|
PR CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$614.00
|
|
|
Service Code
|
HCPCS 23570
|
| Min. Negotiated Rate |
$164.86 |
| Max. Negotiated Rate |
$43,178.00 |
| Rate for Payer: Aetna Commercial |
$320.30
|
| Rate for Payer: Aetna Medicare |
$248.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.20
|
| Rate for Payer: BCBS Complete |
$173.10
|
| Rate for Payer: BCBS MAPPO |
$239.03
|
| Rate for Payer: BCBS Trust/PPO |
$553.66
|
| Rate for Payer: BCN Commercial |
$353.31
|
| Rate for Payer: BCN Medicare Advantage |
$239.03
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cofinity Commercial |
$344.20
|
| Rate for Payer: Cofinity Commercial |
$320.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.03
|
| Rate for Payer: Healthscope Commercial |
$442.21
|
| Rate for Payer: Healthscope Commercial |
$382.45
|
| Rate for Payer: Mclaren Medicaid |
$164.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$250.98
|
| Rate for Payer: Meridian Medicaid |
$173.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,178.00
|
| Rate for Payer: Nomi Health Commercial |
$286.84
|
| Rate for Payer: PACE SWMI |
$239.03
|
| Rate for Payer: PHP Medicare Advantage |
$239.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$387.75
|
| Rate for Payer: Priority Health Medicare |
$239.03
|
| Rate for Payer: Priority Health Narrow Network |
$387.75
|
| Rate for Payer: Priority Health SBD |
$387.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.03
|
| Rate for Payer: UHC Exchange |
$252.95
|
| Rate for Payer: UHC Medicare Advantage |
$239.03
|
| Rate for Payer: UHCCP Medicaid |
$164.86
|
|
|
PR CLOSED TX STERNOCLAVICULAR DISLC W/MANIPULATION
|
Professional
|
Both
|
$783.00
|
|
|
Service Code
|
HCPCS 23525
|
| Min. Negotiated Rate |
$244.52 |
| Max. Negotiated Rate |
$64,715.00 |
| Rate for Payer: Aetna Commercial |
$476.89
|
| Rate for Payer: Aetna Medicare |
$370.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$476.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.48
|
| Rate for Payer: BCBS Complete |
$256.75
|
| Rate for Payer: BCBS MAPPO |
$355.89
|
| Rate for Payer: BCBS Trust/PPO |
$399.45
|
| Rate for Payer: BCN Commercial |
$595.21
|
| Rate for Payer: BCN Medicare Advantage |
$355.89
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cofinity Commercial |
$512.48
|
| Rate for Payer: Cofinity Commercial |
$476.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$355.89
|
| Rate for Payer: Healthscope Commercial |
$658.40
|
| Rate for Payer: Healthscope Commercial |
$569.42
|
| Rate for Payer: Mclaren Medicaid |
$244.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.68
|
| Rate for Payer: Meridian Medicaid |
$256.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64,715.00
|
| Rate for Payer: Nomi Health Commercial |
$427.07
|
| Rate for Payer: PACE SWMI |
$355.89
|
| Rate for Payer: PHP Medicare Advantage |
$355.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$508.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$576.54
|
| Rate for Payer: Priority Health Medicare |
$355.89
|
| Rate for Payer: Priority Health Narrow Network |
$576.54
|
| Rate for Payer: Priority Health SBD |
$576.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$355.89
|
| Rate for Payer: UHC Exchange |
$386.36
|
| Rate for Payer: UHC Medicare Advantage |
$355.89
|
| Rate for Payer: UHCCP Medicaid |
$244.52
|
|
|
PR CLOSED TX TALOTARSAL JOINT DISLC W/O ANES
|
Professional
|
Both
|
$358.00
|
|
|
Service Code
|
HCPCS 28570
|
| Min. Negotiated Rate |
$133.55 |
| Max. Negotiated Rate |
$34,760.00 |
| Rate for Payer: Aetna Commercial |
$258.69
|
| Rate for Payer: Aetna Medicare |
$200.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$277.99
|
| Rate for Payer: BCBS Complete |
$140.23
|
| Rate for Payer: BCBS MAPPO |
$193.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,383.62
|
| Rate for Payer: BCN Commercial |
$351.85
|
| Rate for Payer: BCN Medicare Advantage |
$193.05
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cofinity Commercial |
$277.99
|
| Rate for Payer: Cofinity Commercial |
$258.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.05
|
| Rate for Payer: Healthscope Commercial |
$357.14
|
| Rate for Payer: Healthscope Commercial |
$308.88
|
| Rate for Payer: Mclaren Medicaid |
$133.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$202.70
|
| Rate for Payer: Meridian Medicaid |
$140.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34,760.00
|
| Rate for Payer: Nomi Health Commercial |
$231.66
|
| Rate for Payer: PACE SWMI |
$193.05
|
| Rate for Payer: PHP Medicare Advantage |
$193.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$313.96
|
| Rate for Payer: Priority Health Medicare |
$193.05
|
| Rate for Payer: Priority Health Narrow Network |
$313.96
|
| Rate for Payer: Priority Health SBD |
$313.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.05
|
| Rate for Payer: UHC Exchange |
$232.72
|
| Rate for Payer: UHC Medicare Advantage |
$193.05
|
| Rate for Payer: UHCCP Medicaid |
$133.55
|
|
|
PR CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES
|
Professional
|
Both
|
$808.00
|
|
|
Service Code
|
HCPCS 28575
|
| Min. Negotiated Rate |
$227.27 |
| Max. Negotiated Rate |
$60,233.00 |
| Rate for Payer: Aetna Commercial |
$442.84
|
| Rate for Payer: Aetna Medicare |
$343.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$442.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$475.89
|
| Rate for Payer: BCBS Complete |
$238.63
|
| Rate for Payer: BCBS MAPPO |
$330.48
|
| Rate for Payer: BCBS Trust/PPO |
$804.60
|
| Rate for Payer: BCN Commercial |
$565.40
|
| Rate for Payer: BCN Medicare Advantage |
$330.48
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cofinity Commercial |
$475.89
|
| Rate for Payer: Cofinity Commercial |
$442.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$330.48
|
| Rate for Payer: Healthscope Commercial |
$611.39
|
| Rate for Payer: Healthscope Commercial |
$528.77
|
| Rate for Payer: Mclaren Medicaid |
$227.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$347.00
|
| Rate for Payer: Meridian Medicaid |
$238.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60,233.00
|
| Rate for Payer: Nomi Health Commercial |
$396.58
|
| Rate for Payer: PACE SWMI |
$330.48
|
| Rate for Payer: PHP Medicare Advantage |
$330.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$536.34
|
| Rate for Payer: Priority Health Medicare |
$330.48
|
| Rate for Payer: Priority Health Narrow Network |
$536.34
|
| Rate for Payer: Priority Health SBD |
$536.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$376.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$330.48
|
| Rate for Payer: UHC Exchange |
$376.43
|
| Rate for Payer: UHC Medicare Advantage |
$330.48
|
| Rate for Payer: UHCCP Medicaid |
$227.27
|
|
|
PR CLOSED TX TALUS FRACTURE W/MANIPULATION
|
Professional
|
Both
|
$808.00
|
|
|
Service Code
|
HCPCS 28435
|
| Min. Negotiated Rate |
$219.82 |
| Max. Negotiated Rate |
$58,381.00 |
| Rate for Payer: Aetna Commercial |
$429.34
|
| Rate for Payer: Aetna Medicare |
$333.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.38
|
| Rate for Payer: BCBS Complete |
$230.81
|
| Rate for Payer: BCBS MAPPO |
$320.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,149.05
|
| Rate for Payer: BCN Commercial |
$553.67
|
| Rate for Payer: BCN Medicare Advantage |
$320.40
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cofinity Commercial |
$461.38
|
| Rate for Payer: Cofinity Commercial |
$429.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.40
|
| Rate for Payer: Healthscope Commercial |
$592.74
|
| Rate for Payer: Healthscope Commercial |
$512.64
|
| Rate for Payer: Mclaren Medicaid |
$219.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.42
|
| Rate for Payer: Meridian Medicaid |
$230.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58,381.00
|
| Rate for Payer: Nomi Health Commercial |
$384.48
|
| Rate for Payer: PACE SWMI |
$320.40
|
| Rate for Payer: PHP Medicare Advantage |
$320.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$519.03
|
| Rate for Payer: Priority Health Medicare |
$320.40
|
| Rate for Payer: Priority Health Narrow Network |
$519.03
|
| Rate for Payer: Priority Health SBD |
$519.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$373.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.40
|
| Rate for Payer: UHC Exchange |
$373.84
|
| Rate for Payer: UHC Medicare Advantage |
$320.40
|
| Rate for Payer: UHCCP Medicaid |
$219.82
|
|
|
PR CLOSED TX TALUS FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$673.00
|
|
|
Service Code
|
HCPCS 28430
|
| Min. Negotiated Rate |
$141.01 |
| Max. Negotiated Rate |
$37,287.00 |
| Rate for Payer: Aetna Commercial |
$274.06
|
| Rate for Payer: Aetna Medicare |
$212.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.51
|
| Rate for Payer: BCBS Complete |
$148.06
|
| Rate for Payer: BCBS MAPPO |
$204.52
|
| Rate for Payer: BCBS Trust/PPO |
$540.45
|
| Rate for Payer: BCN Commercial |
$358.20
|
| Rate for Payer: BCN Medicare Advantage |
$204.52
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cofinity Commercial |
$294.51
|
| Rate for Payer: Cofinity Commercial |
$274.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.52
|
| Rate for Payer: Healthscope Commercial |
$378.36
|
| Rate for Payer: Healthscope Commercial |
$327.23
|
| Rate for Payer: Mclaren Medicaid |
$141.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.75
|
| Rate for Payer: Meridian Medicaid |
$148.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37,287.00
|
| Rate for Payer: Nomi Health Commercial |
$245.42
|
| Rate for Payer: PACE SWMI |
$204.52
|
| Rate for Payer: PHP Medicare Advantage |
$204.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$141.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$333.30
|
| Rate for Payer: Priority Health Medicare |
$204.52
|
| Rate for Payer: Priority Health Narrow Network |
$333.30
|
| Rate for Payer: Priority Health SBD |
$333.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$301.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.52
|
| Rate for Payer: UHC Exchange |
$301.88
|
| Rate for Payer: UHC Medicare Advantage |
$204.52
|
| Rate for Payer: UHCCP Medicaid |
$141.01
|
|
|
PR CLOSED TX TARSOMETATARSAL DISLOCATION W/ANES
|
Professional
|
Both
|
$808.00
|
|
|
Service Code
|
HCPCS 28605
|
| Min. Negotiated Rate |
$205.33 |
| Max. Negotiated Rate |
$53,942.00 |
| Rate for Payer: Aetna Commercial |
$398.61
|
| Rate for Payer: Aetna Medicare |
$309.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$398.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$428.36
|
| Rate for Payer: BCBS Complete |
$215.60
|
| Rate for Payer: BCBS MAPPO |
$297.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,031.31
|
| Rate for Payer: BCN Commercial |
$511.16
|
| Rate for Payer: BCN Medicare Advantage |
$297.47
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cash Price |
$646.40
|
| Rate for Payer: Cofinity Commercial |
$428.36
|
| Rate for Payer: Cofinity Commercial |
$398.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.47
|
| Rate for Payer: Healthscope Commercial |
$550.32
|
| Rate for Payer: Healthscope Commercial |
$475.95
|
| Rate for Payer: Mclaren Medicaid |
$205.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.34
|
| Rate for Payer: Meridian Medicaid |
$215.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53,942.00
|
| Rate for Payer: Nomi Health Commercial |
$356.96
|
| Rate for Payer: PACE SWMI |
$297.47
|
| Rate for Payer: PHP Medicare Advantage |
$297.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$483.42
|
| Rate for Payer: Priority Health Medicare |
$297.47
|
| Rate for Payer: Priority Health Narrow Network |
$483.42
|
| Rate for Payer: Priority Health SBD |
$483.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$318.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$297.47
|
| Rate for Payer: UHC Exchange |
$318.45
|
| Rate for Payer: UHC Medicare Advantage |
$297.47
|
| Rate for Payer: UHCCP Medicaid |
$205.33
|
|
|
PR CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS 28600
|
| Min. Negotiated Rate |
$124.39 |
| Max. Negotiated Rate |
$32,755.00 |
| Rate for Payer: Aetna Commercial |
$241.45
|
| Rate for Payer: Aetna Medicare |
$187.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.47
|
| Rate for Payer: BCBS Complete |
$130.61
|
| Rate for Payer: BCBS MAPPO |
$180.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.75
|
| Rate for Payer: BCN Commercial |
$324.48
|
| Rate for Payer: BCN Medicare Advantage |
$180.19
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cofinity Commercial |
$259.47
|
| Rate for Payer: Cofinity Commercial |
$241.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.19
|
| Rate for Payer: Healthscope Commercial |
$333.35
|
| Rate for Payer: Healthscope Commercial |
$288.30
|
| Rate for Payer: Mclaren Medicaid |
$124.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.20
|
| Rate for Payer: Meridian Medicaid |
$130.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32,755.00
|
| Rate for Payer: Nomi Health Commercial |
$216.23
|
| Rate for Payer: PACE SWMI |
$180.19
|
| Rate for Payer: PHP Medicare Advantage |
$180.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.88
|
| Rate for Payer: Priority Health Medicare |
$180.19
|
| Rate for Payer: Priority Health Narrow Network |
$251.88
|
| Rate for Payer: Priority Health SBD |
$251.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.19
|
| Rate for Payer: UHC Exchange |
$255.69
|
| Rate for Payer: UHC Medicare Advantage |
$180.19
|
| Rate for Payer: UHCCP Medicaid |
$124.39
|
|
|
PR CLOSED TX TEMPOROMANDIBULAR DISLC COMP 1ST/SBSQ
|
Professional
|
Both
|
$1,088.00
|
|
|
Service Code
|
HCPCS 21485
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$135,648.00 |
| Rate for Payer: Aetna Commercial |
$937.80
|
| Rate for Payer: Aetna Medicare |
$727.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,007.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$937.80
|
| Rate for Payer: BCBS Complete |
$517.52
|
| Rate for Payer: BCBS MAPPO |
$699.85
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$1,428.40
|
| Rate for Payer: BCN Medicare Advantage |
$699.85
|
| Rate for Payer: Cash Price |
$870.40
|
| Rate for Payer: Cash Price |
$870.40
|
| Rate for Payer: Cofinity Commercial |
$937.80
|
| Rate for Payer: Cofinity Commercial |
$1,007.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.85
|
| Rate for Payer: Healthscope Commercial |
$1,294.72
|
| Rate for Payer: Healthscope Commercial |
$1,119.76
|
| Rate for Payer: Mclaren Medicaid |
$492.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$734.84
|
| Rate for Payer: Meridian Medicaid |
$517.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135,648.00
|
| Rate for Payer: Nomi Health Commercial |
$839.82
|
| Rate for Payer: PACE SWMI |
$699.85
|
| Rate for Payer: PHP Medicare Advantage |
$699.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,194.30
|
| Rate for Payer: Priority Health Medicare |
$699.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,194.30
|
| Rate for Payer: Priority Health SBD |
$1,194.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$407.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$699.85
|
| Rate for Payer: UHC Exchange |
$407.25
|
| Rate for Payer: UHC Medicare Advantage |
$699.85
|
| Rate for Payer: UHCCP Medicaid |
$492.88
|
|
|
PR CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ
|
Professional
|
Both
|
$142.00
|
|
|
Service Code
|
HCPCS 21480
|
| Min. Negotiated Rate |
$20.24 |
| Max. Negotiated Rate |
$5,620.00 |
| Rate for Payer: Aetna Commercial |
$41.34
|
| Rate for Payer: Aetna Medicare |
$32.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.42
|
| Rate for Payer: BCBS Complete |
$21.25
|
| Rate for Payer: BCBS MAPPO |
$30.85
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: BCN Commercial |
$209.15
|
| Rate for Payer: BCN Medicare Advantage |
$30.85
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cofinity Commercial |
$44.42
|
| Rate for Payer: Cofinity Commercial |
$41.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.85
|
| Rate for Payer: Healthscope Commercial |
$57.07
|
| Rate for Payer: Healthscope Commercial |
$49.36
|
| Rate for Payer: Mclaren Medicaid |
$20.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.39
|
| Rate for Payer: Meridian Medicaid |
$21.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,620.00
|
| Rate for Payer: Nomi Health Commercial |
$37.02
|
| Rate for Payer: PACE SWMI |
$30.85
|
| Rate for Payer: PHP Medicare Advantage |
$30.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.33
|
| Rate for Payer: Priority Health Medicare |
$30.85
|
| Rate for Payer: Priority Health Narrow Network |
$47.33
|
| Rate for Payer: Priority Health SBD |
$47.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.85
|
| Rate for Payer: UHC Exchange |
$103.69
|
| Rate for Payer: UHC Medicare Advantage |
$30.85
|
| Rate for Payer: UHCCP Medicaid |
$20.24
|
|
|
PR CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ
|
Professional
|
Both
|
$1,255.00
|
|
|
Service Code
|
HCPCS 24675
|
| Min. Negotiated Rate |
$277.97 |
| Max. Negotiated Rate |
$74,628.00 |
| Rate for Payer: Aetna Commercial |
$545.37
|
| Rate for Payer: Aetna Medicare |
$423.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$586.07
|
| Rate for Payer: BCBS Complete |
$291.87
|
| Rate for Payer: BCBS MAPPO |
$406.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,365.66
|
| Rate for Payer: BCN Commercial |
$690.01
|
| Rate for Payer: BCN Medicare Advantage |
$406.99
|
| Rate for Payer: Cash Price |
$1,004.00
|
| Rate for Payer: Cash Price |
$1,004.00
|
| Rate for Payer: Cofinity Commercial |
$586.07
|
| Rate for Payer: Cofinity Commercial |
$545.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$406.99
|
| Rate for Payer: Healthscope Commercial |
$752.93
|
| Rate for Payer: Healthscope Commercial |
$651.18
|
| Rate for Payer: Mclaren Medicaid |
$277.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$427.34
|
| Rate for Payer: Meridian Medicaid |
$291.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74,628.00
|
| Rate for Payer: Nomi Health Commercial |
$488.39
|
| Rate for Payer: PACE SWMI |
$406.99
|
| Rate for Payer: PHP Medicare Advantage |
$406.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$815.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.99
|
| Rate for Payer: Priority Health Medicare |
$406.99
|
| Rate for Payer: Priority Health Narrow Network |
$659.99
|
| Rate for Payer: Priority Health SBD |
$659.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$510.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$406.99
|
| Rate for Payer: UHC Exchange |
$510.79
|
| Rate for Payer: UHC Medicare Advantage |
$406.99
|
| Rate for Payer: UHCCP Medicaid |
$277.97
|
|
|
PR CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ
|
Professional
|
Both
|
$797.00
|
|
|
Service Code
|
HCPCS 24670
|
| Min. Negotiated Rate |
$181.05 |
| Max. Negotiated Rate |
$47,893.00 |
| Rate for Payer: Aetna Commercial |
$352.03
|
| Rate for Payer: Aetna Medicare |
$273.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$378.30
|
| Rate for Payer: BCBS Complete |
$190.10
|
| Rate for Payer: BCBS MAPPO |
$262.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,283.24
|
| Rate for Payer: BCN Commercial |
$441.27
|
| Rate for Payer: BCN Medicare Advantage |
$262.71
|
| Rate for Payer: Cash Price |
$637.60
|
| Rate for Payer: Cash Price |
$637.60
|
| Rate for Payer: Cofinity Commercial |
$378.30
|
| Rate for Payer: Cofinity Commercial |
$352.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$262.71
|
| Rate for Payer: Healthscope Commercial |
$486.01
|
| Rate for Payer: Healthscope Commercial |
$420.34
|
| Rate for Payer: Mclaren Medicaid |
$181.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$275.85
|
| Rate for Payer: Meridian Medicaid |
$190.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47,893.00
|
| Rate for Payer: Nomi Health Commercial |
$315.25
|
| Rate for Payer: PACE SWMI |
$262.71
|
| Rate for Payer: PHP Medicare Advantage |
$262.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$518.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$427.45
|
| Rate for Payer: Priority Health Medicare |
$262.71
|
| Rate for Payer: Priority Health Narrow Network |
$427.45
|
| Rate for Payer: Priority Health SBD |
$427.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$262.71
|
| Rate for Payer: UHC Exchange |
$292.08
|
| Rate for Payer: UHC Medicare Advantage |
$262.71
|
| Rate for Payer: UHCCP Medicaid |
$181.05
|
|
|
PR CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION
|
Professional
|
Both
|
$1,190.00
|
|
|
Service Code
|
HCPCS 25535
|
| Min. Negotiated Rate |
$304.38 |
| Max. Negotiated Rate |
$81,677.00 |
| Rate for Payer: Aetna Commercial |
$596.76
|
| Rate for Payer: Aetna Medicare |
$463.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$596.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$641.29
|
| Rate for Payer: BCBS Complete |
$319.60
|
| Rate for Payer: BCBS MAPPO |
$445.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,028.60
|
| Rate for Payer: BCN Commercial |
$741.32
|
| Rate for Payer: BCN Medicare Advantage |
$445.34
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cofinity Commercial |
$641.29
|
| Rate for Payer: Cofinity Commercial |
$596.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.34
|
| Rate for Payer: Healthscope Commercial |
$823.88
|
| Rate for Payer: Healthscope Commercial |
$712.54
|
| Rate for Payer: Mclaren Medicaid |
$304.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.61
|
| Rate for Payer: Meridian Medicaid |
$319.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81,677.00
|
| Rate for Payer: Nomi Health Commercial |
$534.41
|
| Rate for Payer: PACE SWMI |
$445.34
|
| Rate for Payer: PHP Medicare Advantage |
$445.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$773.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$722.58
|
| Rate for Payer: Priority Health Medicare |
$445.34
|
| Rate for Payer: Priority Health Narrow Network |
$722.58
|
| Rate for Payer: Priority Health SBD |
$722.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$596.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$445.34
|
| Rate for Payer: UHC Exchange |
$596.75
|
| Rate for Payer: UHC Medicare Advantage |
$445.34
|
| Rate for Payer: UHCCP Medicaid |
$304.38
|
|
|
PR CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION
|
Professional
|
Both
|
$655.00
|
|
|
Service Code
|
HCPCS 25530
|
| Min. Negotiated Rate |
$165.71 |
| Max. Negotiated Rate |
$43,270.00 |
| Rate for Payer: Aetna Commercial |
$320.85
|
| Rate for Payer: Aetna Medicare |
$249.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.79
|
| Rate for Payer: BCBS Complete |
$174.00
|
| Rate for Payer: BCBS MAPPO |
$239.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,133.73
|
| Rate for Payer: BCN Commercial |
$398.76
|
| Rate for Payer: BCN Medicare Advantage |
$239.44
|
| Rate for Payer: Cash Price |
$524.00
|
| Rate for Payer: Cash Price |
$524.00
|
| Rate for Payer: Cofinity Commercial |
$344.79
|
| Rate for Payer: Cofinity Commercial |
$320.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.44
|
| Rate for Payer: Healthscope Commercial |
$442.96
|
| Rate for Payer: Healthscope Commercial |
$383.10
|
| Rate for Payer: Mclaren Medicaid |
$165.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$251.41
|
| Rate for Payer: Meridian Medicaid |
$174.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,270.00
|
| Rate for Payer: Nomi Health Commercial |
$287.33
|
| Rate for Payer: PACE SWMI |
$239.44
|
| Rate for Payer: PHP Medicare Advantage |
$239.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$425.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$389.28
|
| Rate for Payer: Priority Health Medicare |
$239.44
|
| Rate for Payer: Priority Health Narrow Network |
$389.28
|
| Rate for Payer: Priority Health SBD |
$389.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.44
|
| Rate for Payer: UHC Exchange |
$293.72
|
| Rate for Payer: UHC Medicare Advantage |
$239.44
|
| Rate for Payer: UHCCP Medicaid |
$165.71
|
|
|
PR CLOSE MEDIAN STERNOTOMY SEP W/WO DEBRIDEMENT SPX
|
Professional
|
Both
|
$2,094.00
|
|
|
Service Code
|
HCPCS 21750
|
| Min. Negotiated Rate |
$432.39 |
| Max. Negotiated Rate |
$120,492.00 |
| Rate for Payer: Aetna Commercial |
$875.98
|
| Rate for Payer: Aetna Medicare |
$679.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$875.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$941.36
|
| Rate for Payer: BCBS Complete |
$454.01
|
| Rate for Payer: BCBS MAPPO |
$653.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,388.14
|
| Rate for Payer: BCN Commercial |
$981.75
|
| Rate for Payer: BCN Medicare Advantage |
$653.72
|
| Rate for Payer: Cash Price |
$1,675.20
|
| Rate for Payer: Cash Price |
$1,675.20
|
| Rate for Payer: Cofinity Commercial |
$941.36
|
| Rate for Payer: Cofinity Commercial |
$875.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$653.72
|
| Rate for Payer: Healthscope Commercial |
$1,209.38
|
| Rate for Payer: Healthscope Commercial |
$1,045.95
|
| Rate for Payer: Mclaren Medicaid |
$432.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$686.41
|
| Rate for Payer: Meridian Medicaid |
$454.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120,492.00
|
| Rate for Payer: Nomi Health Commercial |
$784.46
|
| Rate for Payer: PACE SWMI |
$653.72
|
| Rate for Payer: PHP Medicare Advantage |
$653.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,361.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,027.38
|
| Rate for Payer: Priority Health Medicare |
$653.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,027.38
|
| Rate for Payer: Priority Health SBD |
$1,027.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$934.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$653.72
|
| Rate for Payer: UHC Exchange |
$934.81
|
| Rate for Payer: UHC Medicare Advantage |
$653.72
|
| Rate for Payer: UHCCP Medicaid |
$432.39
|
|
|
PR CLOSURE CYSTOSTOMY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,420.00
|
|
|
Service Code
|
HCPCS 51880
|
| Min. Negotiated Rate |
$298.84 |
| Max. Negotiated Rate |
$81,695.00 |
| Rate for Payer: Aetna Commercial |
$596.06
|
| Rate for Payer: Aetna Medicare |
$462.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$596.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$640.54
|
| Rate for Payer: BCBS Complete |
$313.78
|
| Rate for Payer: BCBS MAPPO |
$444.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,691.09
|
| Rate for Payer: BCN Commercial |
$671.93
|
| Rate for Payer: BCN Medicare Advantage |
$444.82
|
| Rate for Payer: Cash Price |
$1,136.00
|
| Rate for Payer: Cash Price |
$1,136.00
|
| Rate for Payer: Cofinity Commercial |
$640.54
|
| Rate for Payer: Cofinity Commercial |
$596.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$444.82
|
| Rate for Payer: Healthscope Commercial |
$822.92
|
| Rate for Payer: Healthscope Commercial |
$711.71
|
| Rate for Payer: Mclaren Medicaid |
$298.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.06
|
| Rate for Payer: Meridian Medicaid |
$313.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81,695.00
|
| Rate for Payer: Nomi Health Commercial |
$533.78
|
| Rate for Payer: PACE SWMI |
$444.82
|
| Rate for Payer: PHP Medicare Advantage |
$444.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$923.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$745.65
|
| Rate for Payer: Priority Health Medicare |
$444.82
|
| Rate for Payer: Priority Health Narrow Network |
$745.65
|
| Rate for Payer: Priority Health SBD |
$745.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$603.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$444.82
|
| Rate for Payer: UHC Exchange |
$603.83
|
| Rate for Payer: UHC Medicare Advantage |
$444.82
|
| Rate for Payer: UHCCP Medicaid |
$298.84
|
|
|
PR CLOSURE ENTEROSTOMY LG/SMALL INTESTINE
|
Professional
|
Both
|
$2,261.00
|
|
|
Service Code
|
HCPCS 44620
|
| Min. Negotiated Rate |
$210.79 |
| Max. Negotiated Rate |
$154,028.00 |
| Rate for Payer: Aetna Commercial |
$1,115.83
|
| Rate for Payer: Aetna Medicare |
$866.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,115.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,199.10
|
| Rate for Payer: BCBS Complete |
$581.04
|
| Rate for Payer: BCBS MAPPO |
$832.71
|
| Rate for Payer: BCBS Trust/PPO |
$210.79
|
| Rate for Payer: BCN Commercial |
$1,258.83
|
| Rate for Payer: BCN Medicare Advantage |
$832.71
|
| Rate for Payer: Cash Price |
$1,808.80
|
| Rate for Payer: Cash Price |
$1,808.80
|
| Rate for Payer: Cofinity Commercial |
$1,199.10
|
| Rate for Payer: Cofinity Commercial |
$1,115.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$832.71
|
| Rate for Payer: Healthscope Commercial |
$1,540.51
|
| Rate for Payer: Healthscope Commercial |
$1,332.34
|
| Rate for Payer: Mclaren Medicaid |
$553.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$874.35
|
| Rate for Payer: Meridian Medicaid |
$581.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154,028.00
|
| Rate for Payer: Nomi Health Commercial |
$999.25
|
| Rate for Payer: PACE SWMI |
$832.71
|
| Rate for Payer: PHP Medicare Advantage |
$832.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$553.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,469.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,542.78
|
| Rate for Payer: Priority Health Medicare |
$832.71
|
| Rate for Payer: Priority Health Narrow Network |
$1,542.78
|
| Rate for Payer: Priority Health SBD |
$1,542.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$871.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$832.71
|
| Rate for Payer: UHC Exchange |
$871.50
|
| Rate for Payer: UHC Medicare Advantage |
$832.71
|
| Rate for Payer: UHCCP Medicaid |
$553.37
|
|
|
PR CLOSURE GASTROCOLIC FISTULA
|
Professional
|
Both
|
$3,893.00
|
|
|
Service Code
|
HCPCS 43880
|
| Min. Negotiated Rate |
$198.11 |
| Max. Negotiated Rate |
$283,864.00 |
| Rate for Payer: Aetna Commercial |
$2,095.77
|
| Rate for Payer: Aetna Medicare |
$1,626.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,095.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,252.17
|
| Rate for Payer: BCBS Complete |
$1,083.14
|
| Rate for Payer: BCBS MAPPO |
$1,564.01
|
| Rate for Payer: BCBS Trust/PPO |
$198.11
|
| Rate for Payer: BCN Commercial |
$2,311.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,564.01
|
| Rate for Payer: Cash Price |
$3,114.40
|
| Rate for Payer: Cash Price |
$3,114.40
|
| Rate for Payer: Cofinity Commercial |
$2,252.17
|
| Rate for Payer: Cofinity Commercial |
$2,095.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,564.01
|
| Rate for Payer: Healthscope Commercial |
$2,893.42
|
| Rate for Payer: Healthscope Commercial |
$2,502.42
|
| Rate for Payer: Mclaren Medicaid |
$1,031.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,642.21
|
| Rate for Payer: Meridian Medicaid |
$1,083.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283,864.00
|
| Rate for Payer: Nomi Health Commercial |
$1,876.81
|
| Rate for Payer: PACE SWMI |
$1,564.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,564.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,031.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,530.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,873.80
|
| Rate for Payer: Priority Health Medicare |
$1,564.01
|
| Rate for Payer: Priority Health Narrow Network |
$2,873.80
|
| Rate for Payer: Priority Health SBD |
$2,873.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,467.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,564.01
|
| Rate for Payer: UHC Exchange |
$1,467.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,564.01
|
| Rate for Payer: UHCCP Medicaid |
$1,031.56
|
|
|
PR CLOSURE GASTROSTOMY SURG
|
Professional
|
Both
|
$1,955.00
|
|
|
Service Code
|
HCPCS 43870
|
| Min. Negotiated Rate |
$202.87 |
| Max. Negotiated Rate |
$127,035.00 |
| Rate for Payer: Aetna Commercial |
$921.16
|
| Rate for Payer: Aetna Medicare |
$714.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$921.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$989.90
|
| Rate for Payer: BCBS Complete |
$479.50
|
| Rate for Payer: BCBS MAPPO |
$687.43
|
| Rate for Payer: BCBS Trust/PPO |
$202.87
|
| Rate for Payer: BCN Commercial |
$1,038.93
|
| Rate for Payer: BCN Medicare Advantage |
$687.43
|
| Rate for Payer: Cash Price |
$1,564.00
|
| Rate for Payer: Cash Price |
$1,564.00
|
| Rate for Payer: Cofinity Commercial |
$989.90
|
| Rate for Payer: Cofinity Commercial |
$921.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$687.43
|
| Rate for Payer: Healthscope Commercial |
$1,271.75
|
| Rate for Payer: Healthscope Commercial |
$1,099.89
|
| Rate for Payer: Mclaren Medicaid |
$456.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$721.80
|
| Rate for Payer: Meridian Medicaid |
$479.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127,035.00
|
| Rate for Payer: Nomi Health Commercial |
$824.92
|
| Rate for Payer: PACE SWMI |
$687.43
|
| Rate for Payer: PHP Medicare Advantage |
$687.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$456.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,270.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,273.14
|
| Rate for Payer: Priority Health Medicare |
$687.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,273.14
|
| Rate for Payer: Priority Health SBD |
$1,273.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$654.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$687.43
|
| Rate for Payer: UHC Exchange |
$654.09
|
| Rate for Payer: UHC Medicare Advantage |
$687.43
|
| Rate for Payer: UHCCP Medicaid |
$456.67
|
|
|
PR CLOSURE INTESTINAL CUTANEOUS FISTULA
|
Professional
|
Both
|
$2,546.00
|
|
|
Service Code
|
HCPCS 44640
|
| Min. Negotiated Rate |
$175.40 |
| Max. Negotiated Rate |
$248,868.00 |
| Rate for Payer: Aetna Commercial |
$1,805.96
|
| Rate for Payer: Aetna Medicare |
$1,401.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,805.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,940.73
|
| Rate for Payer: BCBS Complete |
$935.53
|
| Rate for Payer: BCBS MAPPO |
$1,347.73
|
| Rate for Payer: BCBS Trust/PPO |
$175.40
|
| Rate for Payer: BCN Commercial |
$2,026.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,347.73
|
| Rate for Payer: Cash Price |
$2,036.80
|
| Rate for Payer: Cash Price |
$2,036.80
|
| Rate for Payer: Cofinity Commercial |
$1,940.73
|
| Rate for Payer: Cofinity Commercial |
$1,805.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,347.73
|
| Rate for Payer: Healthscope Commercial |
$2,493.30
|
| Rate for Payer: Healthscope Commercial |
$2,156.37
|
| Rate for Payer: Mclaren Medicaid |
$890.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,415.12
|
| Rate for Payer: Meridian Medicaid |
$935.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248,868.00
|
| Rate for Payer: Nomi Health Commercial |
$1,617.28
|
| Rate for Payer: PACE SWMI |
$1,347.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,347.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$890.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,484.81
|
| Rate for Payer: Priority Health Medicare |
$1,347.73
|
| Rate for Payer: Priority Health Narrow Network |
$2,484.81
|
| Rate for Payer: Priority Health SBD |
$2,484.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,360.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,347.73
|
| Rate for Payer: UHC Exchange |
$1,360.14
|
| Rate for Payer: UHC Medicare Advantage |
$1,347.73
|
| Rate for Payer: UHCCP Medicaid |
$890.98
|
|
|
PR CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<
|
Professional
|
Both
|
$537.00
|
|
|
Service Code
|
HCPCS 40830
|
| Min. Negotiated Rate |
$94.79 |
| Max. Negotiated Rate |
$25,438.00 |
| Rate for Payer: Aetna Commercial |
$185.12
|
| Rate for Payer: Aetna Medicare |
$143.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.94
|
| Rate for Payer: BCBS Complete |
$99.53
|
| Rate for Payer: BCBS MAPPO |
$138.15
|
| Rate for Payer: BCBS Trust/PPO |
$805.66
|
| Rate for Payer: BCN Commercial |
$332.79
|
| Rate for Payer: BCN Medicare Advantage |
$138.15
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cofinity Commercial |
$198.94
|
| Rate for Payer: Cofinity Commercial |
$185.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.15
|
| Rate for Payer: Healthscope Commercial |
$255.58
|
| Rate for Payer: Healthscope Commercial |
$221.04
|
| Rate for Payer: Mclaren Medicaid |
$94.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.06
|
| Rate for Payer: Meridian Medicaid |
$99.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,438.00
|
| Rate for Payer: Nomi Health Commercial |
$165.78
|
| Rate for Payer: PACE SWMI |
$138.15
|
| Rate for Payer: PHP Medicare Advantage |
$138.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$349.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.72
|
| Rate for Payer: Priority Health Medicare |
$138.15
|
| Rate for Payer: Priority Health Narrow Network |
$260.72
|
| Rate for Payer: Priority Health SBD |
$260.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.15
|
| Rate for Payer: UHC Exchange |
$197.89
|
| Rate for Payer: UHC Medicare Advantage |
$138.15
|
| Rate for Payer: UHCCP Medicaid |
$94.79
|
|
|
PR CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL
|
Professional
|
Both
|
$691.00
|
|
|
Service Code
|
HCPCS 40831
|
| Min. Negotiated Rate |
$131.00 |
| Max. Negotiated Rate |
$35,140.00 |
| Rate for Payer: Aetna Commercial |
$256.05
|
| Rate for Payer: Aetna Medicare |
$198.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.16
|
| Rate for Payer: BCBS Complete |
$137.55
|
| Rate for Payer: BCBS MAPPO |
$191.08
|
| Rate for Payer: BCBS Trust/PPO |
$949.88
|
| Rate for Payer: BCN Commercial |
$436.39
|
| Rate for Payer: BCN Medicare Advantage |
$191.08
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cofinity Commercial |
$275.16
|
| Rate for Payer: Cofinity Commercial |
$256.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.08
|
| Rate for Payer: Healthscope Commercial |
$353.50
|
| Rate for Payer: Healthscope Commercial |
$305.73
|
| Rate for Payer: Mclaren Medicaid |
$131.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$200.63
|
| Rate for Payer: Meridian Medicaid |
$137.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35,140.00
|
| Rate for Payer: Nomi Health Commercial |
$229.30
|
| Rate for Payer: PACE SWMI |
$191.08
|
| Rate for Payer: PHP Medicare Advantage |
$191.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$359.74
|
| Rate for Payer: Priority Health Medicare |
$191.08
|
| Rate for Payer: Priority Health Narrow Network |
$359.74
|
| Rate for Payer: Priority Health SBD |
$359.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.08
|
| Rate for Payer: UHC Exchange |
$250.13
|
| Rate for Payer: UHC Medicare Advantage |
$191.08
|
| Rate for Payer: UHCCP Medicaid |
$131.00
|
|
|
PR CLOSURE RECTOURETHRAL FISTULA
|
Professional
|
Both
|
$3,283.00
|
|
|
Service Code
|
HCPCS 45820
|
| Min. Negotiated Rate |
$527.24 |
| Max. Negotiated Rate |
$227,972.00 |
| Rate for Payer: Aetna Commercial |
$1,658.04
|
| Rate for Payer: Aetna Medicare |
$1,286.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,658.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,781.77
|
| Rate for Payer: BCBS Complete |
$861.27
|
| Rate for Payer: BCBS MAPPO |
$1,237.34
|
| Rate for Payer: BCBS Trust/PPO |
$527.24
|
| Rate for Payer: BCN Commercial |
$1,862.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,237.34
|
| Rate for Payer: Cash Price |
$2,626.40
|
| Rate for Payer: Cash Price |
$2,626.40
|
| Rate for Payer: Cofinity Commercial |
$1,781.77
|
| Rate for Payer: Cofinity Commercial |
$1,658.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,237.34
|
| Rate for Payer: Healthscope Commercial |
$2,289.08
|
| Rate for Payer: Healthscope Commercial |
$1,979.74
|
| Rate for Payer: Mclaren Medicaid |
$820.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,299.21
|
| Rate for Payer: Meridian Medicaid |
$861.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227,972.00
|
| Rate for Payer: Nomi Health Commercial |
$1,484.81
|
| Rate for Payer: PACE SWMI |
$1,237.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,237.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,133.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,281.98
|
| Rate for Payer: Priority Health Medicare |
$1,237.34
|
| Rate for Payer: Priority Health Narrow Network |
$2,281.98
|
| Rate for Payer: Priority Health SBD |
$2,281.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,180.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,237.34
|
| Rate for Payer: UHC Exchange |
$1,180.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,237.34
|
| Rate for Payer: UHCCP Medicaid |
$820.26
|
|
|
PR CLOSURE RECTOVESICAL FISTULA
|
Professional
|
Both
|
$2,859.00
|
|
|
Service Code
|
HCPCS 45800
|
| Min. Negotiated Rate |
$818.35 |
| Max. Negotiated Rate |
$227,374.00 |
| Rate for Payer: Aetna Commercial |
$1,654.14
|
| Rate for Payer: Aetna Medicare |
$1,283.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,654.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,777.58
|
| Rate for Payer: BCBS Complete |
$859.27
|
| Rate for Payer: BCBS MAPPO |
$1,234.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,277.43
|
| Rate for Payer: BCN Commercial |
$1,857.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,234.43
|
| Rate for Payer: Cash Price |
$2,287.20
|
| Rate for Payer: Cash Price |
$2,287.20
|
| Rate for Payer: Cofinity Commercial |
$1,777.58
|
| Rate for Payer: Cofinity Commercial |
$1,654.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,234.43
|
| Rate for Payer: Healthscope Commercial |
$2,283.70
|
| Rate for Payer: Healthscope Commercial |
$1,975.09
|
| Rate for Payer: Mclaren Medicaid |
$818.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,296.15
|
| Rate for Payer: Meridian Medicaid |
$859.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227,374.00
|
| Rate for Payer: Nomi Health Commercial |
$1,481.32
|
| Rate for Payer: PACE SWMI |
$1,234.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,234.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$818.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,858.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,276.01
|
| Rate for Payer: Priority Health Medicare |
$1,234.43
|
| Rate for Payer: Priority Health Narrow Network |
$2,276.01
|
| Rate for Payer: Priority Health SBD |
$2,276.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,238.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,234.43
|
| Rate for Payer: UHC Exchange |
$1,238.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,234.43
|
| Rate for Payer: UHCCP Medicaid |
$818.35
|
|
|
PR CLOSURE SALIVARY FISTULA
|
Professional
|
Both
|
$818.00
|
|
|
Service Code
|
HCPCS 42600
|
| Min. Negotiated Rate |
$231.11 |
| Max. Negotiated Rate |
$63,022.00 |
| Rate for Payer: Aetna Commercial |
$455.55
|
| Rate for Payer: Aetna Medicare |
$353.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$489.54
|
| Rate for Payer: BCBS Complete |
$242.67
|
| Rate for Payer: BCBS MAPPO |
$339.96
|
| Rate for Payer: BCBS Trust/PPO |
$547.85
|
| Rate for Payer: BCN Commercial |
$808.27
|
| Rate for Payer: BCN Medicare Advantage |
$339.96
|
| Rate for Payer: Cash Price |
$654.40
|
| Rate for Payer: Cash Price |
$654.40
|
| Rate for Payer: Cofinity Commercial |
$489.54
|
| Rate for Payer: Cofinity Commercial |
$455.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.96
|
| Rate for Payer: Healthscope Commercial |
$628.93
|
| Rate for Payer: Healthscope Commercial |
$543.94
|
| Rate for Payer: Mclaren Medicaid |
$231.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.96
|
| Rate for Payer: Meridian Medicaid |
$242.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63,022.00
|
| Rate for Payer: Nomi Health Commercial |
$407.95
|
| Rate for Payer: PACE SWMI |
$339.96
|
| Rate for Payer: PHP Medicare Advantage |
$339.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$231.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$531.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$645.51
|
| Rate for Payer: Priority Health Medicare |
$339.96
|
| Rate for Payer: Priority Health Narrow Network |
$645.51
|
| Rate for Payer: Priority Health SBD |
$645.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$438.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.96
|
| Rate for Payer: UHC Exchange |
$438.63
|
| Rate for Payer: UHC Medicare Advantage |
$339.96
|
| Rate for Payer: UHCCP Medicaid |
$231.11
|
|
