|
PR CABG W/ARTERIAL GRAFT SINGLE ARTERIAL GRAFT
|
Professional
|
Both
|
$4,028.00
|
|
|
Service Code
|
HCPCS 33533
|
| Min. Negotiated Rate |
$1,121.02 |
| Max. Negotiated Rate |
$3,334.21 |
| Rate for Payer: Aetna Commercial |
$2,357.38
|
| Rate for Payer: Aetna Medicare |
$1,829.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,357.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,533.31
|
| Rate for Payer: BCBS Complete |
$1,177.07
|
| Rate for Payer: BCBS MAPPO |
$1,759.24
|
| Rate for Payer: BCN Commercial |
$2,754.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,759.24
|
| Rate for Payer: Cash Price |
$3,222.40
|
| Rate for Payer: Cash Price |
$3,222.40
|
| Rate for Payer: Cofinity Commercial |
$2,533.31
|
| Rate for Payer: Cofinity Commercial |
$2,357.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,759.24
|
| Rate for Payer: Healthscope Commercial |
$3,254.59
|
| Rate for Payer: Healthscope Commercial |
$2,814.78
|
| Rate for Payer: Mclaren Medicaid |
$1,121.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,847.20
|
| Rate for Payer: Meridian Medicaid |
$1,177.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,935.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,313.33
|
| Rate for Payer: Nomi Health Commercial |
$2,111.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,021.00
|
| Rate for Payer: PACE SWMI |
$1,759.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,759.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,121.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,961.93
|
| Rate for Payer: Priority Health Medicare |
$1,759.24
|
| Rate for Payer: Priority Health SBD |
$2,961.93
|
| Rate for Payer: Priority Health Tiered Network |
$2,961.93
|
| Rate for Payer: Railroad Medicare Medicare |
$1,759.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,334.21
|
| Rate for Payer: UHC Core |
$3,334.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,759.24
|
| Rate for Payer: UHC Exchange |
$3,334.21
|
| Rate for Payer: UHC Medicaid |
$1,121.02
|
| Rate for Payer: UHCCP Medicaid |
$1,121.02
|
|
|
PR CABG W/ARTERIAL GRAFT THREE ARTERIAL GRAFTS
|
Professional
|
Both
|
$5,290.00
|
|
|
Service Code
|
HCPCS 33535
|
| Min. Negotiated Rate |
$1,457.56 |
| Max. Negotiated Rate |
$4,373.14 |
| Rate for Payer: Aetna Commercial |
$3,069.81
|
| Rate for Payer: Aetna Medicare |
$2,382.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,069.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,298.90
|
| Rate for Payer: BCBS Complete |
$1,530.44
|
| Rate for Payer: BCBS MAPPO |
$2,290.90
|
| Rate for Payer: BCN Commercial |
$3,593.92
|
| Rate for Payer: BCN Medicare Advantage |
$2,290.90
|
| Rate for Payer: Cash Price |
$4,232.00
|
| Rate for Payer: Cash Price |
$4,232.00
|
| Rate for Payer: Cofinity Commercial |
$3,298.90
|
| Rate for Payer: Cofinity Commercial |
$3,069.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,290.90
|
| Rate for Payer: Healthscope Commercial |
$4,238.16
|
| Rate for Payer: Healthscope Commercial |
$3,665.44
|
| Rate for Payer: Mclaren Medicaid |
$1,457.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,405.45
|
| Rate for Payer: Meridian Medicaid |
$1,530.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,519.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,328.37
|
| Rate for Payer: Nomi Health Commercial |
$2,749.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,967.50
|
| Rate for Payer: PACE SWMI |
$2,290.90
|
| Rate for Payer: PHP Medicare Advantage |
$2,290.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,457.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,864.82
|
| Rate for Payer: Priority Health Medicare |
$2,290.90
|
| Rate for Payer: Priority Health SBD |
$3,864.82
|
| Rate for Payer: Priority Health Tiered Network |
$3,864.82
|
| Rate for Payer: Railroad Medicare Medicare |
$2,290.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,373.14
|
| Rate for Payer: UHC Core |
$4,373.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,290.90
|
| Rate for Payer: UHC Exchange |
$4,373.14
|
| Rate for Payer: UHC Medicaid |
$1,457.56
|
| Rate for Payer: UHCCP Medicaid |
$1,457.56
|
|
|
PR CABG W/ARTERIAL GRAFT TWO ARTERIAL GRAFTS
|
Professional
|
Both
|
$4,740.00
|
|
|
Service Code
|
HCPCS 33534
|
| Min. Negotiated Rate |
$1,314.42 |
| Max. Negotiated Rate |
$3,919.54 |
| Rate for Payer: Aetna Commercial |
$2,765.97
|
| Rate for Payer: Aetna Medicare |
$2,146.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,765.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,972.39
|
| Rate for Payer: BCBS Complete |
$1,380.14
|
| Rate for Payer: BCBS MAPPO |
$2,064.16
|
| Rate for Payer: BCN Commercial |
$3,235.38
|
| Rate for Payer: BCN Medicare Advantage |
$2,064.16
|
| Rate for Payer: Cash Price |
$3,792.00
|
| Rate for Payer: Cash Price |
$3,792.00
|
| Rate for Payer: Cofinity Commercial |
$2,972.39
|
| Rate for Payer: Cofinity Commercial |
$2,765.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,064.16
|
| Rate for Payer: Healthscope Commercial |
$3,818.70
|
| Rate for Payer: Healthscope Commercial |
$3,302.66
|
| Rate for Payer: Mclaren Medicaid |
$1,314.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,167.37
|
| Rate for Payer: Meridian Medicaid |
$1,380.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,270.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,890.61
|
| Rate for Payer: Nomi Health Commercial |
$2,476.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,555.00
|
| Rate for Payer: PACE SWMI |
$2,064.16
|
| Rate for Payer: PHP Medicare Advantage |
$2,064.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,314.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,479.24
|
| Rate for Payer: Priority Health Medicare |
$2,064.16
|
| Rate for Payer: Priority Health SBD |
$3,479.24
|
| Rate for Payer: Priority Health Tiered Network |
$3,479.24
|
| Rate for Payer: Railroad Medicare Medicare |
$2,064.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,919.54
|
| Rate for Payer: UHC Core |
$3,919.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,064.16
|
| Rate for Payer: UHC Exchange |
$3,919.54
|
| Rate for Payer: UHC Medicaid |
$1,314.42
|
| Rate for Payer: UHCCP Medicaid |
$1,314.42
|
|
|
PR CALIBRATED MICROCAP TUBE
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS A4651
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$59.25 |
| Rate for Payer: Aetna Commercial |
$0.03
|
| Rate for Payer: Aetna Medicare |
$39.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.03
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: BCN Commercial |
$1.86
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.25
|
|
|
PR CALORIC VESTIBULAR TEST, EACH IRRIGATION, WITH RECORDING
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS 92543
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$15.00 |
| Rate for Payer: Aetna Medicare |
$10.00
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.00
|
|
|
PR CANALITH REPOSITIONING PROCEDURE
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 95992
|
| Min. Negotiated Rate |
$29.41 |
| Max. Negotiated Rate |
$101.25 |
| Rate for Payer: Aetna Commercial |
$39.41
|
| Rate for Payer: Aetna Medicare |
$30.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.35
|
| Rate for Payer: BCBS Complete |
$54.00
|
| Rate for Payer: BCBS MAPPO |
$29.41
|
| Rate for Payer: BCN Commercial |
$52.79
|
| Rate for Payer: BCN Medicare Advantage |
$29.41
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cofinity Commercial |
$39.41
|
| Rate for Payer: Cofinity Commercial |
$42.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.41
|
| Rate for Payer: Healthscope Commercial |
$54.41
|
| Rate for Payer: Healthscope Commercial |
$47.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.28
|
| Rate for Payer: Nomi Health Commercial |
$35.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.25
|
| Rate for Payer: PACE SWMI |
$29.41
|
| Rate for Payer: PHP Medicare Advantage |
$29.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$48.68
|
| Rate for Payer: Priority Health Medicare |
$29.41
|
| Rate for Payer: Priority Health SBD |
$48.68
|
| Rate for Payer: Priority Health Tiered Network |
$48.68
|
| Rate for Payer: Railroad Medicare Medicare |
$29.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.37
|
| Rate for Payer: UHC Core |
$61.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.41
|
| Rate for Payer: UHC Exchange |
$61.37
|
|
|
PR CANTHOPLASTY
|
Professional
|
Both
|
$1,180.00
|
|
|
Service Code
|
HCPCS 67950
|
| Min. Negotiated Rate |
$253.47 |
| Max. Negotiated Rate |
$885.00 |
| Rate for Payer: Aetna Commercial |
$513.85
|
| Rate for Payer: Aetna Medicare |
$398.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$552.20
|
| Rate for Payer: BCBS Complete |
$266.14
|
| Rate for Payer: BCBS MAPPO |
$383.47
|
| Rate for Payer: BCN Commercial |
$685.22
|
| Rate for Payer: BCN Medicare Advantage |
$383.47
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$552.20
|
| Rate for Payer: Cofinity Commercial |
$513.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.47
|
| Rate for Payer: Healthscope Commercial |
$709.42
|
| Rate for Payer: Healthscope Commercial |
$613.55
|
| Rate for Payer: Mclaren Medicaid |
$253.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$402.64
|
| Rate for Payer: Meridian Medicaid |
$266.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$421.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$794.14
|
| Rate for Payer: Nomi Health Commercial |
$460.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$885.00
|
| Rate for Payer: PACE SWMI |
$383.47
|
| Rate for Payer: PHP Medicare Advantage |
$383.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$802.63
|
| Rate for Payer: Priority Health Medicare |
$383.47
|
| Rate for Payer: Priority Health SBD |
$802.63
|
| Rate for Payer: Priority Health Tiered Network |
$802.63
|
| Rate for Payer: Railroad Medicare Medicare |
$383.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$787.37
|
| Rate for Payer: UHC Core |
$787.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$383.47
|
| Rate for Payer: UHC Exchange |
$787.37
|
| Rate for Payer: UHC Medicaid |
$253.47
|
| Rate for Payer: UHCCP Medicaid |
$253.47
|
|
|
PR CANTHOTOMY SEPARATE PROCEDURE
|
Professional
|
Both
|
$385.00
|
|
|
Service Code
|
HCPCS 67715
|
| Min. Negotiated Rate |
$65.18 |
| Max. Negotiated Rate |
$288.75 |
| Rate for Payer: Aetna Commercial |
$131.61
|
| Rate for Payer: Aetna Medicare |
$102.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.44
|
| Rate for Payer: BCBS Complete |
$68.44
|
| Rate for Payer: BCBS MAPPO |
$98.22
|
| Rate for Payer: BCN Commercial |
$161.34
|
| Rate for Payer: BCN Medicare Advantage |
$98.22
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: Cofinity Commercial |
$141.44
|
| Rate for Payer: Cofinity Commercial |
$131.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.22
|
| Rate for Payer: Healthscope Commercial |
$181.71
|
| Rate for Payer: Healthscope Commercial |
$157.15
|
| Rate for Payer: Mclaren Medicaid |
$65.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.13
|
| Rate for Payer: Meridian Medicaid |
$68.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.07
|
| Rate for Payer: Nomi Health Commercial |
$117.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$288.75
|
| Rate for Payer: PACE SWMI |
$98.22
|
| Rate for Payer: PHP Medicare Advantage |
$98.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$188.99
|
| Rate for Payer: Priority Health Medicare |
$98.22
|
| Rate for Payer: Priority Health SBD |
$188.99
|
| Rate for Payer: Priority Health Tiered Network |
$188.99
|
| Rate for Payer: Railroad Medicare Medicare |
$98.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.57
|
| Rate for Payer: UHC Core |
$181.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.22
|
| Rate for Payer: UHC Exchange |
$181.57
|
| Rate for Payer: UHC Medicaid |
$65.18
|
| Rate for Payer: UHCCP Medicaid |
$65.18
|
|
|
PR CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS
|
Professional
|
Both
|
$1,808.00
|
|
|
Service Code
|
HCPCS 25320
|
| Min. Negotiated Rate |
$591.50 |
| Max. Negotiated Rate |
$1,747.24 |
| Rate for Payer: Aetna Commercial |
$1,206.47
|
| Rate for Payer: Aetna Medicare |
$936.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,206.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,296.50
|
| Rate for Payer: BCBS Complete |
$621.08
|
| Rate for Payer: BCBS MAPPO |
$900.35
|
| Rate for Payer: BCN Commercial |
$1,516.85
|
| Rate for Payer: BCN Medicare Advantage |
$900.35
|
| Rate for Payer: Cash Price |
$1,446.40
|
| Rate for Payer: Cash Price |
$1,446.40
|
| Rate for Payer: Cofinity Commercial |
$1,296.50
|
| Rate for Payer: Cofinity Commercial |
$1,206.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$900.35
|
| Rate for Payer: Healthscope Commercial |
$1,665.65
|
| Rate for Payer: Healthscope Commercial |
$1,440.56
|
| Rate for Payer: Mclaren Medicaid |
$591.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$945.37
|
| Rate for Payer: Meridian Medicaid |
$621.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$990.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,747.24
|
| Rate for Payer: Nomi Health Commercial |
$1,080.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,356.00
|
| Rate for Payer: PACE SWMI |
$900.35
|
| Rate for Payer: PHP Medicare Advantage |
$900.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$591.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,621.46
|
| Rate for Payer: Priority Health Medicare |
$900.35
|
| Rate for Payer: Priority Health SBD |
$1,621.46
|
| Rate for Payer: Priority Health Tiered Network |
$1,621.46
|
| Rate for Payer: Railroad Medicare Medicare |
$900.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,708.56
|
| Rate for Payer: UHC Core |
$1,708.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$900.35
|
| Rate for Payer: UHC Exchange |
$1,708.56
|
| Rate for Payer: UHC Medicaid |
$591.50
|
| Rate for Payer: UHCCP Medicaid |
$591.50
|
|
|
PR CAPSULAR CONTRACTURE RELEASE
|
Professional
|
Both
|
$2,070.00
|
|
|
Service Code
|
HCPCS 23020
|
| Min. Negotiated Rate |
$414.92 |
| Max. Negotiated Rate |
$1,552.50 |
| Rate for Payer: Aetna Commercial |
$850.03
|
| Rate for Payer: Aetna Medicare |
$659.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$850.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$913.46
|
| Rate for Payer: BCBS Complete |
$435.67
|
| Rate for Payer: BCBS MAPPO |
$634.35
|
| Rate for Payer: BCN Commercial |
$1,056.72
|
| Rate for Payer: BCN Medicare Advantage |
$634.35
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cofinity Commercial |
$913.46
|
| Rate for Payer: Cofinity Commercial |
$850.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$634.35
|
| Rate for Payer: Healthscope Commercial |
$1,173.55
|
| Rate for Payer: Healthscope Commercial |
$1,014.96
|
| Rate for Payer: Mclaren Medicaid |
$414.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$666.07
|
| Rate for Payer: Meridian Medicaid |
$435.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$697.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,226.92
|
| Rate for Payer: Nomi Health Commercial |
$761.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,552.50
|
| Rate for Payer: PACE SWMI |
$634.35
|
| Rate for Payer: PHP Medicare Advantage |
$634.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,129.59
|
| Rate for Payer: Priority Health Medicare |
$634.35
|
| Rate for Payer: Priority Health SBD |
$1,129.59
|
| Rate for Payer: Priority Health Tiered Network |
$1,129.59
|
| Rate for Payer: Railroad Medicare Medicare |
$634.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,204.13
|
| Rate for Payer: UHC Core |
$1,204.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$634.35
|
| Rate for Payer: UHC Exchange |
$1,204.13
|
| Rate for Payer: UHC Medicaid |
$414.92
|
| Rate for Payer: UHCCP Medicaid |
$414.92
|
|
|
PR CAPSULECTOMY/CAPSULOTOMY HIP W/RLS HIP FLXR MUSC
|
Professional
|
Both
|
$4,943.00
|
|
|
Service Code
|
HCPCS 27036
|
| Min. Negotiated Rate |
$601.30 |
| Max. Negotiated Rate |
$3,707.25 |
| Rate for Payer: Aetna Commercial |
$1,236.87
|
| Rate for Payer: Aetna Medicare |
$959.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,329.18
|
| Rate for Payer: BCBS Complete |
$631.37
|
| Rate for Payer: BCBS MAPPO |
$923.04
|
| Rate for Payer: BCN Commercial |
$1,547.23
|
| Rate for Payer: BCN Medicare Advantage |
$923.04
|
| Rate for Payer: Cash Price |
$3,954.40
|
| Rate for Payer: Cash Price |
$3,954.40
|
| Rate for Payer: Cofinity Commercial |
$1,329.18
|
| Rate for Payer: Cofinity Commercial |
$1,236.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$923.04
|
| Rate for Payer: Healthscope Commercial |
$1,707.62
|
| Rate for Payer: Healthscope Commercial |
$1,476.86
|
| Rate for Payer: Mclaren Medicaid |
$601.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$969.19
|
| Rate for Payer: Meridian Medicaid |
$631.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,015.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,804.10
|
| Rate for Payer: Nomi Health Commercial |
$1,107.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,707.25
|
| Rate for Payer: PACE SWMI |
$923.04
|
| Rate for Payer: PHP Medicare Advantage |
$923.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$601.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,653.95
|
| Rate for Payer: Priority Health Medicare |
$923.04
|
| Rate for Payer: Priority Health SBD |
$1,653.95
|
| Rate for Payer: Priority Health Tiered Network |
$1,653.95
|
| Rate for Payer: Railroad Medicare Medicare |
$923.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,770.55
|
| Rate for Payer: UHC Core |
$1,770.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$923.04
|
| Rate for Payer: UHC Exchange |
$1,770.55
|
| Rate for Payer: UHC Medicaid |
$601.30
|
| Rate for Payer: UHCCP Medicaid |
$601.30
|
|
|
PR CAPSULECTOMY/CAPSULOTOMY IPHAL JOINT EACH
|
Professional
|
Both
|
$1,634.00
|
|
|
Service Code
|
HCPCS 26525
|
| Min. Negotiated Rate |
$431.75 |
| Max. Negotiated Rate |
$1,225.50 |
| Rate for Payer: Aetna Commercial |
$859.22
|
| Rate for Payer: Aetna Medicare |
$666.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$859.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$923.34
|
| Rate for Payer: BCBS Complete |
$453.34
|
| Rate for Payer: BCBS MAPPO |
$641.21
|
| Rate for Payer: BCN Commercial |
$1,030.32
|
| Rate for Payer: BCN Medicare Advantage |
$641.21
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cofinity Commercial |
$923.34
|
| Rate for Payer: Cofinity Commercial |
$859.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.21
|
| Rate for Payer: Healthscope Commercial |
$1,186.24
|
| Rate for Payer: Healthscope Commercial |
$1,025.94
|
| Rate for Payer: Mclaren Medicaid |
$431.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.27
|
| Rate for Payer: Meridian Medicaid |
$453.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$705.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,202.06
|
| Rate for Payer: Nomi Health Commercial |
$769.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,225.50
|
| Rate for Payer: PACE SWMI |
$641.21
|
| Rate for Payer: PHP Medicare Advantage |
$641.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,101.39
|
| Rate for Payer: Priority Health Medicare |
$641.21
|
| Rate for Payer: Priority Health SBD |
$1,101.39
|
| Rate for Payer: Priority Health Tiered Network |
$1,101.39
|
| Rate for Payer: Railroad Medicare Medicare |
$641.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,125.61
|
| Rate for Payer: UHC Core |
$1,125.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$641.21
|
| Rate for Payer: UHC Exchange |
$1,125.61
|
| Rate for Payer: UHC Medicaid |
$431.75
|
| Rate for Payer: UHCCP Medicaid |
$431.75
|
|
|
PR CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH
|
Professional
|
Both
|
$1,634.00
|
|
|
Service Code
|
HCPCS 26520
|
| Min. Negotiated Rate |
$427.70 |
| Max. Negotiated Rate |
$1,225.50 |
| Rate for Payer: Aetna Commercial |
$851.15
|
| Rate for Payer: Aetna Medicare |
$660.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$851.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$914.67
|
| Rate for Payer: BCBS Complete |
$449.08
|
| Rate for Payer: BCBS MAPPO |
$635.19
|
| Rate for Payer: BCN Commercial |
$1,022.85
|
| Rate for Payer: BCN Medicare Advantage |
$635.19
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cash Price |
$1,307.20
|
| Rate for Payer: Cofinity Commercial |
$914.67
|
| Rate for Payer: Cofinity Commercial |
$851.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$635.19
|
| Rate for Payer: Healthscope Commercial |
$1,175.10
|
| Rate for Payer: Healthscope Commercial |
$1,016.30
|
| Rate for Payer: Mclaren Medicaid |
$427.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$666.95
|
| Rate for Payer: Meridian Medicaid |
$449.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$698.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,196.69
|
| Rate for Payer: Nomi Health Commercial |
$762.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,225.50
|
| Rate for Payer: PACE SWMI |
$635.19
|
| Rate for Payer: PHP Medicare Advantage |
$635.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,093.41
|
| Rate for Payer: Priority Health Medicare |
$635.19
|
| Rate for Payer: Priority Health SBD |
$1,093.41
|
| Rate for Payer: Priority Health Tiered Network |
$1,093.41
|
| Rate for Payer: Railroad Medicare Medicare |
$635.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,122.53
|
| Rate for Payer: UHC Core |
$1,122.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$635.19
|
| Rate for Payer: UHC Exchange |
$1,122.53
|
| Rate for Payer: UHC Medicaid |
$427.70
|
| Rate for Payer: UHCCP Medicaid |
$427.70
|
|
|
PR CAPSUL MTTARPHLNGL JT W/WO TENORRHAPHY EA JT SPX
|
Professional
|
Both
|
$826.00
|
|
|
Service Code
|
HCPCS 28270
|
| Min. Negotiated Rate |
$202.78 |
| Max. Negotiated Rate |
$619.50 |
| Rate for Payer: Aetna Commercial |
$412.59
|
| Rate for Payer: Aetna Medicare |
$320.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$443.38
|
| Rate for Payer: BCBS Complete |
$212.92
|
| Rate for Payer: BCBS MAPPO |
$307.90
|
| Rate for Payer: BCN Commercial |
$509.93
|
| Rate for Payer: BCN Medicare Advantage |
$307.90
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cofinity Commercial |
$443.38
|
| Rate for Payer: Cofinity Commercial |
$412.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$307.90
|
| Rate for Payer: Healthscope Commercial |
$569.62
|
| Rate for Payer: Healthscope Commercial |
$492.64
|
| Rate for Payer: Mclaren Medicaid |
$202.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$323.30
|
| Rate for Payer: Meridian Medicaid |
$212.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$338.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.16
|
| Rate for Payer: Nomi Health Commercial |
$369.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$619.50
|
| Rate for Payer: PACE SWMI |
$307.90
|
| Rate for Payer: PHP Medicare Advantage |
$307.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$545.11
|
| Rate for Payer: Priority Health Medicare |
$307.90
|
| Rate for Payer: Priority Health SBD |
$545.11
|
| Rate for Payer: Priority Health Tiered Network |
$545.11
|
| Rate for Payer: Railroad Medicare Medicare |
$307.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$582.90
|
| Rate for Payer: UHC Core |
$582.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$307.90
|
| Rate for Payer: UHC Exchange |
$582.90
|
| Rate for Payer: UHC Medicaid |
$202.78
|
| Rate for Payer: UHCCP Medicaid |
$202.78
|
|
|
PR CAPSULODESIS MTCARPHLNGL JOINT SINGLE DIGIT
|
Professional
|
Both
|
$2,063.00
|
|
|
Service Code
|
HCPCS 26516
|
| Min. Negotiated Rate |
$457.52 |
| Max. Negotiated Rate |
$1,547.25 |
| Rate for Payer: Aetna Commercial |
$918.80
|
| Rate for Payer: Aetna Medicare |
$713.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$918.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$987.36
|
| Rate for Payer: BCBS Complete |
$480.40
|
| Rate for Payer: BCBS MAPPO |
$685.67
|
| Rate for Payer: BCN Commercial |
$1,124.44
|
| Rate for Payer: BCN Medicare Advantage |
$685.67
|
| Rate for Payer: Cash Price |
$1,650.40
|
| Rate for Payer: Cash Price |
$1,650.40
|
| Rate for Payer: Cofinity Commercial |
$987.36
|
| Rate for Payer: Cofinity Commercial |
$918.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$685.67
|
| Rate for Payer: Healthscope Commercial |
$1,268.49
|
| Rate for Payer: Healthscope Commercial |
$1,097.07
|
| Rate for Payer: Mclaren Medicaid |
$457.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$719.95
|
| Rate for Payer: Meridian Medicaid |
$480.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$754.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,310.74
|
| Rate for Payer: Nomi Health Commercial |
$822.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,547.25
|
| Rate for Payer: PACE SWMI |
$685.67
|
| Rate for Payer: PHP Medicare Advantage |
$685.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,201.99
|
| Rate for Payer: Priority Health Medicare |
$685.67
|
| Rate for Payer: Priority Health SBD |
$1,201.99
|
| Rate for Payer: Priority Health Tiered Network |
$1,201.99
|
| Rate for Payer: Railroad Medicare Medicare |
$685.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,229.00
|
| Rate for Payer: UHC Core |
$1,229.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$685.67
|
| Rate for Payer: UHC Exchange |
$1,229.00
|
| Rate for Payer: UHC Medicaid |
$457.52
|
| Rate for Payer: UHCCP Medicaid |
$457.52
|
|
|
PR CAPSULORRHAPHY ANTERIOR PUTTI-PLATT/MAGNUSON
|
Professional
|
Both
|
$2,953.00
|
|
|
Service Code
|
HCPCS 23450
|
| Min. Negotiated Rate |
$555.93 |
| Max. Negotiated Rate |
$2,214.75 |
| Rate for Payer: Aetna Commercial |
$1,146.10
|
| Rate for Payer: Aetna Medicare |
$889.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,146.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,231.63
|
| Rate for Payer: BCBS Complete |
$583.73
|
| Rate for Payer: BCBS MAPPO |
$855.30
|
| Rate for Payer: BCN Commercial |
$1,436.18
|
| Rate for Payer: BCN Medicare Advantage |
$855.30
|
| Rate for Payer: Cash Price |
$2,362.40
|
| Rate for Payer: Cash Price |
$2,362.40
|
| Rate for Payer: Cofinity Commercial |
$1,231.63
|
| Rate for Payer: Cofinity Commercial |
$1,146.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$855.30
|
| Rate for Payer: Healthscope Commercial |
$1,582.31
|
| Rate for Payer: Healthscope Commercial |
$1,368.48
|
| Rate for Payer: Mclaren Medicaid |
$555.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$898.07
|
| Rate for Payer: Meridian Medicaid |
$583.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$940.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,680.84
|
| Rate for Payer: Nomi Health Commercial |
$1,026.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,214.75
|
| Rate for Payer: PACE SWMI |
$855.30
|
| Rate for Payer: PHP Medicare Advantage |
$855.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$555.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,535.23
|
| Rate for Payer: Priority Health Medicare |
$855.30
|
| Rate for Payer: Priority Health SBD |
$1,535.23
|
| Rate for Payer: Priority Health Tiered Network |
$1,535.23
|
| Rate for Payer: Railroad Medicare Medicare |
$855.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,661.30
|
| Rate for Payer: UHC Core |
$1,661.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$855.30
|
| Rate for Payer: UHC Exchange |
$1,661.30
|
| Rate for Payer: UHC Medicaid |
$555.93
|
| Rate for Payer: UHCCP Medicaid |
$555.93
|
|
|
PR CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR
|
Professional
|
Both
|
$3,516.00
|
|
|
Service Code
|
HCPCS 23462
|
| Min. Negotiated Rate |
$623.24 |
| Max. Negotiated Rate |
$2,637.00 |
| Rate for Payer: Aetna Commercial |
$1,286.87
|
| Rate for Payer: Aetna Medicare |
$998.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,286.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,382.90
|
| Rate for Payer: BCBS Complete |
$654.40
|
| Rate for Payer: BCBS MAPPO |
$960.35
|
| Rate for Payer: BCN Commercial |
$1,617.44
|
| Rate for Payer: BCN Medicare Advantage |
$960.35
|
| Rate for Payer: Cash Price |
$2,812.80
|
| Rate for Payer: Cash Price |
$2,812.80
|
| Rate for Payer: Cofinity Commercial |
$1,382.90
|
| Rate for Payer: Cofinity Commercial |
$1,286.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$960.35
|
| Rate for Payer: Healthscope Commercial |
$1,776.65
|
| Rate for Payer: Healthscope Commercial |
$1,536.56
|
| Rate for Payer: Mclaren Medicaid |
$623.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,008.37
|
| Rate for Payer: Meridian Medicaid |
$654.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,056.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,896.64
|
| Rate for Payer: Nomi Health Commercial |
$1,152.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,637.00
|
| Rate for Payer: PACE SWMI |
$960.35
|
| Rate for Payer: PHP Medicare Advantage |
$960.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,728.99
|
| Rate for Payer: Priority Health Medicare |
$960.35
|
| Rate for Payer: Priority Health SBD |
$1,728.99
|
| Rate for Payer: Priority Health Tiered Network |
$1,728.99
|
| Rate for Payer: Railroad Medicare Medicare |
$960.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,875.72
|
| Rate for Payer: UHC Core |
$1,875.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$960.35
|
| Rate for Payer: UHC Exchange |
$1,875.72
|
| Rate for Payer: UHC Medicaid |
$623.24
|
| Rate for Payer: UHCCP Medicaid |
$623.24
|
|
|
PR CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK
|
Professional
|
Both
|
$2,877.00
|
|
|
Service Code
|
HCPCS 23460
|
| Min. Negotiated Rate |
$638.15 |
| Max. Negotiated Rate |
$2,157.75 |
| Rate for Payer: Aetna Commercial |
$1,316.01
|
| Rate for Payer: Aetna Medicare |
$1,021.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,316.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,414.22
|
| Rate for Payer: BCBS Complete |
$670.06
|
| Rate for Payer: BCBS MAPPO |
$982.10
|
| Rate for Payer: BCN Commercial |
$1,653.30
|
| Rate for Payer: BCN Medicare Advantage |
$982.10
|
| Rate for Payer: Cash Price |
$2,301.60
|
| Rate for Payer: Cash Price |
$2,301.60
|
| Rate for Payer: Cofinity Commercial |
$1,414.22
|
| Rate for Payer: Cofinity Commercial |
$1,316.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$982.10
|
| Rate for Payer: Healthscope Commercial |
$1,816.88
|
| Rate for Payer: Healthscope Commercial |
$1,571.36
|
| Rate for Payer: Mclaren Medicaid |
$638.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,031.20
|
| Rate for Payer: Meridian Medicaid |
$670.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,080.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,935.52
|
| Rate for Payer: Nomi Health Commercial |
$1,178.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,157.75
|
| Rate for Payer: PACE SWMI |
$982.10
|
| Rate for Payer: PHP Medicare Advantage |
$982.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$638.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,767.32
|
| Rate for Payer: Priority Health Medicare |
$982.10
|
| Rate for Payer: Priority Health SBD |
$1,767.32
|
| Rate for Payer: Priority Health Tiered Network |
$1,767.32
|
| Rate for Payer: Railroad Medicare Medicare |
$982.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,909.63
|
| Rate for Payer: UHC Core |
$1,909.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$982.10
|
| Rate for Payer: UHC Exchange |
$1,909.63
|
| Rate for Payer: UHC Medicaid |
$638.15
|
| Rate for Payer: UHCCP Medicaid |
$638.15
|
|
|
PR CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR
|
Professional
|
Both
|
$3,299.00
|
|
|
Service Code
|
HCPCS 23455
|
| Min. Negotiated Rate |
$561.47 |
| Max. Negotiated Rate |
$2,474.25 |
| Rate for Payer: Aetna Commercial |
$1,159.23
|
| Rate for Payer: Aetna Medicare |
$899.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,159.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,245.74
|
| Rate for Payer: BCBS Complete |
$589.54
|
| Rate for Payer: BCBS MAPPO |
$865.10
|
| Rate for Payer: BCN Commercial |
$1,473.03
|
| Rate for Payer: BCN Medicare Advantage |
$865.10
|
| Rate for Payer: Cash Price |
$2,639.20
|
| Rate for Payer: Cash Price |
$2,639.20
|
| Rate for Payer: Cofinity Commercial |
$1,245.74
|
| Rate for Payer: Cofinity Commercial |
$1,159.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$865.10
|
| Rate for Payer: Healthscope Commercial |
$1,600.43
|
| Rate for Payer: Healthscope Commercial |
$1,384.16
|
| Rate for Payer: Mclaren Medicaid |
$561.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$908.36
|
| Rate for Payer: Meridian Medicaid |
$589.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$951.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,755.88
|
| Rate for Payer: Nomi Health Commercial |
$1,038.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,474.25
|
| Rate for Payer: PACE SWMI |
$865.10
|
| Rate for Payer: PHP Medicare Advantage |
$865.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$561.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,574.63
|
| Rate for Payer: Priority Health Medicare |
$865.10
|
| Rate for Payer: Priority Health SBD |
$1,574.63
|
| Rate for Payer: Priority Health Tiered Network |
$1,574.63
|
| Rate for Payer: Railroad Medicare Medicare |
$865.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,743.11
|
| Rate for Payer: UHC Core |
$1,743.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$865.10
|
| Rate for Payer: UHC Exchange |
$1,743.11
|
| Rate for Payer: UHC Medicaid |
$561.47
|
| Rate for Payer: UHCCP Medicaid |
$561.47
|
|
|
PR CAPSULORRHAPHY GLENOHUMERAL JT PST W/WO BONE BLK
|
Professional
|
Both
|
$3,605.00
|
|
|
Service Code
|
HCPCS 23465
|
| Min. Negotiated Rate |
$653.48 |
| Max. Negotiated Rate |
$2,703.75 |
| Rate for Payer: Aetna Commercial |
$1,348.24
|
| Rate for Payer: Aetna Medicare |
$1,046.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,348.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,448.86
|
| Rate for Payer: BCBS Complete |
$686.15
|
| Rate for Payer: BCBS MAPPO |
$1,006.15
|
| Rate for Payer: BCN Commercial |
$1,694.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,006.15
|
| Rate for Payer: Cash Price |
$2,884.00
|
| Rate for Payer: Cash Price |
$2,884.00
|
| Rate for Payer: Cofinity Commercial |
$1,448.86
|
| Rate for Payer: Cofinity Commercial |
$1,348.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,006.15
|
| Rate for Payer: Healthscope Commercial |
$1,861.38
|
| Rate for Payer: Healthscope Commercial |
$1,609.84
|
| Rate for Payer: Mclaren Medicaid |
$653.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,056.46
|
| Rate for Payer: Meridian Medicaid |
$686.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,106.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,985.26
|
| Rate for Payer: Nomi Health Commercial |
$1,207.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,703.75
|
| Rate for Payer: PACE SWMI |
$1,006.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,006.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$653.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,811.51
|
| Rate for Payer: Priority Health Medicare |
$1,006.15
|
| Rate for Payer: Priority Health SBD |
$1,811.51
|
| Rate for Payer: Priority Health Tiered Network |
$1,811.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,006.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,961.73
|
| Rate for Payer: UHC Core |
$1,961.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,006.15
|
| Rate for Payer: UHC Exchange |
$1,961.73
|
| Rate for Payer: UHC Medicaid |
$653.48
|
| Rate for Payer: UHCCP Medicaid |
$653.48
|
|
|
PR CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS
|
Professional
|
Both
|
$2,068.00
|
|
|
Service Code
|
HCPCS 23466
|
| Min. Negotiated Rate |
$659.87 |
| Max. Negotiated Rate |
$1,986.95 |
| Rate for Payer: Aetna Commercial |
$1,356.31
|
| Rate for Payer: Aetna Medicare |
$1,052.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,356.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,457.52
|
| Rate for Payer: BCBS Complete |
$692.86
|
| Rate for Payer: BCBS MAPPO |
$1,012.17
|
| Rate for Payer: BCN Commercial |
$1,698.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,012.17
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Cofinity Commercial |
$1,457.52
|
| Rate for Payer: Cofinity Commercial |
$1,356.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,012.17
|
| Rate for Payer: Healthscope Commercial |
$1,872.51
|
| Rate for Payer: Healthscope Commercial |
$1,619.47
|
| Rate for Payer: Mclaren Medicaid |
$659.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,062.78
|
| Rate for Payer: Meridian Medicaid |
$692.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,113.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,986.95
|
| Rate for Payer: Nomi Health Commercial |
$1,214.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,551.00
|
| Rate for Payer: PACE SWMI |
$1,012.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,012.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$659.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,815.77
|
| Rate for Payer: Priority Health Medicare |
$1,012.17
|
| Rate for Payer: Priority Health SBD |
$1,815.77
|
| Rate for Payer: Priority Health Tiered Network |
$1,815.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,012.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,941.13
|
| Rate for Payer: UHC Core |
$1,941.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,012.17
|
| Rate for Payer: UHC Exchange |
$1,941.13
|
| Rate for Payer: UHC Medicaid |
$659.87
|
| Rate for Payer: UHCCP Medicaid |
$659.87
|
|
|
PR CAPSULOTOMY MIDFOOT MEDIAL RELEASE ONLY SPX
|
Professional
|
Both
|
$1,603.00
|
|
|
Service Code
|
HCPCS 28260
|
| Min. Negotiated Rate |
$324.61 |
| Max. Negotiated Rate |
$1,202.25 |
| Rate for Payer: Aetna Commercial |
$665.86
|
| Rate for Payer: Aetna Medicare |
$516.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$665.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$715.55
|
| Rate for Payer: BCBS Complete |
$340.84
|
| Rate for Payer: BCBS MAPPO |
$496.91
|
| Rate for Payer: BCN Commercial |
$815.20
|
| Rate for Payer: BCN Medicare Advantage |
$496.91
|
| Rate for Payer: Cash Price |
$1,282.40
|
| Rate for Payer: Cash Price |
$1,282.40
|
| Rate for Payer: Cofinity Commercial |
$715.55
|
| Rate for Payer: Cofinity Commercial |
$665.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.91
|
| Rate for Payer: Healthscope Commercial |
$919.28
|
| Rate for Payer: Healthscope Commercial |
$795.06
|
| Rate for Payer: Mclaren Medicaid |
$324.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.76
|
| Rate for Payer: Meridian Medicaid |
$340.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$546.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$942.16
|
| Rate for Payer: Nomi Health Commercial |
$596.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,202.25
|
| Rate for Payer: PACE SWMI |
$496.91
|
| Rate for Payer: PHP Medicare Advantage |
$496.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$871.42
|
| Rate for Payer: Priority Health Medicare |
$496.91
|
| Rate for Payer: Priority Health SBD |
$871.42
|
| Rate for Payer: Priority Health Tiered Network |
$871.42
|
| Rate for Payer: Railroad Medicare Medicare |
$496.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$909.25
|
| Rate for Payer: UHC Core |
$909.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$496.91
|
| Rate for Payer: UHC Exchange |
$909.25
|
| Rate for Payer: UHC Medicaid |
$324.61
|
| Rate for Payer: UHCCP Medicaid |
$324.61
|
|
|
PR CAPSULOTOMY POSTERIOR CAPSULAR RELEASE KNEE
|
Professional
|
Both
|
$2,796.00
|
|
|
Service Code
|
HCPCS 27435
|
| Min. Negotiated Rate |
$485.00 |
| Max. Negotiated Rate |
$2,097.00 |
| Rate for Payer: Aetna Commercial |
$993.14
|
| Rate for Payer: Aetna Medicare |
$770.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,067.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$993.14
|
| Rate for Payer: BCBS Complete |
$509.25
|
| Rate for Payer: BCBS MAPPO |
$741.15
|
| Rate for Payer: BCN Commercial |
$1,232.51
|
| Rate for Payer: BCN Medicare Advantage |
$741.15
|
| Rate for Payer: Cash Price |
$2,236.80
|
| Rate for Payer: Cash Price |
$2,236.80
|
| Rate for Payer: Cofinity Commercial |
$993.14
|
| Rate for Payer: Cofinity Commercial |
$1,067.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$741.15
|
| Rate for Payer: Healthscope Commercial |
$1,371.13
|
| Rate for Payer: Healthscope Commercial |
$1,185.84
|
| Rate for Payer: Mclaren Medicaid |
$485.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$778.21
|
| Rate for Payer: Meridian Medicaid |
$509.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$815.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,437.79
|
| Rate for Payer: Nomi Health Commercial |
$889.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,097.00
|
| Rate for Payer: PACE SWMI |
$741.15
|
| Rate for Payer: PHP Medicare Advantage |
$741.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,317.52
|
| Rate for Payer: Priority Health Medicare |
$741.15
|
| Rate for Payer: Priority Health SBD |
$1,317.52
|
| Rate for Payer: Priority Health Tiered Network |
$1,317.52
|
| Rate for Payer: Railroad Medicare Medicare |
$741.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,411.75
|
| Rate for Payer: UHC Core |
$1,411.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$741.15
|
| Rate for Payer: UHC Exchange |
$1,411.75
|
| Rate for Payer: UHC Medicaid |
$485.00
|
| Rate for Payer: UHCCP Medicaid |
$485.00
|
|
|
PR CAPSULOTOMY WRIST
|
Professional
|
Both
|
$1,689.00
|
|
|
Service Code
|
HCPCS 25085
|
| Min. Negotiated Rate |
$271.79 |
| Max. Negotiated Rate |
$1,266.75 |
| Rate for Payer: Aetna Commercial |
$553.09
|
| Rate for Payer: Aetna Medicare |
$429.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$594.36
|
| Rate for Payer: BCBS Complete |
$285.38
|
| Rate for Payer: BCBS MAPPO |
$412.75
|
| Rate for Payer: BCN Commercial |
$692.69
|
| Rate for Payer: BCN Medicare Advantage |
$412.75
|
| Rate for Payer: Cash Price |
$1,351.20
|
| Rate for Payer: Cash Price |
$1,351.20
|
| Rate for Payer: Cofinity Commercial |
$594.36
|
| Rate for Payer: Cofinity Commercial |
$553.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$412.75
|
| Rate for Payer: Healthscope Commercial |
$763.59
|
| Rate for Payer: Healthscope Commercial |
$660.40
|
| Rate for Payer: Mclaren Medicaid |
$271.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$433.39
|
| Rate for Payer: Meridian Medicaid |
$285.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$454.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$796.72
|
| Rate for Payer: Nomi Health Commercial |
$495.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,266.75
|
| Rate for Payer: PACE SWMI |
$412.75
|
| Rate for Payer: PHP Medicare Advantage |
$412.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$740.47
|
| Rate for Payer: Priority Health Medicare |
$412.75
|
| Rate for Payer: Priority Health SBD |
$740.47
|
| Rate for Payer: Priority Health Tiered Network |
$740.47
|
| Rate for Payer: Railroad Medicare Medicare |
$412.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$778.48
|
| Rate for Payer: UHC Core |
$778.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$412.75
|
| Rate for Payer: UHC Exchange |
$778.48
|
| Rate for Payer: UHC Medicaid |
$271.79
|
| Rate for Payer: UHCCP Medicaid |
$271.79
|
|
|
PR CARDIOPULMONARY EXERCISE TESTING
|
Professional
|
Both
|
$291.00
|
|
|
Service Code
|
HCPCS 94621
|
| Min. Negotiated Rate |
$155.91 |
| Max. Negotiated Rate |
$288.43 |
| Rate for Payer: Aetna Commercial |
$208.92
|
| Rate for Payer: Aetna Medicare |
$162.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.92
|
| Rate for Payer: BCBS MAPPO |
$155.91
|
| Rate for Payer: BCN Commercial |
$232.06
|
| Rate for Payer: BCN Medicare Advantage |
$155.91
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$224.51
|
| Rate for Payer: Cofinity Commercial |
$208.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.91
|
| Rate for Payer: Healthscope Commercial |
$249.46
|
| Rate for Payer: Healthscope Commercial |
$288.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$171.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218.60
|
| Rate for Payer: Nomi Health Commercial |
$187.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.25
|
| Rate for Payer: PACE SWMI |
$155.91
|
| Rate for Payer: PHP Medicare Advantage |
$155.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$214.00
|
| Rate for Payer: Priority Health Medicare |
$155.91
|
| Rate for Payer: Priority Health SBD |
$214.00
|
| Rate for Payer: Priority Health Tiered Network |
$214.00
|
| Rate for Payer: Railroad Medicare Medicare |
$155.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.80
|
| Rate for Payer: UHC Core |
$246.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$155.91
|
| Rate for Payer: UHC Exchange |
$246.80
|
|
