|
PR CLOSED TX ULNAR FRACTURE PROXIMAL END W/MNPJ
|
Professional
|
Both
|
$1,293.00
|
|
|
Service Code
|
HCPCS 24675
|
| Min. Negotiated Rate |
$270.08 |
| Max. Negotiated Rate |
$969.75 |
| Rate for Payer: Aetna Commercial |
$546.56
|
| Rate for Payer: Aetna Medicare |
$424.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$546.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$587.35
|
| Rate for Payer: BCBS Complete |
$283.58
|
| Rate for Payer: BCBS MAPPO |
$407.88
|
| Rate for Payer: BCN Commercial |
$649.86
|
| Rate for Payer: BCN Medicare Advantage |
$407.88
|
| Rate for Payer: Cash Price |
$1,034.40
|
| Rate for Payer: Cash Price |
$1,034.40
|
| Rate for Payer: Cofinity Commercial |
$587.35
|
| Rate for Payer: Cofinity Commercial |
$546.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$407.88
|
| Rate for Payer: Healthscope Commercial |
$754.58
|
| Rate for Payer: Healthscope Commercial |
$652.61
|
| Rate for Payer: Mclaren Medicaid |
$270.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$428.27
|
| Rate for Payer: Meridian Medicaid |
$283.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$448.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$746.28
|
| Rate for Payer: Nomi Health Commercial |
$489.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.75
|
| Rate for Payer: PACE SWMI |
$407.88
|
| Rate for Payer: PHP Medicare Advantage |
$407.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$694.68
|
| Rate for Payer: Priority Health Medicare |
$407.88
|
| Rate for Payer: Priority Health SBD |
$694.68
|
| Rate for Payer: Priority Health Tiered Network |
$694.68
|
| Rate for Payer: Railroad Medicare Medicare |
$407.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$720.20
|
| Rate for Payer: UHC Core |
$720.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$407.88
|
| Rate for Payer: UHC Exchange |
$720.20
|
| Rate for Payer: UHC Medicaid |
$270.08
|
| Rate for Payer: UHCCP Medicaid |
$270.08
|
|
|
PR CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MNPJ
|
Professional
|
Both
|
$821.00
|
|
|
Service Code
|
HCPCS 24670
|
| Min. Negotiated Rate |
$179.56 |
| Max. Negotiated Rate |
$615.75 |
| Rate for Payer: Aetna Commercial |
$359.90
|
| Rate for Payer: Aetna Medicare |
$279.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.76
|
| Rate for Payer: BCBS Complete |
$188.54
|
| Rate for Payer: BCBS MAPPO |
$268.58
|
| Rate for Payer: BCN Commercial |
$423.28
|
| Rate for Payer: BCN Medicare Advantage |
$268.58
|
| Rate for Payer: Cash Price |
$656.80
|
| Rate for Payer: Cash Price |
$656.80
|
| Rate for Payer: Cofinity Commercial |
$386.76
|
| Rate for Payer: Cofinity Commercial |
$359.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.58
|
| Rate for Payer: Healthscope Commercial |
$496.87
|
| Rate for Payer: Healthscope Commercial |
$429.73
|
| Rate for Payer: Mclaren Medicaid |
$179.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$282.01
|
| Rate for Payer: Meridian Medicaid |
$188.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$295.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.93
|
| Rate for Payer: Nomi Health Commercial |
$322.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$615.75
|
| Rate for Payer: PACE SWMI |
$268.58
|
| Rate for Payer: PHP Medicare Advantage |
$268.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$452.49
|
| Rate for Payer: Priority Health Medicare |
$268.58
|
| Rate for Payer: Priority Health SBD |
$452.49
|
| Rate for Payer: Priority Health Tiered Network |
$452.49
|
| Rate for Payer: Railroad Medicare Medicare |
$268.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$454.94
|
| Rate for Payer: UHC Core |
$454.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$268.58
|
| Rate for Payer: UHC Exchange |
$454.94
|
| Rate for Payer: UHC Medicaid |
$179.56
|
| Rate for Payer: UHCCP Medicaid |
$179.56
|
|
|
PR CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION
|
Professional
|
Both
|
$1,226.00
|
|
|
Service Code
|
HCPCS 25535
|
| Min. Negotiated Rate |
$289.04 |
| Max. Negotiated Rate |
$919.50 |
| Rate for Payer: Aetna Commercial |
$585.33
|
| Rate for Payer: Aetna Medicare |
$454.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$585.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$629.01
|
| Rate for Payer: BCBS Complete |
$303.49
|
| Rate for Payer: BCBS MAPPO |
$436.81
|
| Rate for Payer: BCN Commercial |
$711.62
|
| Rate for Payer: BCN Medicare Advantage |
$436.81
|
| Rate for Payer: Cash Price |
$980.80
|
| Rate for Payer: Cash Price |
$980.80
|
| Rate for Payer: Cofinity Commercial |
$629.01
|
| Rate for Payer: Cofinity Commercial |
$585.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.81
|
| Rate for Payer: Healthscope Commercial |
$808.10
|
| Rate for Payer: Healthscope Commercial |
$698.90
|
| Rate for Payer: Mclaren Medicaid |
$289.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$458.65
|
| Rate for Payer: Meridian Medicaid |
$303.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$480.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$816.77
|
| Rate for Payer: Nomi Health Commercial |
$524.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$919.50
|
| Rate for Payer: PACE SWMI |
$436.81
|
| Rate for Payer: PHP Medicare Advantage |
$436.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$760.69
|
| Rate for Payer: Priority Health Medicare |
$436.81
|
| Rate for Payer: Priority Health SBD |
$760.69
|
| Rate for Payer: Priority Health Tiered Network |
$760.69
|
| Rate for Payer: Railroad Medicare Medicare |
$436.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$783.19
|
| Rate for Payer: UHC Core |
$783.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$436.81
|
| Rate for Payer: UHC Exchange |
$783.19
|
| Rate for Payer: UHC Medicaid |
$289.04
|
| Rate for Payer: UHCCP Medicaid |
$289.04
|
|
|
PR CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$675.00
|
|
|
Service Code
|
HCPCS 25530
|
| Min. Negotiated Rate |
$162.09 |
| Max. Negotiated Rate |
$506.25 |
| Rate for Payer: Aetna Commercial |
$323.72
|
| Rate for Payer: Aetna Medicare |
$251.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$323.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$347.88
|
| Rate for Payer: BCBS Complete |
$170.19
|
| Rate for Payer: BCBS MAPPO |
$241.58
|
| Rate for Payer: BCN Commercial |
$387.43
|
| Rate for Payer: BCN Medicare Advantage |
$241.58
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cofinity Commercial |
$347.88
|
| Rate for Payer: Cofinity Commercial |
$323.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$241.58
|
| Rate for Payer: Healthscope Commercial |
$446.92
|
| Rate for Payer: Healthscope Commercial |
$386.53
|
| Rate for Payer: Mclaren Medicaid |
$162.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$253.66
|
| Rate for Payer: Meridian Medicaid |
$170.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$265.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.70
|
| Rate for Payer: Nomi Health Commercial |
$289.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$506.25
|
| Rate for Payer: PACE SWMI |
$241.58
|
| Rate for Payer: PHP Medicare Advantage |
$241.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$414.16
|
| Rate for Payer: Priority Health Medicare |
$241.58
|
| Rate for Payer: Priority Health SBD |
$414.16
|
| Rate for Payer: Priority Health Tiered Network |
$414.16
|
| Rate for Payer: Railroad Medicare Medicare |
$241.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$409.54
|
| Rate for Payer: UHC Core |
$409.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$241.58
|
| Rate for Payer: UHC Exchange |
$409.54
|
| Rate for Payer: UHC Medicaid |
$162.09
|
| Rate for Payer: UHCCP Medicaid |
$162.09
|
|
|
PR CLOSE MEDIAN STERNOTOMY SEP W/WO DEBRIDEMENT SPX
|
Professional
|
Both
|
$2,157.00
|
|
|
Service Code
|
HCPCS 21750
|
| Min. Negotiated Rate |
$421.31 |
| Max. Negotiated Rate |
$1,617.75 |
| Rate for Payer: Aetna Commercial |
$877.97
|
| Rate for Payer: Aetna Medicare |
$681.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$877.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$943.49
|
| Rate for Payer: BCBS Complete |
$442.38
|
| Rate for Payer: BCBS MAPPO |
$655.20
|
| Rate for Payer: BCN Commercial |
$1,010.90
|
| Rate for Payer: BCN Medicare Advantage |
$655.20
|
| Rate for Payer: Cash Price |
$1,725.60
|
| Rate for Payer: Cash Price |
$1,725.60
|
| Rate for Payer: Cofinity Commercial |
$943.49
|
| Rate for Payer: Cofinity Commercial |
$877.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$655.20
|
| Rate for Payer: Healthscope Commercial |
$1,212.12
|
| Rate for Payer: Healthscope Commercial |
$1,048.32
|
| Rate for Payer: Mclaren Medicaid |
$421.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$687.96
|
| Rate for Payer: Meridian Medicaid |
$442.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$720.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,204.92
|
| Rate for Payer: Nomi Health Commercial |
$786.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,617.75
|
| Rate for Payer: PACE SWMI |
$655.20
|
| Rate for Payer: PHP Medicare Advantage |
$655.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$421.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,080.62
|
| Rate for Payer: Priority Health Medicare |
$655.20
|
| Rate for Payer: Priority Health SBD |
$1,080.62
|
| Rate for Payer: Priority Health Tiered Network |
$1,080.62
|
| Rate for Payer: Railroad Medicare Medicare |
$655.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,203.98
|
| Rate for Payer: UHC Core |
$1,203.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$655.20
|
| Rate for Payer: UHC Exchange |
$1,203.98
|
| Rate for Payer: UHC Medicaid |
$421.31
|
| Rate for Payer: UHCCP Medicaid |
$421.31
|
|
|
PR CLOSURE CYSTOSTOMY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,463.00
|
|
|
Service Code
|
HCPCS 51880
|
| Min. Negotiated Rate |
$273.92 |
| Max. Negotiated Rate |
$1,097.25 |
| Rate for Payer: Aetna Commercial |
$566.10
|
| Rate for Payer: Aetna Medicare |
$439.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$608.34
|
| Rate for Payer: BCBS Complete |
$287.62
|
| Rate for Payer: BCBS MAPPO |
$422.46
|
| Rate for Payer: BCN Commercial |
$698.67
|
| Rate for Payer: BCN Medicare Advantage |
$422.46
|
| Rate for Payer: Cash Price |
$1,170.40
|
| Rate for Payer: Cash Price |
$1,170.40
|
| Rate for Payer: Cofinity Commercial |
$608.34
|
| Rate for Payer: Cofinity Commercial |
$566.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$422.46
|
| Rate for Payer: Healthscope Commercial |
$781.55
|
| Rate for Payer: Healthscope Commercial |
$675.94
|
| Rate for Payer: Mclaren Medicaid |
$273.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$443.58
|
| Rate for Payer: Meridian Medicaid |
$287.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$464.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$816.95
|
| Rate for Payer: Nomi Health Commercial |
$506.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,097.25
|
| Rate for Payer: PACE SWMI |
$422.46
|
| Rate for Payer: PHP Medicare Advantage |
$422.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$761.07
|
| Rate for Payer: Priority Health Medicare |
$422.46
|
| Rate for Payer: Priority Health SBD |
$761.07
|
| Rate for Payer: Priority Health Tiered Network |
$761.07
|
| Rate for Payer: Railroad Medicare Medicare |
$422.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$820.10
|
| Rate for Payer: UHC Core |
$820.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$422.46
|
| Rate for Payer: UHC Exchange |
$820.10
|
| Rate for Payer: UHC Medicaid |
$273.92
|
| Rate for Payer: UHCCP Medicaid |
$273.92
|
|
|
PR CLOSURE ENTEROSTOMY LG/SMALL INTESTINE
|
Professional
|
Both
|
$2,329.00
|
|
|
Service Code
|
HCPCS 44620
|
| Min. Negotiated Rate |
$512.69 |
| Max. Negotiated Rate |
$1,746.75 |
| Rate for Payer: Aetna Commercial |
$1,067.75
|
| Rate for Payer: Aetna Medicare |
$828.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,067.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,147.44
|
| Rate for Payer: BCBS Complete |
$538.32
|
| Rate for Payer: BCBS MAPPO |
$796.83
|
| Rate for Payer: BCN Commercial |
$1,293.75
|
| Rate for Payer: BCN Medicare Advantage |
$796.83
|
| Rate for Payer: Cash Price |
$1,863.20
|
| Rate for Payer: Cash Price |
$1,863.20
|
| Rate for Payer: Cofinity Commercial |
$1,147.44
|
| Rate for Payer: Cofinity Commercial |
$1,067.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$796.83
|
| Rate for Payer: Healthscope Commercial |
$1,474.14
|
| Rate for Payer: Healthscope Commercial |
$1,274.93
|
| Rate for Payer: Mclaren Medicaid |
$512.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$836.67
|
| Rate for Payer: Meridian Medicaid |
$538.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$876.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,540.28
|
| Rate for Payer: Nomi Health Commercial |
$956.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,746.75
|
| Rate for Payer: PACE SWMI |
$796.83
|
| Rate for Payer: PHP Medicare Advantage |
$796.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$512.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,576.35
|
| Rate for Payer: Priority Health Medicare |
$796.83
|
| Rate for Payer: Priority Health SBD |
$1,576.35
|
| Rate for Payer: Priority Health Tiered Network |
$1,576.35
|
| Rate for Payer: Railroad Medicare Medicare |
$796.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,538.54
|
| Rate for Payer: UHC Core |
$1,538.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$796.83
|
| Rate for Payer: UHC Exchange |
$1,538.54
|
| Rate for Payer: UHC Medicaid |
$512.69
|
| Rate for Payer: UHCCP Medicaid |
$512.69
|
|
|
PR CLOSURE GASTROCOLIC FISTULA
|
Professional
|
Both
|
$4,010.00
|
|
|
Service Code
|
HCPCS 43880
|
| Min. Negotiated Rate |
$954.45 |
| Max. Negotiated Rate |
$3,007.50 |
| Rate for Payer: Aetna Commercial |
$2,002.82
|
| Rate for Payer: Aetna Medicare |
$1,554.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,002.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,152.28
|
| Rate for Payer: BCBS Complete |
$1,002.17
|
| Rate for Payer: BCBS MAPPO |
$1,494.64
|
| Rate for Payer: BCN Commercial |
$2,411.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,494.64
|
| Rate for Payer: Cash Price |
$3,208.00
|
| Rate for Payer: Cash Price |
$3,208.00
|
| Rate for Payer: Cofinity Commercial |
$2,152.28
|
| Rate for Payer: Cofinity Commercial |
$2,002.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,494.64
|
| Rate for Payer: Healthscope Commercial |
$2,765.08
|
| Rate for Payer: Healthscope Commercial |
$2,391.42
|
| Rate for Payer: Mclaren Medicaid |
$954.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,569.37
|
| Rate for Payer: Meridian Medicaid |
$1,002.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,644.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,838.64
|
| Rate for Payer: Nomi Health Commercial |
$1,793.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,007.50
|
| Rate for Payer: PACE SWMI |
$1,494.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,494.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$954.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,938.52
|
| Rate for Payer: Priority Health Medicare |
$1,494.64
|
| Rate for Payer: Priority Health SBD |
$2,938.52
|
| Rate for Payer: Priority Health Tiered Network |
$2,938.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1,494.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,844.57
|
| Rate for Payer: UHC Core |
$2,844.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,494.64
|
| Rate for Payer: UHC Exchange |
$2,844.57
|
| Rate for Payer: UHC Medicaid |
$954.45
|
| Rate for Payer: UHCCP Medicaid |
$954.45
|
|
|
PR CLOSURE GASTROSTOMY SURGICAL
|
Professional
|
Both
|
$2,014.00
|
|
|
Service Code
|
HCPCS 43870
|
| Min. Negotiated Rate |
$429.62 |
| Max. Negotiated Rate |
$1,510.50 |
| Rate for Payer: Aetna Commercial |
$893.93
|
| Rate for Payer: Aetna Medicare |
$693.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$893.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$960.64
|
| Rate for Payer: BCBS Complete |
$451.10
|
| Rate for Payer: BCBS MAPPO |
$667.11
|
| Rate for Payer: BCN Commercial |
$1,067.67
|
| Rate for Payer: BCN Medicare Advantage |
$667.11
|
| Rate for Payer: Cash Price |
$1,611.20
|
| Rate for Payer: Cash Price |
$1,611.20
|
| Rate for Payer: Cofinity Commercial |
$960.64
|
| Rate for Payer: Cofinity Commercial |
$893.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$667.11
|
| Rate for Payer: Healthscope Commercial |
$1,234.15
|
| Rate for Payer: Healthscope Commercial |
$1,067.38
|
| Rate for Payer: Mclaren Medicaid |
$429.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$700.47
|
| Rate for Payer: Meridian Medicaid |
$451.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$733.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,270.35
|
| Rate for Payer: Nomi Health Commercial |
$800.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,510.50
|
| Rate for Payer: PACE SWMI |
$667.11
|
| Rate for Payer: PHP Medicare Advantage |
$667.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,300.89
|
| Rate for Payer: Priority Health Medicare |
$667.11
|
| Rate for Payer: Priority Health SBD |
$1,300.89
|
| Rate for Payer: Priority Health Tiered Network |
$1,300.89
|
| Rate for Payer: Railroad Medicare Medicare |
$667.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,262.91
|
| Rate for Payer: UHC Core |
$1,262.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$667.11
|
| Rate for Payer: UHC Exchange |
$1,262.91
|
| Rate for Payer: UHC Medicaid |
$429.62
|
| Rate for Payer: UHCCP Medicaid |
$429.62
|
|
|
PR CLOSURE INTESTINAL CUTANEOUS FISTULA
|
Professional
|
Both
|
$2,622.00
|
|
|
Service Code
|
HCPCS 44640
|
| Min. Negotiated Rate |
$818.77 |
| Max. Negotiated Rate |
$2,538.06 |
| Rate for Payer: Aetna Commercial |
$1,715.17
|
| Rate for Payer: Aetna Medicare |
$1,331.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,715.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,843.17
|
| Rate for Payer: BCBS Complete |
$859.71
|
| Rate for Payer: BCBS MAPPO |
$1,279.98
|
| Rate for Payer: BCN Commercial |
$2,083.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,279.98
|
| Rate for Payer: Cash Price |
$2,097.60
|
| Rate for Payer: Cash Price |
$2,097.60
|
| Rate for Payer: Cofinity Commercial |
$1,843.17
|
| Rate for Payer: Cofinity Commercial |
$1,715.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,279.98
|
| Rate for Payer: Healthscope Commercial |
$2,367.96
|
| Rate for Payer: Healthscope Commercial |
$2,047.97
|
| Rate for Payer: Mclaren Medicaid |
$818.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,343.98
|
| Rate for Payer: Meridian Medicaid |
$859.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,407.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,488.68
|
| Rate for Payer: Nomi Health Commercial |
$1,535.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,966.50
|
| Rate for Payer: PACE SWMI |
$1,279.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,279.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$818.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,538.06
|
| Rate for Payer: Priority Health Medicare |
$1,279.98
|
| Rate for Payer: Priority Health SBD |
$2,538.06
|
| Rate for Payer: Priority Health Tiered Network |
$2,538.06
|
| Rate for Payer: Railroad Medicare Medicare |
$1,279.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,494.69
|
| Rate for Payer: UHC Core |
$2,494.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,279.98
|
| Rate for Payer: UHC Exchange |
$2,494.69
|
| Rate for Payer: UHC Medicaid |
$818.77
|
| Rate for Payer: UHCCP Medicaid |
$818.77
|
|
|
PR CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<
|
Professional
|
Both
|
$553.00
|
|
|
Service Code
|
HCPCS 40830
|
| Min. Negotiated Rate |
$88.40 |
| Max. Negotiated Rate |
$414.75 |
| Rate for Payer: Aetna Commercial |
$178.70
|
| Rate for Payer: Aetna Medicare |
$138.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.04
|
| Rate for Payer: BCBS Complete |
$92.82
|
| Rate for Payer: BCBS MAPPO |
$133.36
|
| Rate for Payer: BCN Commercial |
$221.60
|
| Rate for Payer: BCN Medicare Advantage |
$133.36
|
| Rate for Payer: Cash Price |
$442.40
|
| Rate for Payer: Cash Price |
$442.40
|
| Rate for Payer: Cofinity Commercial |
$192.04
|
| Rate for Payer: Cofinity Commercial |
$178.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.36
|
| Rate for Payer: Healthscope Commercial |
$246.72
|
| Rate for Payer: Healthscope Commercial |
$213.38
|
| Rate for Payer: Mclaren Medicaid |
$88.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.03
|
| Rate for Payer: Meridian Medicaid |
$92.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$146.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.38
|
| Rate for Payer: Nomi Health Commercial |
$160.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$414.75
|
| Rate for Payer: PACE SWMI |
$133.36
|
| Rate for Payer: PHP Medicare Advantage |
$133.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$270.00
|
| Rate for Payer: Priority Health Medicare |
$133.36
|
| Rate for Payer: Priority Health SBD |
$270.00
|
| Rate for Payer: Priority Health Tiered Network |
$270.00
|
| Rate for Payer: Railroad Medicare Medicare |
$133.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$289.50
|
| Rate for Payer: UHC Core |
$289.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$133.36
|
| Rate for Payer: UHC Exchange |
$289.50
|
| Rate for Payer: UHC Medicaid |
$88.40
|
| Rate for Payer: UHCCP Medicaid |
$88.40
|
|
|
PR CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL
|
Professional
|
Both
|
$712.00
|
|
|
Service Code
|
HCPCS 40831
|
| Min. Negotiated Rate |
$123.33 |
| Max. Negotiated Rate |
$534.00 |
| Rate for Payer: Aetna Commercial |
$249.66
|
| Rate for Payer: Aetna Medicare |
$193.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.29
|
| Rate for Payer: BCBS Complete |
$129.50
|
| Rate for Payer: BCBS MAPPO |
$186.31
|
| Rate for Payer: BCN Commercial |
$306.26
|
| Rate for Payer: BCN Medicare Advantage |
$186.31
|
| Rate for Payer: Cash Price |
$569.60
|
| Rate for Payer: Cash Price |
$569.60
|
| Rate for Payer: Cofinity Commercial |
$268.29
|
| Rate for Payer: Cofinity Commercial |
$249.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.31
|
| Rate for Payer: Healthscope Commercial |
$344.67
|
| Rate for Payer: Healthscope Commercial |
$298.10
|
| Rate for Payer: Mclaren Medicaid |
$123.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.63
|
| Rate for Payer: Meridian Medicaid |
$129.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$204.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.40
|
| Rate for Payer: Nomi Health Commercial |
$223.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$534.00
|
| Rate for Payer: PACE SWMI |
$186.31
|
| Rate for Payer: PHP Medicare Advantage |
$186.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$373.15
|
| Rate for Payer: Priority Health Medicare |
$186.31
|
| Rate for Payer: Priority Health SBD |
$373.15
|
| Rate for Payer: Priority Health Tiered Network |
$373.15
|
| Rate for Payer: Railroad Medicare Medicare |
$186.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.50
|
| Rate for Payer: UHC Core |
$397.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$186.31
|
| Rate for Payer: UHC Exchange |
$397.50
|
| Rate for Payer: UHC Medicaid |
$123.33
|
| Rate for Payer: UHCCP Medicaid |
$123.33
|
|
|
PR CLOSURE RECTOURETHRAL FISTULA
|
Professional
|
Both
|
$3,381.00
|
|
|
Service Code
|
HCPCS 45820
|
| Min. Negotiated Rate |
$772.98 |
| Max. Negotiated Rate |
$2,535.75 |
| Rate for Payer: Aetna Commercial |
$1,611.50
|
| Rate for Payer: Aetna Medicare |
$1,250.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,611.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,731.76
|
| Rate for Payer: BCBS Complete |
$811.63
|
| Rate for Payer: BCBS MAPPO |
$1,202.61
|
| Rate for Payer: BCN Commercial |
$1,917.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,202.61
|
| Rate for Payer: Cash Price |
$2,704.80
|
| Rate for Payer: Cash Price |
$2,704.80
|
| Rate for Payer: Cofinity Commercial |
$1,731.76
|
| Rate for Payer: Cofinity Commercial |
$1,611.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,202.61
|
| Rate for Payer: Healthscope Commercial |
$2,224.83
|
| Rate for Payer: Healthscope Commercial |
$1,924.18
|
| Rate for Payer: Mclaren Medicaid |
$772.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,262.74
|
| Rate for Payer: Meridian Medicaid |
$811.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,322.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,279.72
|
| Rate for Payer: Nomi Health Commercial |
$1,443.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,535.75
|
| Rate for Payer: PACE SWMI |
$1,202.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,202.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$772.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,336.62
|
| Rate for Payer: Priority Health Medicare |
$1,202.61
|
| Rate for Payer: Priority Health SBD |
$2,336.62
|
| Rate for Payer: Priority Health Tiered Network |
$2,336.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,202.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,263.62
|
| Rate for Payer: UHC Core |
$2,263.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,202.61
|
| Rate for Payer: UHC Exchange |
$2,263.62
|
| Rate for Payer: UHC Medicaid |
$772.98
|
| Rate for Payer: UHCCP Medicaid |
$772.98
|
|
|
PR CLOSURE RECTOVESICAL FISTULA
|
Professional
|
Both
|
$2,945.00
|
|
|
Service Code
|
HCPCS 45800
|
| Min. Negotiated Rate |
$771.27 |
| Max. Negotiated Rate |
$2,331.16 |
| Rate for Payer: Aetna Commercial |
$1,607.91
|
| Rate for Payer: Aetna Medicare |
$1,247.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,607.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,727.90
|
| Rate for Payer: BCBS Complete |
$809.83
|
| Rate for Payer: BCBS MAPPO |
$1,199.93
|
| Rate for Payer: BCN Commercial |
$1,913.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,199.93
|
| Rate for Payer: Cash Price |
$2,356.00
|
| Rate for Payer: Cash Price |
$2,356.00
|
| Rate for Payer: Cofinity Commercial |
$1,727.90
|
| Rate for Payer: Cofinity Commercial |
$1,607.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,199.93
|
| Rate for Payer: Healthscope Commercial |
$2,219.87
|
| Rate for Payer: Healthscope Commercial |
$1,919.89
|
| Rate for Payer: Mclaren Medicaid |
$771.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,259.93
|
| Rate for Payer: Meridian Medicaid |
$809.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,319.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,273.74
|
| Rate for Payer: Nomi Health Commercial |
$1,439.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,208.75
|
| Rate for Payer: PACE SWMI |
$1,199.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,199.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$771.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,331.16
|
| Rate for Payer: Priority Health Medicare |
$1,199.93
|
| Rate for Payer: Priority Health SBD |
$2,331.16
|
| Rate for Payer: Priority Health Tiered Network |
$2,331.16
|
| Rate for Payer: Railroad Medicare Medicare |
$1,199.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,257.44
|
| Rate for Payer: UHC Core |
$2,257.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,199.93
|
| Rate for Payer: UHC Exchange |
$2,257.44
|
| Rate for Payer: UHC Medicaid |
$771.27
|
| Rate for Payer: UHCCP Medicaid |
$771.27
|
|
|
PR CLOSURE SALIVARY FISTULA
|
Professional
|
Both
|
$843.00
|
|
|
Service Code
|
HCPCS 42600
|
| Min. Negotiated Rate |
$203.63 |
| Max. Negotiated Rate |
$658.33 |
| Rate for Payer: Aetna Commercial |
$416.19
|
| Rate for Payer: Aetna Medicare |
$323.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.25
|
| Rate for Payer: BCBS Complete |
$213.81
|
| Rate for Payer: BCBS MAPPO |
$310.59
|
| Rate for Payer: BCN Commercial |
$540.31
|
| Rate for Payer: BCN Medicare Advantage |
$310.59
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cofinity Commercial |
$447.25
|
| Rate for Payer: Cofinity Commercial |
$416.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.59
|
| Rate for Payer: Healthscope Commercial |
$574.59
|
| Rate for Payer: Healthscope Commercial |
$496.94
|
| Rate for Payer: Mclaren Medicaid |
$203.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$326.12
|
| Rate for Payer: Meridian Medicaid |
$213.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$341.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$630.22
|
| Rate for Payer: Nomi Health Commercial |
$372.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$632.25
|
| Rate for Payer: PACE SWMI |
$310.59
|
| Rate for Payer: PHP Medicare Advantage |
$310.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$658.33
|
| Rate for Payer: Priority Health Medicare |
$310.59
|
| Rate for Payer: Priority Health SBD |
$658.33
|
| Rate for Payer: Priority Health Tiered Network |
$658.33
|
| Rate for Payer: Railroad Medicare Medicare |
$310.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$603.80
|
| Rate for Payer: UHC Core |
$603.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$310.59
|
| Rate for Payer: UHC Exchange |
$603.80
|
| Rate for Payer: UHC Medicaid |
$203.63
|
| Rate for Payer: UHCCP Medicaid |
$203.63
|
|
|
PR CLOSURE VESICOVAGINAL FISTULA VAGINAL APPROACH
|
Professional
|
Both
|
$992.00
|
|
|
Service Code
|
HCPCS 57320
|
| Min. Negotiated Rate |
$319.93 |
| Max. Negotiated Rate |
$1,008.88 |
| Rate for Payer: Aetna Commercial |
$661.99
|
| Rate for Payer: Aetna Medicare |
$513.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$661.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$711.39
|
| Rate for Payer: BCBS Complete |
$335.93
|
| Rate for Payer: BCBS MAPPO |
$494.02
|
| Rate for Payer: BCN Commercial |
$847.06
|
| Rate for Payer: BCN Medicare Advantage |
$494.02
|
| Rate for Payer: Cash Price |
$793.60
|
| Rate for Payer: Cash Price |
$793.60
|
| Rate for Payer: Cofinity Commercial |
$711.39
|
| Rate for Payer: Cofinity Commercial |
$661.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$494.02
|
| Rate for Payer: Healthscope Commercial |
$913.94
|
| Rate for Payer: Healthscope Commercial |
$790.43
|
| Rate for Payer: Mclaren Medicaid |
$319.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$518.72
|
| Rate for Payer: Meridian Medicaid |
$335.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$543.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,008.88
|
| Rate for Payer: Nomi Health Commercial |
$592.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$744.00
|
| Rate for Payer: PACE SWMI |
$494.02
|
| Rate for Payer: PHP Medicare Advantage |
$494.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$857.89
|
| Rate for Payer: Priority Health Medicare |
$494.02
|
| Rate for Payer: Priority Health SBD |
$857.89
|
| Rate for Payer: Priority Health Tiered Network |
$857.89
|
| Rate for Payer: Railroad Medicare Medicare |
$494.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$964.24
|
| Rate for Payer: UHC Core |
$964.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$494.02
|
| Rate for Payer: UHC Exchange |
$964.24
|
| Rate for Payer: UHC Medicaid |
$319.93
|
| Rate for Payer: UHCCP Medicaid |
$319.93
|
|
|
PR CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION
|
Professional
|
Both
|
$616.00
|
|
|
Service Code
|
HCPCS 23540
|
| Min. Negotiated Rate |
$163.80 |
| Max. Negotiated Rate |
$462.00 |
| Rate for Payer: Aetna Commercial |
$327.94
|
| Rate for Payer: Aetna Medicare |
$254.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$327.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.41
|
| Rate for Payer: BCBS Complete |
$171.99
|
| Rate for Payer: BCBS MAPPO |
$244.73
|
| Rate for Payer: BCN Commercial |
$372.99
|
| Rate for Payer: BCN Medicare Advantage |
$244.73
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$352.41
|
| Rate for Payer: Cofinity Commercial |
$327.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$244.73
|
| Rate for Payer: Healthscope Commercial |
$452.75
|
| Rate for Payer: Healthscope Commercial |
$391.57
|
| Rate for Payer: Mclaren Medicaid |
$163.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$256.97
|
| Rate for Payer: Meridian Medicaid |
$171.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$269.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$423.09
|
| Rate for Payer: Nomi Health Commercial |
$293.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$462.00
|
| Rate for Payer: PACE SWMI |
$244.73
|
| Rate for Payer: PHP Medicare Advantage |
$244.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$398.72
|
| Rate for Payer: Priority Health Medicare |
$244.73
|
| Rate for Payer: Priority Health SBD |
$398.72
|
| Rate for Payer: Priority Health Tiered Network |
$398.72
|
| Rate for Payer: Railroad Medicare Medicare |
$244.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.55
|
| Rate for Payer: UHC Core |
$396.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$244.73
|
| Rate for Payer: UHC Exchange |
$396.55
|
| Rate for Payer: UHC Medicaid |
$163.80
|
| Rate for Payer: UHCCP Medicaid |
$163.80
|
|
|
PR CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$531.00
|
|
|
Service Code
|
HCPCS 23500
|
| Min. Negotiated Rate |
$156.34 |
| Max. Negotiated Rate |
$431.66 |
| Rate for Payer: Aetna Commercial |
$312.66
|
| Rate for Payer: Aetna Medicare |
$242.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.00
|
| Rate for Payer: BCBS Complete |
$164.16
|
| Rate for Payer: BCBS MAPPO |
$233.33
|
| Rate for Payer: BCN Commercial |
$363.53
|
| Rate for Payer: BCN Medicare Advantage |
$233.33
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cofinity Commercial |
$336.00
|
| Rate for Payer: Cofinity Commercial |
$312.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.33
|
| Rate for Payer: Healthscope Commercial |
$431.66
|
| Rate for Payer: Healthscope Commercial |
$373.33
|
| Rate for Payer: Mclaren Medicaid |
$156.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.00
|
| Rate for Payer: Meridian Medicaid |
$164.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$256.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$408.19
|
| Rate for Payer: Nomi Health Commercial |
$280.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$398.25
|
| Rate for Payer: PACE SWMI |
$233.33
|
| Rate for Payer: PHP Medicare Advantage |
$233.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$388.60
|
| Rate for Payer: Priority Health Medicare |
$233.33
|
| Rate for Payer: Priority Health SBD |
$388.60
|
| Rate for Payer: Priority Health Tiered Network |
$388.60
|
| Rate for Payer: Railroad Medicare Medicare |
$233.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$384.66
|
| Rate for Payer: UHC Core |
$384.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$233.33
|
| Rate for Payer: UHC Exchange |
$384.66
|
| Rate for Payer: UHC Medicaid |
$156.34
|
| Rate for Payer: UHCCP Medicaid |
$156.34
|
|
|
PR CLSD TX PELVIC RING FX W/MANIPULATION W/ANES
|
Professional
|
Both
|
$473.00
|
|
|
Service Code
|
HCPCS 27198
|
| Min. Negotiated Rate |
$181.26 |
| Max. Negotiated Rate |
$558.70 |
| Rate for Payer: Aetna Commercial |
$375.35
|
| Rate for Payer: Aetna Medicare |
$291.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$403.36
|
| Rate for Payer: BCBS Complete |
$190.32
|
| Rate for Payer: BCBS MAPPO |
$280.11
|
| Rate for Payer: BCN Commercial |
$478.07
|
| Rate for Payer: BCN Medicare Advantage |
$280.11
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cofinity Commercial |
$403.36
|
| Rate for Payer: Cofinity Commercial |
$375.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.11
|
| Rate for Payer: Healthscope Commercial |
$518.20
|
| Rate for Payer: Healthscope Commercial |
$448.18
|
| Rate for Payer: Mclaren Medicaid |
$181.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.12
|
| Rate for Payer: Meridian Medicaid |
$190.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$308.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$558.70
|
| Rate for Payer: Nomi Health Commercial |
$336.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.75
|
| Rate for Payer: PACE SWMI |
$280.11
|
| Rate for Payer: PHP Medicare Advantage |
$280.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$511.04
|
| Rate for Payer: Priority Health Medicare |
$280.11
|
| Rate for Payer: Priority Health SBD |
$511.04
|
| Rate for Payer: Priority Health Tiered Network |
$511.04
|
| Rate for Payer: Railroad Medicare Medicare |
$280.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$537.45
|
| Rate for Payer: UHC Core |
$537.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$280.11
|
| Rate for Payer: UHC Exchange |
$537.45
|
| Rate for Payer: UHC Medicaid |
$181.26
|
| Rate for Payer: UHCCP Medicaid |
$181.26
|
|
|
PR CLSD TX PELVIC RING FX W/O MANIPULATION
|
Professional
|
Both
|
$243.00
|
|
|
Service Code
|
HCPCS 27197
|
| Min. Negotiated Rate |
$78.81 |
| Max. Negotiated Rate |
$234.70 |
| Rate for Payer: Aetna Commercial |
$159.90
|
| Rate for Payer: Aetna Medicare |
$124.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.84
|
| Rate for Payer: BCBS Complete |
$82.75
|
| Rate for Payer: BCBS MAPPO |
$119.33
|
| Rate for Payer: BCN Commercial |
$200.69
|
| Rate for Payer: BCN Medicare Advantage |
$119.33
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cofinity Commercial |
$171.84
|
| Rate for Payer: Cofinity Commercial |
$159.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.33
|
| Rate for Payer: Healthscope Commercial |
$220.76
|
| Rate for Payer: Healthscope Commercial |
$190.93
|
| Rate for Payer: Mclaren Medicaid |
$78.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.30
|
| Rate for Payer: Meridian Medicaid |
$82.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$131.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.70
|
| Rate for Payer: Nomi Health Commercial |
$143.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.25
|
| Rate for Payer: PACE SWMI |
$119.33
|
| Rate for Payer: PHP Medicare Advantage |
$119.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$214.53
|
| Rate for Payer: Priority Health Medicare |
$119.33
|
| Rate for Payer: Priority Health SBD |
$214.53
|
| Rate for Payer: Priority Health Tiered Network |
$214.53
|
| Rate for Payer: Railroad Medicare Medicare |
$119.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$221.19
|
| Rate for Payer: UHC Core |
$221.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$119.33
|
| Rate for Payer: UHC Exchange |
$221.19
|
| Rate for Payer: UHC Medicaid |
$78.81
|
| Rate for Payer: UHCCP Medicaid |
$78.81
|
|
|
PR CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES
|
Professional
|
Both
|
$1,062.00
|
|
|
Service Code
|
HCPCS 23655
|
| Min. Negotiated Rate |
$267.10 |
| Max. Negotiated Rate |
$796.50 |
| Rate for Payer: Aetna Commercial |
$540.36
|
| Rate for Payer: Aetna Medicare |
$419.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$540.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.68
|
| Rate for Payer: BCBS Complete |
$280.45
|
| Rate for Payer: BCBS MAPPO |
$403.25
|
| Rate for Payer: BCN Commercial |
$631.94
|
| Rate for Payer: BCN Medicare Advantage |
$403.25
|
| Rate for Payer: Cash Price |
$849.60
|
| Rate for Payer: Cash Price |
$849.60
|
| Rate for Payer: Cofinity Commercial |
$580.68
|
| Rate for Payer: Cofinity Commercial |
$540.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.25
|
| Rate for Payer: Healthscope Commercial |
$746.01
|
| Rate for Payer: Healthscope Commercial |
$645.20
|
| Rate for Payer: Mclaren Medicaid |
$267.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.41
|
| Rate for Payer: Meridian Medicaid |
$280.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$443.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$725.81
|
| Rate for Payer: Nomi Health Commercial |
$483.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$796.50
|
| Rate for Payer: PACE SWMI |
$403.25
|
| Rate for Payer: PHP Medicare Advantage |
$403.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$675.53
|
| Rate for Payer: Priority Health Medicare |
$403.25
|
| Rate for Payer: Priority Health SBD |
$675.53
|
| Rate for Payer: Priority Health Tiered Network |
$675.53
|
| Rate for Payer: Railroad Medicare Medicare |
$403.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$699.03
|
| Rate for Payer: UHC Core |
$699.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$403.25
|
| Rate for Payer: UHC Exchange |
$699.03
|
| Rate for Payer: UHC Medicaid |
$267.10
|
| Rate for Payer: UHCCP Medicaid |
$267.10
|
|
|
PR CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES
|
Professional
|
Both
|
$715.00
|
|
|
Service Code
|
HCPCS 23650
|
| Min. Negotiated Rate |
$234.51 |
| Max. Negotiated Rate |
$650.57 |
| Rate for Payer: Aetna Commercial |
$471.22
|
| Rate for Payer: Aetna Medicare |
$365.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$471.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$506.39
|
| Rate for Payer: BCBS Complete |
$246.24
|
| Rate for Payer: BCBS MAPPO |
$351.66
|
| Rate for Payer: BCN Commercial |
$473.58
|
| Rate for Payer: BCN Medicare Advantage |
$351.66
|
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Cash Price |
$572.00
|
| Rate for Payer: Cofinity Commercial |
$506.39
|
| Rate for Payer: Cofinity Commercial |
$471.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.66
|
| Rate for Payer: Healthscope Commercial |
$650.57
|
| Rate for Payer: Healthscope Commercial |
$562.66
|
| Rate for Payer: Mclaren Medicaid |
$234.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$369.24
|
| Rate for Payer: Meridian Medicaid |
$246.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$386.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$538.20
|
| Rate for Payer: Nomi Health Commercial |
$421.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$536.25
|
| Rate for Payer: PACE SWMI |
$351.66
|
| Rate for Payer: PHP Medicare Advantage |
$351.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$506.25
|
| Rate for Payer: Priority Health Medicare |
$351.66
|
| Rate for Payer: Priority Health SBD |
$506.25
|
| Rate for Payer: Priority Health Tiered Network |
$506.25
|
| Rate for Payer: Railroad Medicare Medicare |
$351.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$502.72
|
| Rate for Payer: UHC Core |
$502.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$351.66
|
| Rate for Payer: UHC Exchange |
$502.72
|
| Rate for Payer: UHC Medicaid |
$234.51
|
| Rate for Payer: UHCCP Medicaid |
$234.51
|
|
|
PR CLSR ANAL FSTL W/RCT ADVMNT FLAP
|
Professional
|
Both
|
$1,728.00
|
|
|
Service Code
|
HCPCS 46288
|
| Min. Negotiated Rate |
$352.30 |
| Max. Negotiated Rate |
$1,296.00 |
| Rate for Payer: Aetna Commercial |
$719.34
|
| Rate for Payer: Aetna Medicare |
$558.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$719.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$773.02
|
| Rate for Payer: BCBS Complete |
$369.92
|
| Rate for Payer: BCBS MAPPO |
$536.82
|
| Rate for Payer: BCN Commercial |
$847.57
|
| Rate for Payer: BCN Medicare Advantage |
$536.82
|
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Cofinity Commercial |
$773.02
|
| Rate for Payer: Cofinity Commercial |
$719.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.82
|
| Rate for Payer: Healthscope Commercial |
$993.12
|
| Rate for Payer: Healthscope Commercial |
$858.91
|
| Rate for Payer: Mclaren Medicaid |
$352.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$563.66
|
| Rate for Payer: Meridian Medicaid |
$369.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$590.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$986.35
|
| Rate for Payer: Nomi Health Commercial |
$644.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,296.00
|
| Rate for Payer: PACE SWMI |
$536.82
|
| Rate for Payer: PHP Medicare Advantage |
$536.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,032.71
|
| Rate for Payer: Priority Health Medicare |
$536.82
|
| Rate for Payer: Priority Health SBD |
$1,032.71
|
| Rate for Payer: Priority Health Tiered Network |
$1,032.71
|
| Rate for Payer: Railroad Medicare Medicare |
$536.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$964.22
|
| Rate for Payer: UHC Core |
$964.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$536.82
|
| Rate for Payer: UHC Exchange |
$964.22
|
| Rate for Payer: UHC Medicaid |
$352.30
|
| Rate for Payer: UHCCP Medicaid |
$352.30
|
|
|
PR CLSR CH WALL FLWG OPN FLAP DRG EMPYEMA
|
Professional
|
Both
|
$1,928.00
|
|
|
Service Code
|
HCPCS 32810
|
| Min. Negotiated Rate |
$557.21 |
| Max. Negotiated Rate |
$1,603.06 |
| Rate for Payer: Aetna Commercial |
$1,161.14
|
| Rate for Payer: Aetna Medicare |
$901.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,161.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,247.79
|
| Rate for Payer: BCBS Complete |
$585.07
|
| Rate for Payer: BCBS MAPPO |
$866.52
|
| Rate for Payer: BCN Commercial |
$1,340.07
|
| Rate for Payer: BCN Medicare Advantage |
$866.52
|
| Rate for Payer: Cash Price |
$1,542.40
|
| Rate for Payer: Cash Price |
$1,542.40
|
| Rate for Payer: Cofinity Commercial |
$1,247.79
|
| Rate for Payer: Cofinity Commercial |
$1,161.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$866.52
|
| Rate for Payer: Healthscope Commercial |
$1,603.06
|
| Rate for Payer: Healthscope Commercial |
$1,386.43
|
| Rate for Payer: Mclaren Medicaid |
$557.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$909.85
|
| Rate for Payer: Meridian Medicaid |
$585.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$953.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,595.41
|
| Rate for Payer: Nomi Health Commercial |
$1,039.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,446.00
|
| Rate for Payer: PACE SWMI |
$866.52
|
| Rate for Payer: PHP Medicare Advantage |
$866.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$557.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,261.94
|
| Rate for Payer: Priority Health Medicare |
$866.52
|
| Rate for Payer: Priority Health SBD |
$1,261.94
|
| Rate for Payer: Priority Health Tiered Network |
$1,261.94
|
| Rate for Payer: Railroad Medicare Medicare |
$866.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,590.55
|
| Rate for Payer: UHC Core |
$1,590.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$866.52
|
| Rate for Payer: UHC Exchange |
$1,590.55
|
| Rate for Payer: UHC Medicaid |
$557.21
|
| Rate for Payer: UHCCP Medicaid |
$557.21
|
|
|
PR CLSR ENTEROENTERIC/ENTEROCOLIC FSTL
|
Professional
|
Both
|
$2,656.00
|
|
|
Service Code
|
HCPCS 44650
|
| Min. Negotiated Rate |
$843.91 |
| Max. Negotiated Rate |
$2,611.48 |
| Rate for Payer: Aetna Commercial |
$1,767.54
|
| Rate for Payer: Aetna Medicare |
$1,371.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,767.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,899.45
|
| Rate for Payer: BCBS Complete |
$886.11
|
| Rate for Payer: BCBS MAPPO |
$1,319.06
|
| Rate for Payer: BCN Commercial |
$2,143.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,319.06
|
| Rate for Payer: Cash Price |
$2,124.80
|
| Rate for Payer: Cash Price |
$2,124.80
|
| Rate for Payer: Cofinity Commercial |
$1,899.45
|
| Rate for Payer: Cofinity Commercial |
$1,767.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,319.06
|
| Rate for Payer: Healthscope Commercial |
$2,440.26
|
| Rate for Payer: Healthscope Commercial |
$2,110.50
|
| Rate for Payer: Mclaren Medicaid |
$843.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,385.01
|
| Rate for Payer: Meridian Medicaid |
$886.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,450.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,566.51
|
| Rate for Payer: Nomi Health Commercial |
$1,582.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,992.00
|
| Rate for Payer: PACE SWMI |
$1,319.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,319.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$843.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,611.48
|
| Rate for Payer: Priority Health Medicare |
$1,319.06
|
| Rate for Payer: Priority Health SBD |
$2,611.48
|
| Rate for Payer: Priority Health Tiered Network |
$2,611.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,319.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,578.73
|
| Rate for Payer: UHC Core |
$2,578.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,319.06
|
| Rate for Payer: UHC Exchange |
$2,578.73
|
| Rate for Payer: UHC Medicaid |
$843.91
|
| Rate for Payer: UHCCP Medicaid |
$843.91
|
|
