|
PR CAPSULECTOMY/CAPSULOTOMY IPHAL JOINT EACH
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26525
|
| Min. Negotiated Rate |
$440.70 |
| Max. Negotiated Rate |
$120,206.00 |
| Rate for Payer: Aetna Commercial |
$849.90
|
| Rate for Payer: Aetna Medicare |
$659.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$849.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$913.32
|
| Rate for Payer: BCBS Complete |
$462.74
|
| Rate for Payer: BCBS MAPPO |
$634.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,128.45
|
| Rate for Payer: BCN Commercial |
$1,021.83
|
| Rate for Payer: BCN Medicare Advantage |
$634.25
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$913.32
|
| Rate for Payer: Cofinity Commercial |
$849.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$634.25
|
| Rate for Payer: Healthscope Commercial |
$1,173.36
|
| Rate for Payer: Healthscope Commercial |
$1,014.80
|
| Rate for Payer: Mclaren Medicaid |
$440.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$665.96
|
| Rate for Payer: Meridian Medicaid |
$462.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120,206.00
|
| Rate for Payer: Nomi Health Commercial |
$761.10
|
| Rate for Payer: PACE SWMI |
$634.25
|
| Rate for Payer: PHP Medicare Advantage |
$634.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,030.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,060.97
|
| Rate for Payer: Priority Health Medicare |
$634.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,060.97
|
| Rate for Payer: Priority Health SBD |
$1,060.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$943.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$634.25
|
| Rate for Payer: UHC Exchange |
$943.29
|
| Rate for Payer: UHC Medicare Advantage |
$634.25
|
| Rate for Payer: UHCCP Medicaid |
$440.70
|
|
|
PR CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26520
|
| Min. Negotiated Rate |
$437.50 |
| Max. Negotiated Rate |
$119,669.00 |
| Rate for Payer: Aetna Commercial |
$843.74
|
| Rate for Payer: Aetna Medicare |
$654.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$843.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$906.71
|
| Rate for Payer: BCBS Complete |
$459.38
|
| Rate for Payer: BCBS MAPPO |
$629.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.94
|
| Rate for Payer: BCN Commercial |
$1,017.43
|
| Rate for Payer: BCN Medicare Advantage |
$629.66
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$906.71
|
| Rate for Payer: Cofinity Commercial |
$843.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$629.66
|
| Rate for Payer: Healthscope Commercial |
$1,164.87
|
| Rate for Payer: Healthscope Commercial |
$1,007.46
|
| Rate for Payer: Mclaren Medicaid |
$437.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$661.14
|
| Rate for Payer: Meridian Medicaid |
$459.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119,669.00
|
| Rate for Payer: Nomi Health Commercial |
$755.59
|
| Rate for Payer: PACE SWMI |
$629.66
|
| Rate for Payer: PHP Medicare Advantage |
$629.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$437.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,030.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,054.87
|
| Rate for Payer: Priority Health Medicare |
$629.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,054.87
|
| Rate for Payer: Priority Health SBD |
$1,054.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$935.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$629.66
|
| Rate for Payer: UHC Exchange |
$935.30
|
| Rate for Payer: UHC Medicare Advantage |
$629.66
|
| Rate for Payer: UHCCP Medicaid |
$437.50
|
|
|
PR CAPSUL MTTARPHLNGL JT W/WO TENORRHAPHY EA JT SPX
|
Professional
|
Both
|
$802.00
|
|
|
Service Code
|
HCPCS 28270
|
| Min. Negotiated Rate |
$218.11 |
| Max. Negotiated Rate |
$58,516.00 |
| Rate for Payer: Aetna Commercial |
$429.04
|
| Rate for Payer: Aetna Medicare |
$332.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.06
|
| Rate for Payer: BCBS Complete |
$229.02
|
| Rate for Payer: BCBS MAPPO |
$320.18
|
| Rate for Payer: BCBS Trust/PPO |
$265.73
|
| Rate for Payer: BCN Commercial |
$706.63
|
| Rate for Payer: BCN Medicare Advantage |
$320.18
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Cash Price |
$641.60
|
| Rate for Payer: Cofinity Commercial |
$461.06
|
| Rate for Payer: Cofinity Commercial |
$429.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.18
|
| Rate for Payer: Healthscope Commercial |
$592.33
|
| Rate for Payer: Healthscope Commercial |
$512.29
|
| Rate for Payer: Mclaren Medicaid |
$218.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.19
|
| Rate for Payer: Meridian Medicaid |
$229.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58,516.00
|
| Rate for Payer: Nomi Health Commercial |
$384.22
|
| Rate for Payer: PACE SWMI |
$320.18
|
| Rate for Payer: PHP Medicare Advantage |
$320.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$515.47
|
| Rate for Payer: Priority Health Medicare |
$320.18
|
| Rate for Payer: Priority Health Narrow Network |
$515.47
|
| Rate for Payer: Priority Health SBD |
$515.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$544.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.18
|
| Rate for Payer: UHC Exchange |
$544.30
|
| Rate for Payer: UHC Medicare Advantage |
$320.18
|
| Rate for Payer: UHCCP Medicaid |
$218.11
|
|
|
PR CAPSULODESIS MTCARPHLNGL JOINT SINGLE DIGIT
|
Professional
|
Both
|
$2,003.00
|
|
|
Service Code
|
HCPCS 26516
|
| Min. Negotiated Rate |
$480.95 |
| Max. Negotiated Rate |
$131,074.00 |
| Rate for Payer: Aetna Commercial |
$935.52
|
| Rate for Payer: Aetna Medicare |
$726.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,005.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$935.52
|
| Rate for Payer: BCBS Complete |
$505.00
|
| Rate for Payer: BCBS MAPPO |
$698.15
|
| Rate for Payer: BCBS Trust/PPO |
$3,178.25
|
| Rate for Payer: BCN Commercial |
$1,105.87
|
| Rate for Payer: BCN Medicare Advantage |
$698.15
|
| Rate for Payer: Cash Price |
$1,602.40
|
| Rate for Payer: Cash Price |
$1,602.40
|
| Rate for Payer: Cofinity Commercial |
$935.52
|
| Rate for Payer: Cofinity Commercial |
$1,005.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$698.15
|
| Rate for Payer: Healthscope Commercial |
$1,291.58
|
| Rate for Payer: Healthscope Commercial |
$1,117.04
|
| Rate for Payer: Mclaren Medicaid |
$480.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$733.06
|
| Rate for Payer: Meridian Medicaid |
$505.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131,074.00
|
| Rate for Payer: Nomi Health Commercial |
$837.78
|
| Rate for Payer: PACE SWMI |
$698.15
|
| Rate for Payer: PHP Medicare Advantage |
$698.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$480.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,301.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,150.53
|
| Rate for Payer: Priority Health Medicare |
$698.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,150.53
|
| Rate for Payer: Priority Health SBD |
$1,150.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$884.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$698.15
|
| Rate for Payer: UHC Exchange |
$884.28
|
| Rate for Payer: UHC Medicare Advantage |
$698.15
|
| Rate for Payer: UHCCP Medicaid |
$480.95
|
|
|
PR CAPSULORRHAPHY ANTERIOR PUTTI-PLATT/MAGNUSON
|
Professional
|
Both
|
$2,867.00
|
|
|
Service Code
|
HCPCS 23450
|
| Min. Negotiated Rate |
$146.45 |
| Max. Negotiated Rate |
$168,084.00 |
| Rate for Payer: Aetna Commercial |
$1,223.33
|
| Rate for Payer: Aetna Medicare |
$949.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,223.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,314.62
|
| Rate for Payer: BCBS Complete |
$645.00
|
| Rate for Payer: BCBS MAPPO |
$912.93
|
| Rate for Payer: BCBS Trust/PPO |
$146.45
|
| Rate for Payer: BCN Commercial |
$1,388.33
|
| Rate for Payer: BCN Medicare Advantage |
$912.93
|
| Rate for Payer: Cash Price |
$2,293.60
|
| Rate for Payer: Cash Price |
$2,293.60
|
| Rate for Payer: Cofinity Commercial |
$1,314.62
|
| Rate for Payer: Cofinity Commercial |
$1,223.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$912.93
|
| Rate for Payer: Healthscope Commercial |
$1,688.92
|
| Rate for Payer: Healthscope Commercial |
$1,460.69
|
| Rate for Payer: Mclaren Medicaid |
$614.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$958.58
|
| Rate for Payer: Meridian Medicaid |
$645.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168,084.00
|
| Rate for Payer: Nomi Health Commercial |
$1,095.52
|
| Rate for Payer: PACE SWMI |
$912.93
|
| Rate for Payer: PHP Medicare Advantage |
$912.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$614.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,863.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,455.86
|
| Rate for Payer: Priority Health Medicare |
$912.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,455.86
|
| Rate for Payer: Priority Health SBD |
$1,455.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,343.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$912.93
|
| Rate for Payer: UHC Exchange |
$1,343.47
|
| Rate for Payer: UHC Medicare Advantage |
$912.93
|
| Rate for Payer: UHCCP Medicaid |
$614.29
|
|
|
PR CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR
|
Professional
|
Both
|
$3,414.00
|
|
|
Service Code
|
HCPCS 23462
|
| Min. Negotiated Rate |
$313.71 |
| Max. Negotiated Rate |
$189,664.00 |
| Rate for Payer: Aetna Commercial |
$1,379.50
|
| Rate for Payer: Aetna Medicare |
$1,070.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,379.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,482.45
|
| Rate for Payer: BCBS Complete |
$726.41
|
| Rate for Payer: BCBS MAPPO |
$1,029.48
|
| Rate for Payer: BCBS Trust/PPO |
$313.71
|
| Rate for Payer: BCN Commercial |
$1,564.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,029.48
|
| Rate for Payer: Cash Price |
$2,731.20
|
| Rate for Payer: Cash Price |
$2,731.20
|
| Rate for Payer: Cofinity Commercial |
$1,482.45
|
| Rate for Payer: Cofinity Commercial |
$1,379.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,029.48
|
| Rate for Payer: Healthscope Commercial |
$1,904.54
|
| Rate for Payer: Healthscope Commercial |
$1,647.17
|
| Rate for Payer: Mclaren Medicaid |
$691.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,080.95
|
| Rate for Payer: Meridian Medicaid |
$726.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189,664.00
|
| Rate for Payer: Nomi Health Commercial |
$1,235.38
|
| Rate for Payer: PACE SWMI |
$1,029.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,029.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$691.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,219.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,640.57
|
| Rate for Payer: Priority Health Medicare |
$1,029.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,640.57
|
| Rate for Payer: Priority Health SBD |
$1,640.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,490.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,029.48
|
| Rate for Payer: UHC Exchange |
$1,490.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,029.48
|
| Rate for Payer: UHCCP Medicaid |
$691.82
|
|
|
PR CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK
|
Professional
|
Both
|
$2,793.00
|
|
|
Service Code
|
HCPCS 23460
|
| Min. Negotiated Rate |
$208.43 |
| Max. Negotiated Rate |
$193,552.00 |
| Rate for Payer: Aetna Commercial |
$1,408.66
|
| Rate for Payer: Aetna Medicare |
$1,093.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,408.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,513.79
|
| Rate for Payer: BCBS Complete |
$742.52
|
| Rate for Payer: BCBS MAPPO |
$1,051.24
|
| Rate for Payer: BCBS Trust/PPO |
$208.43
|
| Rate for Payer: BCN Commercial |
$1,598.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,051.24
|
| Rate for Payer: Cash Price |
$2,234.40
|
| Rate for Payer: Cash Price |
$2,234.40
|
| Rate for Payer: Cofinity Commercial |
$1,513.79
|
| Rate for Payer: Cofinity Commercial |
$1,408.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,051.24
|
| Rate for Payer: Healthscope Commercial |
$1,944.79
|
| Rate for Payer: Healthscope Commercial |
$1,681.98
|
| Rate for Payer: Mclaren Medicaid |
$707.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,103.80
|
| Rate for Payer: Meridian Medicaid |
$742.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193,552.00
|
| Rate for Payer: Nomi Health Commercial |
$1,261.49
|
| Rate for Payer: PACE SWMI |
$1,051.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,051.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$707.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,815.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,676.69
|
| Rate for Payer: Priority Health Medicare |
$1,051.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,676.69
|
| Rate for Payer: Priority Health SBD |
$1,676.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,508.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,051.24
|
| Rate for Payer: UHC Exchange |
$1,508.81
|
| Rate for Payer: UHC Medicare Advantage |
$1,051.24
|
| Rate for Payer: UHCCP Medicaid |
$707.16
|
|
|
PR CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR
|
Professional
|
Both
|
$3,203.00
|
|
|
Service Code
|
HCPCS 23455
|
| Min. Negotiated Rate |
$188.90 |
| Max. Negotiated Rate |
$175,588.00 |
| Rate for Payer: Aetna Commercial |
$1,255.83
|
| Rate for Payer: Aetna Medicare |
$974.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,255.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,349.55
|
| Rate for Payer: BCBS Complete |
$661.55
|
| Rate for Payer: BCBS MAPPO |
$937.19
|
| Rate for Payer: BCBS Trust/PPO |
$188.90
|
| Rate for Payer: BCN Commercial |
$1,449.42
|
| Rate for Payer: BCN Medicare Advantage |
$937.19
|
| Rate for Payer: Cash Price |
$2,562.40
|
| Rate for Payer: Cash Price |
$2,562.40
|
| Rate for Payer: Cofinity Commercial |
$1,349.55
|
| Rate for Payer: Cofinity Commercial |
$1,255.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$937.19
|
| Rate for Payer: Healthscope Commercial |
$1,733.80
|
| Rate for Payer: Healthscope Commercial |
$1,499.50
|
| Rate for Payer: Mclaren Medicaid |
$630.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$984.05
|
| Rate for Payer: Meridian Medicaid |
$661.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175,588.00
|
| Rate for Payer: Nomi Health Commercial |
$1,124.63
|
| Rate for Payer: PACE SWMI |
$937.19
|
| Rate for Payer: PHP Medicare Advantage |
$937.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$630.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,081.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,516.41
|
| Rate for Payer: Priority Health Medicare |
$937.19
|
| Rate for Payer: Priority Health Narrow Network |
$1,516.41
|
| Rate for Payer: Priority Health SBD |
$1,516.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,425.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$937.19
|
| Rate for Payer: UHC Exchange |
$1,425.08
|
| Rate for Payer: UHC Medicare Advantage |
$937.19
|
| Rate for Payer: UHCCP Medicaid |
$630.05
|
|
|
PR CAPSULORRHAPHY GLENOHUMERAL JT PST W/WO BONE BLK
|
Professional
|
Both
|
$3,500.00
|
|
|
Service Code
|
HCPCS 23465
|
| Min. Negotiated Rate |
$104.00 |
| Max. Negotiated Rate |
$198,526.00 |
| Rate for Payer: Aetna Commercial |
$1,444.32
|
| Rate for Payer: Aetna Medicare |
$1,120.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,444.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,552.10
|
| Rate for Payer: BCBS Complete |
$761.08
|
| Rate for Payer: BCBS MAPPO |
$1,077.85
|
| Rate for Payer: BCBS Trust/PPO |
$104.00
|
| Rate for Payer: BCN Commercial |
$1,639.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,077.85
|
| Rate for Payer: Cash Price |
$2,800.00
|
| Rate for Payer: Cash Price |
$2,800.00
|
| Rate for Payer: Cofinity Commercial |
$1,552.10
|
| Rate for Payer: Cofinity Commercial |
$1,444.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,077.85
|
| Rate for Payer: Healthscope Commercial |
$1,994.02
|
| Rate for Payer: Healthscope Commercial |
$1,724.56
|
| Rate for Payer: Mclaren Medicaid |
$724.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,131.74
|
| Rate for Payer: Meridian Medicaid |
$761.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198,526.00
|
| Rate for Payer: Nomi Health Commercial |
$1,293.42
|
| Rate for Payer: PACE SWMI |
$1,077.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,077.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$724.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,275.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,718.93
|
| Rate for Payer: Priority Health Medicare |
$1,077.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,718.93
|
| Rate for Payer: Priority Health SBD |
$1,718.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,521.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,077.85
|
| Rate for Payer: UHC Exchange |
$1,521.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,077.85
|
| Rate for Payer: UHCCP Medicaid |
$724.84
|
|
|
PR CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS
|
Professional
|
Both
|
$2,008.00
|
|
|
Service Code
|
HCPCS 23466
|
| Min. Negotiated Rate |
$138.81 |
| Max. Negotiated Rate |
$198,695.00 |
| Rate for Payer: Aetna Commercial |
$1,443.50
|
| Rate for Payer: Aetna Medicare |
$1,120.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,443.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,551.23
|
| Rate for Payer: BCBS Complete |
$762.87
|
| Rate for Payer: BCBS MAPPO |
$1,077.24
|
| Rate for Payer: BCBS Trust/PPO |
$138.81
|
| Rate for Payer: BCN Commercial |
$1,644.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,077.24
|
| Rate for Payer: Cash Price |
$1,606.40
|
| Rate for Payer: Cash Price |
$1,606.40
|
| Rate for Payer: Cofinity Commercial |
$1,551.23
|
| Rate for Payer: Cofinity Commercial |
$1,443.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,077.24
|
| Rate for Payer: Healthscope Commercial |
$1,992.89
|
| Rate for Payer: Healthscope Commercial |
$1,723.58
|
| Rate for Payer: Mclaren Medicaid |
$726.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,131.10
|
| Rate for Payer: Meridian Medicaid |
$762.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198,695.00
|
| Rate for Payer: Nomi Health Commercial |
$1,292.69
|
| Rate for Payer: PACE SWMI |
$1,077.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,077.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$726.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,305.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,728.61
|
| Rate for Payer: Priority Health Medicare |
$1,077.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,728.61
|
| Rate for Payer: Priority Health SBD |
$1,728.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,449.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,077.24
|
| Rate for Payer: UHC Exchange |
$1,449.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,077.24
|
| Rate for Payer: UHCCP Medicaid |
$726.54
|
|
|
PR CAPSULOTOMY MIDFOOT MEDIAL RELEASE ONLY SPX
|
Professional
|
Both
|
$1,556.00
|
|
|
Service Code
|
HCPCS 28260
|
| Min. Negotiated Rate |
$348.68 |
| Max. Negotiated Rate |
$94,216.00 |
| Rate for Payer: Aetna Commercial |
$691.05
|
| Rate for Payer: Aetna Medicare |
$536.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$691.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$742.62
|
| Rate for Payer: BCBS Complete |
$366.11
|
| Rate for Payer: BCBS MAPPO |
$515.71
|
| Rate for Payer: BCN Commercial |
$1,049.19
|
| Rate for Payer: BCN Medicare Advantage |
$515.71
|
| Rate for Payer: Cash Price |
$1,244.80
|
| Rate for Payer: Cash Price |
$1,244.80
|
| Rate for Payer: Cofinity Commercial |
$742.62
|
| Rate for Payer: Cofinity Commercial |
$691.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$515.71
|
| Rate for Payer: Healthscope Commercial |
$954.06
|
| Rate for Payer: Healthscope Commercial |
$825.14
|
| Rate for Payer: Mclaren Medicaid |
$348.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$541.50
|
| Rate for Payer: Meridian Medicaid |
$366.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94,216.00
|
| Rate for Payer: Nomi Health Commercial |
$618.85
|
| Rate for Payer: PACE SWMI |
$515.71
|
| Rate for Payer: PHP Medicare Advantage |
$515.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,011.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$833.01
|
| Rate for Payer: Priority Health Medicare |
$515.71
|
| Rate for Payer: Priority Health Narrow Network |
$833.01
|
| Rate for Payer: Priority Health SBD |
$833.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$721.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$515.71
|
| Rate for Payer: UHC Exchange |
$721.98
|
| Rate for Payer: UHC Medicare Advantage |
$515.71
|
| Rate for Payer: UHCCP Medicaid |
$348.68
|
|
|
PR CAPSULOTOMY POSTERIOR CAPSULAR RELEASE KNEE
|
Professional
|
Both
|
$2,715.00
|
|
|
Service Code
|
HCPCS 27435
|
| Min. Negotiated Rate |
$527.18 |
| Max. Negotiated Rate |
$143,779.00 |
| Rate for Payer: Aetna Commercial |
$1,044.02
|
| Rate for Payer: Aetna Medicare |
$810.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,044.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,121.93
|
| Rate for Payer: BCBS Complete |
$553.54
|
| Rate for Payer: BCBS MAPPO |
$779.12
|
| Rate for Payer: BCN Commercial |
$1,193.35
|
| Rate for Payer: BCN Medicare Advantage |
$779.12
|
| Rate for Payer: Cash Price |
$2,172.00
|
| Rate for Payer: Cash Price |
$2,172.00
|
| Rate for Payer: Cofinity Commercial |
$1,121.93
|
| Rate for Payer: Cofinity Commercial |
$1,044.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$779.12
|
| Rate for Payer: Healthscope Commercial |
$1,441.37
|
| Rate for Payer: Healthscope Commercial |
$1,246.59
|
| Rate for Payer: Mclaren Medicaid |
$527.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$818.08
|
| Rate for Payer: Meridian Medicaid |
$553.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143,779.00
|
| Rate for Payer: Nomi Health Commercial |
$934.94
|
| Rate for Payer: PACE SWMI |
$779.12
|
| Rate for Payer: PHP Medicare Advantage |
$779.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$527.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,764.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,248.75
|
| Rate for Payer: Priority Health Medicare |
$779.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,248.75
|
| Rate for Payer: Priority Health SBD |
$1,248.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$821.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$779.12
|
| Rate for Payer: UHC Exchange |
$821.96
|
| Rate for Payer: UHC Medicare Advantage |
$779.12
|
| Rate for Payer: UHCCP Medicaid |
$527.18
|
|
|
PR CAPSULOTOMY WRIST
|
Professional
|
Both
|
$1,640.00
|
|
|
Service Code
|
HCPCS 25085
|
| Min. Negotiated Rate |
$119.92 |
| Max. Negotiated Rate |
$79,672.00 |
| Rate for Payer: Aetna Commercial |
$582.94
|
| Rate for Payer: Aetna Medicare |
$452.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$582.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$626.44
|
| Rate for Payer: BCBS Complete |
$311.09
|
| Rate for Payer: BCBS MAPPO |
$435.03
|
| Rate for Payer: BCBS Trust/PPO |
$119.92
|
| Rate for Payer: BCN Commercial |
$664.60
|
| Rate for Payer: BCN Medicare Advantage |
$435.03
|
| Rate for Payer: Cash Price |
$1,312.00
|
| Rate for Payer: Cash Price |
$1,312.00
|
| Rate for Payer: Cofinity Commercial |
$626.44
|
| Rate for Payer: Cofinity Commercial |
$582.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$435.03
|
| Rate for Payer: Healthscope Commercial |
$804.81
|
| Rate for Payer: Healthscope Commercial |
$696.05
|
| Rate for Payer: Mclaren Medicaid |
$296.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$456.78
|
| Rate for Payer: Meridian Medicaid |
$311.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79,672.00
|
| Rate for Payer: Nomi Health Commercial |
$522.04
|
| Rate for Payer: PACE SWMI |
$435.03
|
| Rate for Payer: PHP Medicare Advantage |
$435.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,066.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$701.21
|
| Rate for Payer: Priority Health Medicare |
$435.03
|
| Rate for Payer: Priority Health Narrow Network |
$701.21
|
| Rate for Payer: Priority Health SBD |
$701.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$670.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$435.03
|
| Rate for Payer: UHC Exchange |
$670.25
|
| Rate for Payer: UHC Medicare Advantage |
$435.03
|
| Rate for Payer: UHCCP Medicaid |
$296.28
|
|
|
PR CARDIOPULMONARY EXERCISE TESTING
|
Professional
|
Both
|
$283.00
|
|
|
Service Code
|
HCPCS 94621
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$21,860.00 |
| Rate for Payer: Aetna Commercial |
$190.74
|
| Rate for Payer: Aetna Medicare |
$148.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.97
|
| Rate for Payer: BCBS Complete |
$44.73
|
| Rate for Payer: BCBS MAPPO |
$142.34
|
| Rate for Payer: BCBS Trust/PPO |
$256.23
|
| Rate for Payer: BCN Commercial |
$222.83
|
| Rate for Payer: BCN Medicare Advantage |
$142.34
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cash Price |
$226.40
|
| Rate for Payer: Cofinity Commercial |
$204.97
|
| Rate for Payer: Cofinity Commercial |
$190.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.34
|
| Rate for Payer: Healthscope Commercial |
$263.33
|
| Rate for Payer: Healthscope Commercial |
$227.74
|
| Rate for Payer: Mclaren Medicaid |
$42.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.46
|
| Rate for Payer: Meridian Medicaid |
$44.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,860.00
|
| Rate for Payer: Nomi Health Commercial |
$170.81
|
| Rate for Payer: PACE SWMI |
$142.34
|
| Rate for Payer: PHP Medicare Advantage |
$142.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$209.87
|
| Rate for Payer: Priority Health Medicare |
$142.34
|
| Rate for Payer: Priority Health Narrow Network |
$209.87
|
| Rate for Payer: Priority Health SBD |
$90.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.34
|
| Rate for Payer: UHC Exchange |
$148.67
|
| Rate for Payer: UHC Medicare Advantage |
$142.34
|
| Rate for Payer: UHCCP Medicaid |
$42.60
|
|
|
PR CARDIOPULMONARY RESUSCITATION
|
Professional
|
Both
|
$559.00
|
|
|
Service Code
|
HCPCS 92950
|
| Min. Negotiated Rate |
$115.66 |
| Max. Negotiated Rate |
$27,042.00 |
| Rate for Payer: Aetna Commercial |
$234.38
|
| Rate for Payer: Aetna Medicare |
$181.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.87
|
| Rate for Payer: BCBS Complete |
$121.44
|
| Rate for Payer: BCBS MAPPO |
$174.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,166.03
|
| Rate for Payer: BCN Commercial |
$475.97
|
| Rate for Payer: BCN Medicare Advantage |
$174.91
|
| Rate for Payer: Cash Price |
$447.20
|
| Rate for Payer: Cash Price |
$447.20
|
| Rate for Payer: Cofinity Commercial |
$251.87
|
| Rate for Payer: Cofinity Commercial |
$234.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.91
|
| Rate for Payer: Healthscope Commercial |
$323.58
|
| Rate for Payer: Healthscope Commercial |
$279.86
|
| Rate for Payer: Mclaren Medicaid |
$115.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.66
|
| Rate for Payer: Meridian Medicaid |
$121.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,042.00
|
| Rate for Payer: Nomi Health Commercial |
$209.89
|
| Rate for Payer: PACE SWMI |
$174.91
|
| Rate for Payer: PHP Medicare Advantage |
$174.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$363.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.73
|
| Rate for Payer: Priority Health Medicare |
$174.91
|
| Rate for Payer: Priority Health Narrow Network |
$254.73
|
| Rate for Payer: Priority Health SBD |
$254.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.91
|
| Rate for Payer: UHC Exchange |
$324.85
|
| Rate for Payer: UHC Medicare Advantage |
$174.91
|
| Rate for Payer: UHCCP Medicaid |
$115.66
|
|
|
PR CARDIOT EXPL RMVL FB ATR/VENTR THRMB CARD BYP
|
Professional
|
Both
|
$6,846.00
|
|
|
Service Code
|
HCPCS 33315
|
| Min. Negotiated Rate |
$1,200.89 |
| Max. Negotiated Rate |
$339,435.00 |
| Rate for Payer: Aetna Commercial |
$2,454.50
|
| Rate for Payer: Aetna Medicare |
$1,904.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,454.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,637.68
|
| Rate for Payer: BCBS Complete |
$1,260.93
|
| Rate for Payer: BCBS MAPPO |
$1,831.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,311.77
|
| Rate for Payer: BCN Commercial |
$2,745.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,831.72
|
| Rate for Payer: Cash Price |
$5,476.80
|
| Rate for Payer: Cash Price |
$5,476.80
|
| Rate for Payer: Cofinity Commercial |
$2,637.68
|
| Rate for Payer: Cofinity Commercial |
$2,454.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,831.72
|
| Rate for Payer: Healthscope Commercial |
$3,388.68
|
| Rate for Payer: Healthscope Commercial |
$2,930.75
|
| Rate for Payer: Mclaren Medicaid |
$1,200.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,923.31
|
| Rate for Payer: Meridian Medicaid |
$1,260.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$339,435.00
|
| Rate for Payer: Nomi Health Commercial |
$2,198.06
|
| Rate for Payer: PACE SWMI |
$1,831.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,831.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,200.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,449.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,999.50
|
| Rate for Payer: Priority Health Medicare |
$1,831.72
|
| Rate for Payer: Priority Health Narrow Network |
$2,999.50
|
| Rate for Payer: Priority Health SBD |
$2,999.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,795.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,831.72
|
| Rate for Payer: UHC Exchange |
$1,795.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,831.72
|
| Rate for Payer: UHCCP Medicaid |
$1,200.89
|
|
|
PR CARDIOT EXPL W/RMVL FB ATR/VENTR THRMB W/O BYP
|
Professional
|
Both
|
$4,619.00
|
|
|
Service Code
|
HCPCS 33310
|
| Min. Negotiated Rate |
$738.05 |
| Max. Negotiated Rate |
$206,539.00 |
| Rate for Payer: Aetna Commercial |
$1,499.49
|
| Rate for Payer: Aetna Medicare |
$1,163.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,499.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,611.39
|
| Rate for Payer: BCBS Complete |
$774.95
|
| Rate for Payer: BCBS MAPPO |
$1,119.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,038.64
|
| Rate for Payer: BCN Commercial |
$1,678.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,119.02
|
| Rate for Payer: Cash Price |
$3,695.20
|
| Rate for Payer: Cash Price |
$3,695.20
|
| Rate for Payer: Cofinity Commercial |
$1,611.39
|
| Rate for Payer: Cofinity Commercial |
$1,499.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,119.02
|
| Rate for Payer: Healthscope Commercial |
$2,070.19
|
| Rate for Payer: Healthscope Commercial |
$1,790.43
|
| Rate for Payer: Mclaren Medicaid |
$738.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,174.97
|
| Rate for Payer: Meridian Medicaid |
$774.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206,539.00
|
| Rate for Payer: Nomi Health Commercial |
$1,342.82
|
| Rate for Payer: PACE SWMI |
$1,119.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,119.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$738.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,002.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,830.55
|
| Rate for Payer: Priority Health Medicare |
$1,119.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,830.55
|
| Rate for Payer: Priority Health SBD |
$1,830.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,461.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,119.02
|
| Rate for Payer: UHC Exchange |
$1,461.37
|
| Rate for Payer: UHC Medicare Advantage |
$1,119.02
|
| Rate for Payer: UHCCP Medicaid |
$738.05
|
|
|
PR CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR
|
Professional
|
Both
|
$573.00
|
|
|
Service Code
|
HCPCS 93660
|
| Min. Negotiated Rate |
$57.08 |
| Max. Negotiated Rate |
$23,073.00 |
| Rate for Payer: Aetna Commercial |
$202.47
|
| Rate for Payer: Aetna Medicare |
$157.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.58
|
| Rate for Payer: BCBS Complete |
$59.93
|
| Rate for Payer: BCBS MAPPO |
$151.10
|
| Rate for Payer: BCBS Trust/PPO |
$3,564.97
|
| Rate for Payer: BCN Commercial |
$233.59
|
| Rate for Payer: BCN Medicare Advantage |
$151.10
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cofinity Commercial |
$217.58
|
| Rate for Payer: Cofinity Commercial |
$202.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.10
|
| Rate for Payer: Healthscope Commercial |
$279.54
|
| Rate for Payer: Healthscope Commercial |
$241.76
|
| Rate for Payer: Mclaren Medicaid |
$57.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.66
|
| Rate for Payer: Meridian Medicaid |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,073.00
|
| Rate for Payer: Nomi Health Commercial |
$181.32
|
| Rate for Payer: PACE SWMI |
$151.10
|
| Rate for Payer: PHP Medicare Advantage |
$151.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.83
|
| Rate for Payer: Priority Health Medicare |
$151.10
|
| Rate for Payer: Priority Health Narrow Network |
$228.83
|
| Rate for Payer: Priority Health SBD |
$125.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$151.10
|
| Rate for Payer: UHC Exchange |
$176.72
|
| Rate for Payer: UHC Medicare Advantage |
$151.10
|
| Rate for Payer: UHCCP Medicaid |
$57.08
|
|
|
PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL
|
Professional
|
Both
|
$501.00
|
|
|
Service Code
|
HCPCS 92960
|
| Min. Negotiated Rate |
$68.37 |
| Max. Negotiated Rate |
$15,819.00 |
| Rate for Payer: Aetna Commercial |
$136.28
|
| Rate for Payer: Aetna Medicare |
$105.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.45
|
| Rate for Payer: BCBS Complete |
$71.79
|
| Rate for Payer: BCBS MAPPO |
$101.70
|
| Rate for Payer: BCBS Trust/PPO |
$237.21
|
| Rate for Payer: BCN Commercial |
$248.59
|
| Rate for Payer: BCN Medicare Advantage |
$101.70
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cofinity Commercial |
$146.45
|
| Rate for Payer: Cofinity Commercial |
$136.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.70
|
| Rate for Payer: Healthscope Commercial |
$188.14
|
| Rate for Payer: Healthscope Commercial |
$162.72
|
| Rate for Payer: Mclaren Medicaid |
$68.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.78
|
| Rate for Payer: Meridian Medicaid |
$71.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,819.00
|
| Rate for Payer: Nomi Health Commercial |
$122.04
|
| Rate for Payer: PACE SWMI |
$101.70
|
| Rate for Payer: PHP Medicare Advantage |
$101.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$149.72
|
| Rate for Payer: Priority Health Medicare |
$101.70
|
| Rate for Payer: Priority Health Narrow Network |
$149.72
|
| Rate for Payer: Priority Health SBD |
$149.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.70
|
| Rate for Payer: UHC Exchange |
$356.59
|
| Rate for Payer: UHC Medicare Advantage |
$101.70
|
| Rate for Payer: UHCCP Medicaid |
$68.37
|
|
|
PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL
|
Professional
|
Both
|
$501.00
|
|
|
Service Code
|
HCPCS 92960
|
| Hospital Charge Code |
92960
|
| Min. Negotiated Rate |
$68.37 |
| Max. Negotiated Rate |
$15,819.00 |
| Rate for Payer: Aetna Commercial |
$136.28
|
| Rate for Payer: Aetna Medicare |
$105.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.45
|
| Rate for Payer: BCBS Complete |
$71.79
|
| Rate for Payer: BCBS MAPPO |
$101.70
|
| Rate for Payer: BCBS Trust/PPO |
$237.21
|
| Rate for Payer: BCN Commercial |
$248.59
|
| Rate for Payer: BCN Medicare Advantage |
$101.70
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cofinity Commercial |
$146.45
|
| Rate for Payer: Cofinity Commercial |
$136.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.70
|
| Rate for Payer: Healthscope Commercial |
$188.14
|
| Rate for Payer: Healthscope Commercial |
$162.72
|
| Rate for Payer: Mclaren Medicaid |
$68.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.78
|
| Rate for Payer: Meridian Medicaid |
$71.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,819.00
|
| Rate for Payer: Nomi Health Commercial |
$122.04
|
| Rate for Payer: PACE SWMI |
$101.70
|
| Rate for Payer: PHP Medicare Advantage |
$101.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$149.72
|
| Rate for Payer: Priority Health Medicare |
$101.70
|
| Rate for Payer: Priority Health Narrow Network |
$149.72
|
| Rate for Payer: Priority Health SBD |
$149.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.70
|
| Rate for Payer: UHC Exchange |
$356.59
|
| Rate for Payer: UHC Medicare Advantage |
$101.70
|
| Rate for Payer: UHCCP Medicaid |
$68.37
|
|
|
PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL
|
Facility
|
IP
|
$501.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
92960
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$315.63 |
| Max. Negotiated Rate |
$450.90 |
| Rate for Payer: Aetna Commercial |
$425.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.65
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cofinity Commercial |
$350.70
|
| Rate for Payer: Cofinity Commercial |
$430.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$350.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.80
|
| Rate for Payer: Healthscope Commercial |
$450.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.85
|
| Rate for Payer: PHP Commercial |
$425.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.65
|
| Rate for Payer: Priority Health SBD |
$315.63
|
|
|
PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL
|
Facility
|
OP
|
$501.00
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
92960
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$112.17 |
| Max. Negotiated Rate |
$2,015.13 |
| Rate for Payer: Aetna Commercial |
$425.85
|
| Rate for Payer: Aetna Medicare |
$666.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$801.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$801.44
|
| Rate for Payer: BCBS Complete |
$360.84
|
| Rate for Payer: BCBS MAPPO |
$641.15
|
| Rate for Payer: BCBS Trust/PPO |
$359.76
|
| Rate for Payer: BCN Commercial |
$359.76
|
| Rate for Payer: BCN Medicare Advantage |
$641.15
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cash Price |
$400.80
|
| Rate for Payer: Cofinity Commercial |
$350.70
|
| Rate for Payer: Cofinity Commercial |
$430.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$350.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.15
|
| Rate for Payer: Healthscope Commercial |
$450.90
|
| Rate for Payer: Mclaren Medicaid |
$343.66
|
| Rate for Payer: Mclaren Medicare |
$641.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.21
|
| Rate for Payer: Meridian Medicaid |
$360.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$737.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.85
|
| Rate for Payer: Nomi Health Commercial |
$1,923.45
|
| Rate for Payer: PACE Medicare |
$609.09
|
| Rate for Payer: PACE SWMI |
$641.15
|
| Rate for Payer: PHP Commercial |
$425.85
|
| Rate for Payer: PHP Medicare Advantage |
$641.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,015.13
|
| Rate for Payer: Priority Health Medicare |
$641.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,612.10
|
| Rate for Payer: Priority Health SBD |
$315.63
|
| Rate for Payer: Railroad Medicare Medicare |
$641.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.17
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$641.15
|
| Rate for Payer: UHC Medicare Advantage |
$641.15
|
| Rate for Payer: UHCCP Medicaid |
$360.97
|
| Rate for Payer: VA VA |
$641.15
|
|
|
PR CARDIOVERSION ELECTIVE ARRHYTHMIA INTERNAL SPX
|
Professional
|
Both
|
$502.00
|
|
|
Service Code
|
HCPCS 92961
|
| Min. Negotiated Rate |
$101.96 |
| Max. Negotiated Rate |
$35,883.00 |
| Rate for Payer: Aetna Commercial |
$310.25
|
| Rate for Payer: Aetna Medicare |
$240.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$310.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$333.40
|
| Rate for Payer: BCBS Complete |
$160.14
|
| Rate for Payer: BCBS MAPPO |
$231.53
|
| Rate for Payer: BCBS Trust/PPO |
$101.96
|
| Rate for Payer: BCN Commercial |
$349.89
|
| Rate for Payer: BCN Medicare Advantage |
$231.53
|
| Rate for Payer: Cash Price |
$401.60
|
| Rate for Payer: Cash Price |
$401.60
|
| Rate for Payer: Cofinity Commercial |
$333.40
|
| Rate for Payer: Cofinity Commercial |
$310.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.53
|
| Rate for Payer: Healthscope Commercial |
$428.33
|
| Rate for Payer: Healthscope Commercial |
$370.45
|
| Rate for Payer: Mclaren Medicaid |
$152.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$243.11
|
| Rate for Payer: Meridian Medicaid |
$160.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35,883.00
|
| Rate for Payer: Nomi Health Commercial |
$277.84
|
| Rate for Payer: PACE SWMI |
$231.53
|
| Rate for Payer: PHP Medicare Advantage |
$231.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$337.12
|
| Rate for Payer: Priority Health Medicare |
$231.53
|
| Rate for Payer: Priority Health Narrow Network |
$337.12
|
| Rate for Payer: Priority Health SBD |
$337.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$231.53
|
| Rate for Payer: UHC Exchange |
$359.40
|
| Rate for Payer: UHC Medicare Advantage |
$231.53
|
| Rate for Payer: UHCCP Medicaid |
$152.51
|
|
|
PR CAREGIVER HLTH RISK ASSMT SCORE DOC STND INSTRM
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS 96161
|
| Min. Negotiated Rate |
$2.65 |
| Max. Negotiated Rate |
$371.00 |
| Rate for Payer: Aetna Commercial |
$3.55
|
| Rate for Payer: Aetna Medicare |
$2.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.82
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: BCBS MAPPO |
$2.65
|
| Rate for Payer: BCBS Trust/PPO |
$179.62
|
| Rate for Payer: BCN Commercial |
$3.91
|
| Rate for Payer: BCN Medicare Advantage |
$2.65
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cofinity Commercial |
$3.82
|
| Rate for Payer: Cofinity Commercial |
$3.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.65
|
| Rate for Payer: Healthscope Commercial |
$4.24
|
| Rate for Payer: Healthscope Commercial |
$4.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.00
|
| Rate for Payer: Nomi Health Commercial |
$3.18
|
| Rate for Payer: PACE SWMI |
$2.65
|
| Rate for Payer: PHP Medicare Advantage |
$2.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.43
|
| Rate for Payer: Priority Health Medicare |
$2.65
|
| Rate for Payer: Priority Health Narrow Network |
$5.43
|
| Rate for Payer: Priority Health SBD |
$5.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.65
|
| Rate for Payer: UHC Medicare Advantage |
$2.65
|
|
|
PR CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS
|
Professional
|
Both
|
$91.00
|
|
|
Service Code
|
HCPCS 99484
|
| Min. Negotiated Rate |
$27.26 |
| Max. Negotiated Rate |
$4,338.00 |
| Rate for Payer: Aetna Commercial |
$54.70
|
| Rate for Payer: Aetna Medicare |
$42.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.78
|
| Rate for Payer: BCBS Complete |
$28.62
|
| Rate for Payer: BCBS MAPPO |
$40.82
|
| Rate for Payer: BCBS Trust/PPO |
$594.87
|
| Rate for Payer: BCN Commercial |
$58.04
|
| Rate for Payer: BCN Medicare Advantage |
$40.82
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cofinity Commercial |
$58.78
|
| Rate for Payer: Cofinity Commercial |
$54.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.82
|
| Rate for Payer: Healthscope Commercial |
$65.31
|
| Rate for Payer: Healthscope Commercial |
$75.52
|
| Rate for Payer: Mclaren Medicaid |
$27.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.86
|
| Rate for Payer: Meridian Medicaid |
$28.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,338.00
|
| Rate for Payer: Nomi Health Commercial |
$48.98
|
| Rate for Payer: PACE SWMI |
$40.82
|
| Rate for Payer: PHP Medicare Advantage |
$40.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.79
|
| Rate for Payer: Priority Health Medicare |
$40.82
|
| Rate for Payer: Priority Health Narrow Network |
$58.79
|
| Rate for Payer: Priority Health SBD |
$58.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.82
|
| Rate for Payer: UHC Medicare Advantage |
$40.82
|
| Rate for Payer: UHCCP Medicaid |
$27.26
|
|
