|
| Rate for Payer: Healthscope Commercial |
$629.26
|
| Rate for Payer: Healthscope Commercial |
$544.22
|
| Rate for Payer: Mclaren Medicaid |
$223.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$357.15
|
| Rate for Payer: Meridian Medicaid |
$235.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$374.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$648.38
|
| Rate for Payer: Nomi Health Commercial |
$408.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$710.25
|
| Rate for Payer: PACE SWMI |
$340.14
|
| Rate for Payer: PHP Medicare Advantage |
$340.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$588.75
|
| Rate for Payer: Priority Health Medicare |
$340.14
|
| Rate for Payer: Priority Health SBD |
$588.75
|
| Rate for Payer: Priority Health Tiered Network |
$588.75
|
| Rate for Payer: Railroad Medicare Medicare |
$340.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$626.14
|
| Rate for Payer: UHC Core |
$626.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$340.14
|
| Rate for Payer: UHC Exchange |
$626.14
|
| Rate for Payer: UHC Medicaid |
$223.86
|
| Rate for Payer: UHCCP Medicaid |
$223.86
|
|
|
PR ARTHRT WRST W/JT EXPL W/WO BX W/WO RMVL LOOSE/FB
|
Professional
|
Both
|
$1,418.00
|
|
|
Service Code
|
HCPCS 25101
|
| Min. Negotiated Rate |
$250.06 |
| Max. Negotiated Rate |
$1,063.50 |
| Rate for Payer: Aetna Commercial |
$506.98
|
| Rate for Payer: Aetna Medicare |
$393.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$506.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$544.81
|
| Rate for Payer: BCBS Complete |
$262.56
|
| Rate for Payer: BCBS MAPPO |
$378.34
|
| Rate for Payer: BCN Commercial |
$628.95
|
| Rate for Payer: BCN Medicare Advantage |
$378.34
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cofinity Commercial |
$544.81
|
| Rate for Payer: Cofinity Commercial |
$506.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$378.34
|
| Rate for Payer: Healthscope Commercial |
$699.93
|
| Rate for Payer: Healthscope Commercial |
$605.34
|
| Rate for Payer: Mclaren Medicaid |
$250.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$397.26
|
| Rate for Payer: Meridian Medicaid |
$262.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$416.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$718.87
|
| Rate for Payer: Nomi Health Commercial |
$454.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,063.50
|
| Rate for Payer: PACE SWMI |
$378.34
|
| Rate for Payer: PHP Medicare Advantage |
$378.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$250.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$672.34
|
| Rate for Payer: Priority Health Medicare |
$378.34
|
| Rate for Payer: Priority Health SBD |
$672.34
|
| Rate for Payer: Priority Health Tiered Network |
$672.34
|
| Rate for Payer: Railroad Medicare Medicare |
$378.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$698.77
|
| Rate for Payer: UHC Core |
$698.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$378.34
|
| Rate for Payer: UHC Exchange |
$698.77
|
| Rate for Payer: UHC Medicaid |
$250.06
|
| Rate for Payer: UHCCP Medicaid |
$250.06
|
|
|
PR ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA
|
Professional
|
Both
|
$2,864.00
|
|
|
Service Code
|
HCPCS 27335
|
| Min. Negotiated Rate |
$458.59 |
| Max. Negotiated Rate |
$2,148.00 |
| Rate for Payer: Aetna Commercial |
$941.03
|
| Rate for Payer: Aetna Medicare |
$730.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,011.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$941.03
|
| Rate for Payer: BCBS Complete |
$481.52
|
| Rate for Payer: BCBS MAPPO |
$702.26
|
| Rate for Payer: BCN Commercial |
$1,169.76
|
| Rate for Payer: BCN Medicare Advantage |
$702.26
|
| Rate for Payer: Cash Price |
$2,291.20
|
| Rate for Payer: Cash Price |
$2,291.20
|
| Rate for Payer: Cofinity Commercial |
$941.03
|
| Rate for Payer: Cofinity Commercial |
$1,011.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$702.26
|
| Rate for Payer: Healthscope Commercial |
$1,299.18
|
| Rate for Payer: Healthscope Commercial |
$1,123.62
|
| Rate for Payer: Mclaren Medicaid |
$458.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$737.37
|
| Rate for Payer: Meridian Medicaid |
$481.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$772.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.37
|
| Rate for Payer: Nomi Health Commercial |
$842.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,148.00
|
| Rate for Payer: PACE SWMI |
$702.26
|
| Rate for Payer: PHP Medicare Advantage |
$702.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$458.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,250.44
|
| Rate for Payer: Priority Health Medicare |
$702.26
|
| Rate for Payer: Priority Health SBD |
$1,250.44
|
| Rate for Payer: Priority Health Tiered Network |
$1,250.44
|
| Rate for Payer: Railroad Medicare Medicare |
$702.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,336.48
|
| Rate for Payer: UHC Core |
$1,336.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$702.26
|
| Rate for Payer: UHC Exchange |
$1,336.48
|
| Rate for Payer: UHC Medicaid |
$458.59
|
| Rate for Payer: UHCCP Medicaid |
$458.59
|
|
|
PR ARTIFICIAL INSEMINATION INTRA-CERVICAL
|
Professional
|
Both
|
$138.00
|
|
|
Service Code
|
HCPCS 58321
|
| Min. Negotiated Rate |
$41.89 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$56.13
|
| Rate for Payer: Aetna Medicare |
$43.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.32
|
| Rate for Payer: BCBS Complete |
$55.20
|
| Rate for Payer: BCBS MAPPO |
$41.89
|
| Rate for Payer: BCN Commercial |
$71.71
|
| Rate for Payer: BCN Medicare Advantage |
$41.89
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cofinity Commercial |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$56.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.89
|
| Rate for Payer: Healthscope Commercial |
$67.02
|
| Rate for Payer: Healthscope Commercial |
$77.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.28
|
| Rate for Payer: Nomi Health Commercial |
$50.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.50
|
| Rate for Payer: PACE SWMI |
$41.89
|
| Rate for Payer: PHP Medicare Advantage |
$41.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$72.63
|
| Rate for Payer: Priority Health Medicare |
$41.89
|
| Rate for Payer: Priority Health SBD |
$72.63
|
| Rate for Payer: Priority Health Tiered Network |
$72.63
|
| Rate for Payer: Railroad Medicare Medicare |
$41.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.04
|
| Rate for Payer: UHC Core |
$86.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.89
|
| Rate for Payer: UHC Exchange |
$86.04
|
|
|
PR ARTIFICIAL INSEMINATION INTRA-UTERINE
|
Professional
|
Both
|
$252.00
|
|
|
Service Code
|
HCPCS 58322
|
| Min. Negotiated Rate |
$49.92 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Aetna Commercial |
$66.89
|
| Rate for Payer: Aetna Medicare |
$51.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.88
|
| Rate for Payer: BCBS Complete |
$100.80
|
| Rate for Payer: BCBS MAPPO |
$49.92
|
| Rate for Payer: BCN Commercial |
$85.15
|
| Rate for Payer: BCN Medicare Advantage |
$49.92
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cofinity Commercial |
$71.88
|
| Rate for Payer: Cofinity Commercial |
$66.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.92
|
| Rate for Payer: Healthscope Commercial |
$92.35
|
| Rate for Payer: Healthscope Commercial |
$79.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.46
|
| Rate for Payer: Nomi Health Commercial |
$59.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.00
|
| Rate for Payer: PACE SWMI |
$49.92
|
| Rate for Payer: PHP Medicare Advantage |
$49.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$86.24
|
| Rate for Payer: Priority Health Medicare |
$49.92
|
| Rate for Payer: Priority Health SBD |
$86.24
|
| Rate for Payer: Priority Health Tiered Network |
$86.24
|
| Rate for Payer: Railroad Medicare Medicare |
$49.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.50
|
| Rate for Payer: UHC Core |
$104.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.92
|
| Rate for Payer: UHC Exchange |
$104.50
|
|
|
PR ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS 36625
|
| Min. Negotiated Rate |
$60.92 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Aetna Commercial |
$128.08
|
| Rate for Payer: Aetna Medicare |
$99.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.64
|
| Rate for Payer: BCBS Complete |
$63.97
|
| Rate for Payer: BCBS MAPPO |
$95.58
|
| Rate for Payer: BCN Commercial |
$154.38
|
| Rate for Payer: BCN Medicare Advantage |
$95.58
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cofinity Commercial |
$137.64
|
| Rate for Payer: Cofinity Commercial |
$128.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.58
|
| Rate for Payer: Healthscope Commercial |
$176.82
|
| Rate for Payer: Healthscope Commercial |
$152.93
|
| Rate for Payer: Mclaren Medicaid |
$60.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.36
|
| Rate for Payer: Meridian Medicaid |
$63.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$105.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.79
|
| Rate for Payer: Nomi Health Commercial |
$114.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$247.50
|
| Rate for Payer: PACE SWMI |
$95.58
|
| Rate for Payer: PHP Medicare Advantage |
$95.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$166.00
|
| Rate for Payer: Priority Health Medicare |
$95.58
|
| Rate for Payer: Priority Health SBD |
$166.00
|
| Rate for Payer: Priority Health Tiered Network |
$166.00
|
| Rate for Payer: Railroad Medicare Medicare |
$95.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.77
|
| Rate for Payer: UHC Core |
$188.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$95.58
|
| Rate for Payer: UHC Exchange |
$188.77
|
| Rate for Payer: UHC Medicaid |
$60.92
|
| Rate for Payer: UHCCP Medicaid |
$60.92
|
|
|
PR ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 36620
|
| Min. Negotiated Rate |
$25.99 |
| Max. Negotiated Rate |
$243.75 |
| Rate for Payer: Aetna Commercial |
$54.44
|
| Rate for Payer: Aetna Medicare |
$42.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.51
|
| Rate for Payer: BCBS Complete |
$27.29
|
| Rate for Payer: BCBS MAPPO |
$40.63
|
| Rate for Payer: BCN Commercial |
$64.24
|
| Rate for Payer: BCN Medicare Advantage |
$40.63
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$58.51
|
| Rate for Payer: Cofinity Commercial |
$54.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.63
|
| Rate for Payer: Healthscope Commercial |
$75.17
|
| Rate for Payer: Healthscope Commercial |
$65.01
|
| Rate for Payer: Mclaren Medicaid |
$25.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.66
|
| Rate for Payer: Meridian Medicaid |
$27.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.24
|
| Rate for Payer: Nomi Health Commercial |
$48.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: PACE SWMI |
$40.63
|
| Rate for Payer: PHP Medicare Advantage |
$40.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$69.09
|
| Rate for Payer: Priority Health Medicare |
$40.63
|
| Rate for Payer: Priority Health SBD |
$69.09
|
| Rate for Payer: Priority Health Tiered Network |
$69.09
|
| Rate for Payer: Railroad Medicare Medicare |
$40.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.36
|
| Rate for Payer: UHC Core |
$79.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.63
|
| Rate for Payer: UHC Exchange |
$79.36
|
| Rate for Payer: UHC Medicaid |
$25.99
|
| Rate for Payer: UHCCP Medicaid |
$25.99
|
|
|
PR ARTL CATHJ PROLNG NFS THER CHEMOTX CUTDOWN
|
Professional
|
Both
|
$575.00
|
|
|
Service Code
|
HCPCS 36640
|
| Min. Negotiated Rate |
$64.33 |
| Max. Negotiated Rate |
$431.25 |
| Rate for Payer: Aetna Commercial |
$132.74
|
| Rate for Payer: Aetna Medicare |
$103.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.65
|
| Rate for Payer: BCBS Complete |
$67.55
|
| Rate for Payer: BCBS MAPPO |
$99.06
|
| Rate for Payer: BCN Commercial |
$173.80
|
| Rate for Payer: BCN Medicare Advantage |
$99.06
|
| Rate for Payer: Cash Price |
$460.00
|
| Rate for Payer: Cash Price |
$460.00
|
| Rate for Payer: Cofinity Commercial |
$142.65
|
| Rate for Payer: Cofinity Commercial |
$132.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.06
|
| Rate for Payer: Healthscope Commercial |
$183.26
|
| Rate for Payer: Healthscope Commercial |
$158.50
|
| Rate for Payer: Mclaren Medicaid |
$64.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.01
|
| Rate for Payer: Meridian Medicaid |
$67.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.26
|
| Rate for Payer: Nomi Health Commercial |
$118.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$431.25
|
| Rate for Payer: PACE SWMI |
$99.06
|
| Rate for Payer: PHP Medicare Advantage |
$99.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$186.90
|
| Rate for Payer: Priority Health Medicare |
$99.06
|
| Rate for Payer: Priority Health SBD |
$186.90
|
| Rate for Payer: Priority Health Tiered Network |
$186.90
|
| Rate for Payer: Railroad Medicare Medicare |
$99.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.19
|
| Rate for Payer: UHC Core |
$202.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$99.06
|
| Rate for Payer: UHC Exchange |
$202.19
|
| Rate for Payer: UHC Medicaid |
$64.33
|
| Rate for Payer: UHCCP Medicaid |
$64.33
|
|
