|
PR DACRYOCSTORHINOSTOMY
|
Professional
|
Both
|
$1,572.00
|
|
|
Service Code
|
HCPCS 68720
|
| Min. Negotiated Rate |
$245.66 |
| Max. Negotiated Rate |
$139,576.00 |
| Rate for Payer: Aetna Commercial |
$997.00
|
| Rate for Payer: Aetna Medicare |
$773.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,071.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$997.00
|
| Rate for Payer: BCBS Complete |
$537.65
|
| Rate for Payer: BCBS MAPPO |
$744.03
|
| Rate for Payer: BCBS Trust/PPO |
$245.66
|
| Rate for Payer: BCN Commercial |
$1,172.83
|
| Rate for Payer: BCN Medicare Advantage |
$744.03
|
| Rate for Payer: Cash Price |
$1,257.60
|
| Rate for Payer: Cash Price |
$1,257.60
|
| Rate for Payer: Cofinity Commercial |
$997.00
|
| Rate for Payer: Cofinity Commercial |
$1,071.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$744.03
|
| Rate for Payer: Healthscope Commercial |
$1,376.46
|
| Rate for Payer: Healthscope Commercial |
$1,190.45
|
| Rate for Payer: Mclaren Medicaid |
$512.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$781.23
|
| Rate for Payer: Meridian Medicaid |
$537.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139,576.00
|
| Rate for Payer: Nomi Health Commercial |
$892.84
|
| Rate for Payer: PACE SWMI |
$744.03
|
| Rate for Payer: PHP Medicare Advantage |
$744.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$512.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,021.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,411.96
|
| Rate for Payer: Priority Health Medicare |
$744.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,411.96
|
| Rate for Payer: Priority Health SBD |
$1,411.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$928.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$744.03
|
| Rate for Payer: UHC Exchange |
$928.53
|
| Rate for Payer: UHC Medicare Advantage |
$744.03
|
| Rate for Payer: UHCCP Medicaid |
$512.05
|
|
|
PR DAILY HOSP MGMT EDRL/SARACH CONT DRUG ADMN
|
Professional
|
Both
|
$3.00
|
|
|
Service Code
|
HCPCS 01996
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$5,000.00 |
| Rate for Payer: Aetna Medicare |
$1.50
|
| Rate for Payer: BCBS Complete |
$1.20
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,000.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.50
|
| Rate for Payer: Priority Health Narrow Network |
$133.50
|
| Rate for Payer: Priority Health SBD |
$133.50
|
|
|
PR DBRDMT EXTENSV ECZMT/INFCT SKIN UP 10% BDY SURF
|
Professional
|
Both
|
$90.00
|
|
|
Service Code
|
HCPCS 11000
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$4,811.00 |
| Rate for Payer: Aetna Commercial |
$34.36
|
| Rate for Payer: Aetna Medicare |
$26.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.92
|
| Rate for Payer: BCBS Complete |
$17.89
|
| Rate for Payer: BCBS MAPPO |
$25.64
|
| Rate for Payer: BCBS Trust/PPO |
$11.15
|
| Rate for Payer: BCN Commercial |
$67.93
|
| Rate for Payer: BCN Medicare Advantage |
$25.64
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$34.36
|
| Rate for Payer: Cofinity Commercial |
$36.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.64
|
| Rate for Payer: Healthscope Commercial |
$41.02
|
| Rate for Payer: Healthscope Commercial |
$47.43
|
| Rate for Payer: Mclaren Medicaid |
$17.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.92
|
| Rate for Payer: Meridian Medicaid |
$17.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,811.00
|
| Rate for Payer: Nomi Health Commercial |
$30.77
|
| Rate for Payer: PACE SWMI |
$25.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.03
|
| Rate for Payer: Priority Health Medicare |
$25.64
|
| Rate for Payer: Priority Health Narrow Network |
$37.03
|
| Rate for Payer: Priority Health SBD |
$37.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.64
|
| Rate for Payer: UHC Exchange |
$51.58
|
| Rate for Payer: UHC Medicare Advantage |
$25.64
|
| Rate for Payer: UHCCP Medicaid |
$17.04
|
|
|
PR DBRDMT EXTNSVE ECZMT/INFCT SKN EA ADDL 10%
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 11001
|
| Min. Negotiated Rate |
$9.37 |
| Max. Negotiated Rate |
$2,904.75 |
| Rate for Payer: Aetna Commercial |
$18.87
|
| Rate for Payer: Aetna Medicare |
$14.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.28
|
| Rate for Payer: BCBS Complete |
$9.84
|
| Rate for Payer: BCBS MAPPO |
$14.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,904.75
|
| Rate for Payer: BCN Commercial |
$32.20
|
| Rate for Payer: BCN Medicare Advantage |
$14.08
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$20.28
|
| Rate for Payer: Cofinity Commercial |
$18.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.08
|
| Rate for Payer: Healthscope Commercial |
$26.05
|
| Rate for Payer: Healthscope Commercial |
$22.53
|
| Rate for Payer: Mclaren Medicaid |
$9.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.78
|
| Rate for Payer: Meridian Medicaid |
$9.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,648.00
|
| Rate for Payer: Nomi Health Commercial |
$16.90
|
| Rate for Payer: PACE SWMI |
$14.08
|
| Rate for Payer: PHP Medicare Advantage |
$14.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.87
|
| Rate for Payer: Priority Health Medicare |
$14.08
|
| Rate for Payer: Priority Health Narrow Network |
$19.87
|
| Rate for Payer: Priority Health SBD |
$19.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.08
|
| Rate for Payer: UHC Exchange |
$34.55
|
| Rate for Payer: UHC Medicare Advantage |
$14.08
|
| Rate for Payer: UHCCP Medicaid |
$9.37
|
|
|
PR DBRDMT FX&/DISLC SUBQ T/M/F BONE
|
Professional
|
Both
|
$1,218.00
|
|
|
Service Code
|
HCPCS 11012
|
| Min. Negotiated Rate |
$25.40 |
| Max. Negotiated Rate |
$73,674.00 |
| Rate for Payer: Aetna Commercial |
$533.78
|
| Rate for Payer: Aetna Medicare |
$414.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.61
|
| Rate for Payer: BCBS Complete |
$278.89
|
| Rate for Payer: BCBS MAPPO |
$398.34
|
| Rate for Payer: BCBS Trust/PPO |
$25.40
|
| Rate for Payer: BCN Commercial |
$955.37
|
| Rate for Payer: BCN Medicare Advantage |
$398.34
|
| Rate for Payer: Cash Price |
$974.40
|
| Rate for Payer: Cash Price |
$974.40
|
| Rate for Payer: Cofinity Commercial |
$573.61
|
| Rate for Payer: Cofinity Commercial |
$533.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.34
|
| Rate for Payer: Healthscope Commercial |
$736.93
|
| Rate for Payer: Healthscope Commercial |
$637.34
|
| Rate for Payer: Mclaren Medicaid |
$265.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.26
|
| Rate for Payer: Meridian Medicaid |
$278.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73,674.00
|
| Rate for Payer: Nomi Health Commercial |
$478.01
|
| Rate for Payer: PACE SWMI |
$398.34
|
| Rate for Payer: PHP Medicare Advantage |
$398.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$791.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$559.89
|
| Rate for Payer: Priority Health Medicare |
$398.34
|
| Rate for Payer: Priority Health Narrow Network |
$559.89
|
| Rate for Payer: Priority Health SBD |
$559.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$789.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$398.34
|
| Rate for Payer: UHC Exchange |
$789.57
|
| Rate for Payer: UHC Medicare Advantage |
$398.34
|
| Rate for Payer: UHCCP Medicaid |
$265.61
|
|
|
PR DBRDMT SKN SBQ T/M/F NECRO INFCTJ XTRNL GENT&PER
|
Professional
|
Both
|
$1,067.00
|
|
|
Service Code
|
HCPCS 11004
|
| Min. Negotiated Rate |
$360.18 |
| Max. Negotiated Rate |
$101,272.00 |
| Rate for Payer: Aetna Commercial |
$732.78
|
| Rate for Payer: Aetna Medicare |
$568.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$732.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$787.46
|
| Rate for Payer: BCBS Complete |
$378.19
|
| Rate for Payer: BCBS MAPPO |
$546.85
|
| Rate for Payer: BCBS Trust/PPO |
$2,904.75
|
| Rate for Payer: BCN Commercial |
$820.97
|
| Rate for Payer: BCN Medicare Advantage |
$546.85
|
| Rate for Payer: Cash Price |
$853.60
|
| Rate for Payer: Cash Price |
$853.60
|
| Rate for Payer: Cofinity Commercial |
$787.46
|
| Rate for Payer: Cofinity Commercial |
$732.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.85
|
| Rate for Payer: Healthscope Commercial |
$874.96
|
| Rate for Payer: Healthscope Commercial |
$1,011.67
|
| Rate for Payer: Mclaren Medicaid |
$360.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$574.19
|
| Rate for Payer: Meridian Medicaid |
$378.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101,272.00
|
| Rate for Payer: Nomi Health Commercial |
$656.22
|
| Rate for Payer: PACE SWMI |
$546.85
|
| Rate for Payer: PHP Medicare Advantage |
$546.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$360.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$693.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.35
|
| Rate for Payer: Priority Health Medicare |
$546.85
|
| Rate for Payer: Priority Health Narrow Network |
$760.35
|
| Rate for Payer: Priority Health SBD |
$760.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$634.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$546.85
|
| Rate for Payer: UHC Exchange |
$634.56
|
| Rate for Payer: UHC Medicare Advantage |
$546.85
|
| Rate for Payer: UHCCP Medicaid |
$360.18
|
|
|
PR DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL
|
Facility
|
OP
|
$1,423.00
|
|
|
Service Code
|
CPT 11005
|
| Hospital Charge Code |
11005
|
| Min. Negotiated Rate |
$569.20 |
| Max. Negotiated Rate |
$3,362.00 |
| Rate for Payer: Aetna Commercial |
$1,209.55
|
| Rate for Payer: Aetna Medicare |
$711.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$924.95
|
| Rate for Payer: BCBS Complete |
$569.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,643.86
|
| Rate for Payer: BCN Commercial |
$1,643.86
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Cofinity Commercial |
$996.10
|
| Rate for Payer: Cofinity Commercial |
$1,223.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$996.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,138.40
|
| Rate for Payer: Healthscope Commercial |
$1,280.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,209.55
|
| Rate for Payer: PHP Commercial |
$1,209.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$924.95
|
| Rate for Payer: Priority Health SBD |
$896.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$830.98
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Exchange |
$3,362.00
|
|
|
PR DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL
|
Professional
|
Both
|
$1,423.00
|
|
|
Service Code
|
HCPCS 11005
|
| Min. Negotiated Rate |
$490.33 |
| Max. Negotiated Rate |
$138,258.00 |
| Rate for Payer: Aetna Commercial |
$1,002.29
|
| Rate for Payer: Aetna Medicare |
$777.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,002.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,077.09
|
| Rate for Payer: BCBS Complete |
$514.85
|
| Rate for Payer: BCBS MAPPO |
$747.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,189.70
|
| Rate for Payer: BCN Commercial |
$1,118.58
|
| Rate for Payer: BCN Medicare Advantage |
$747.98
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Cofinity Commercial |
$1,077.09
|
| Rate for Payer: Cofinity Commercial |
$1,002.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$747.98
|
| Rate for Payer: Healthscope Commercial |
$1,383.76
|
| Rate for Payer: Healthscope Commercial |
$1,196.77
|
| Rate for Payer: Mclaren Medicaid |
$490.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$785.38
|
| Rate for Payer: Meridian Medicaid |
$514.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138,258.00
|
| Rate for Payer: Nomi Health Commercial |
$897.58
|
| Rate for Payer: PACE SWMI |
$747.98
|
| Rate for Payer: PHP Medicare Advantage |
$747.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$924.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,036.23
|
| Rate for Payer: Priority Health Medicare |
$747.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,036.23
|
| Rate for Payer: Priority Health SBD |
$1,036.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$864.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$747.98
|
| Rate for Payer: UHC Exchange |
$864.72
|
| Rate for Payer: UHC Medicare Advantage |
$747.98
|
| Rate for Payer: UHCCP Medicaid |
$490.33
|
|
|
PR DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL
|
Professional
|
Both
|
$1,423.00
|
|
|
Service Code
|
HCPCS 11005
|
| Hospital Charge Code |
11005
|
| Min. Negotiated Rate |
$490.33 |
| Max. Negotiated Rate |
$138,258.00 |
| Rate for Payer: Aetna Commercial |
$1,002.29
|
| Rate for Payer: Aetna Medicare |
$777.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,002.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,077.09
|
| Rate for Payer: BCBS Complete |
$514.85
|
| Rate for Payer: BCBS MAPPO |
$747.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,189.70
|
| Rate for Payer: BCN Commercial |
$1,118.58
|
| Rate for Payer: BCN Medicare Advantage |
$747.98
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Cofinity Commercial |
$1,077.09
|
| Rate for Payer: Cofinity Commercial |
$1,002.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$747.98
|
| Rate for Payer: Healthscope Commercial |
$1,383.76
|
| Rate for Payer: Healthscope Commercial |
$1,196.77
|
| Rate for Payer: Mclaren Medicaid |
$490.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$785.38
|
| Rate for Payer: Meridian Medicaid |
$514.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138,258.00
|
| Rate for Payer: Nomi Health Commercial |
$897.58
|
| Rate for Payer: PACE SWMI |
$747.98
|
| Rate for Payer: PHP Medicare Advantage |
$747.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$924.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,036.23
|
| Rate for Payer: Priority Health Medicare |
$747.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,036.23
|
| Rate for Payer: Priority Health SBD |
$1,036.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$864.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$747.98
|
| Rate for Payer: UHC Exchange |
$864.72
|
| Rate for Payer: UHC Medicare Advantage |
$747.98
|
| Rate for Payer: UHCCP Medicaid |
$490.33
|
|
|
PR DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL
|
Facility
|
IP
|
$1,423.00
|
|
|
Service Code
|
CPT 11005
|
| Hospital Charge Code |
11005
|
| Min. Negotiated Rate |
$896.49 |
| Max. Negotiated Rate |
$1,280.70 |
| Rate for Payer: Aetna Commercial |
$1,209.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$924.95
|
| Rate for Payer: Cash Price |
$1,138.40
|
| Rate for Payer: Cofinity Commercial |
$1,223.78
|
| Rate for Payer: Cofinity Commercial |
$996.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$996.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,138.40
|
| Rate for Payer: Healthscope Commercial |
$1,280.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,209.55
|
| Rate for Payer: PHP Commercial |
$1,209.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$924.95
|
| Rate for Payer: Priority Health SBD |
$896.49
|
|
|
PR DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT PER&ABDL
|
Professional
|
Both
|
$1,301.00
|
|
|
Service Code
|
HCPCS 11006
|
| Min. Negotiated Rate |
$445.17 |
| Max. Negotiated Rate |
$124,951.00 |
| Rate for Payer: Aetna Commercial |
$907.61
|
| Rate for Payer: Aetna Medicare |
$704.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$907.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$975.34
|
| Rate for Payer: BCBS Complete |
$467.43
|
| Rate for Payer: BCBS MAPPO |
$677.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,187.45
|
| Rate for Payer: BCN Commercial |
$1,012.05
|
| Rate for Payer: BCN Medicare Advantage |
$677.32
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cash Price |
$1,040.80
|
| Rate for Payer: Cofinity Commercial |
$975.34
|
| Rate for Payer: Cofinity Commercial |
$907.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$677.32
|
| Rate for Payer: Healthscope Commercial |
$1,253.04
|
| Rate for Payer: Healthscope Commercial |
$1,083.71
|
| Rate for Payer: Mclaren Medicaid |
$445.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$711.19
|
| Rate for Payer: Meridian Medicaid |
$467.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124,951.00
|
| Rate for Payer: Nomi Health Commercial |
$812.78
|
| Rate for Payer: PACE SWMI |
$677.32
|
| Rate for Payer: PHP Medicare Advantage |
$677.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$445.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$845.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$937.35
|
| Rate for Payer: Priority Health Medicare |
$677.32
|
| Rate for Payer: Priority Health Narrow Network |
$937.35
|
| Rate for Payer: Priority Health SBD |
$937.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$808.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$677.32
|
| Rate for Payer: UHC Exchange |
$808.95
|
| Rate for Payer: UHC Medicare Advantage |
$677.32
|
| Rate for Payer: UHCCP Medicaid |
$445.17
|
|
|
PR DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS
|
Professional
|
Both
|
$819.00
|
|
|
Service Code
|
HCPCS 11010
|
| Min. Negotiated Rate |
$145.28 |
| Max. Negotiated Rate |
$48,751.00 |
| Rate for Payer: Aetna Commercial |
$353.49
|
| Rate for Payer: Aetna Medicare |
$274.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$353.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.87
|
| Rate for Payer: BCBS Complete |
$186.30
|
| Rate for Payer: BCBS MAPPO |
$263.80
|
| Rate for Payer: BCBS Trust/PPO |
$145.28
|
| Rate for Payer: BCN Commercial |
$664.60
|
| Rate for Payer: BCN Medicare Advantage |
$263.80
|
| Rate for Payer: Cash Price |
$655.20
|
| Rate for Payer: Cash Price |
$655.20
|
| Rate for Payer: Cofinity Commercial |
$379.87
|
| Rate for Payer: Cofinity Commercial |
$353.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.80
|
| Rate for Payer: Healthscope Commercial |
$488.03
|
| Rate for Payer: Healthscope Commercial |
$422.08
|
| Rate for Payer: Mclaren Medicaid |
$177.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.99
|
| Rate for Payer: Meridian Medicaid |
$186.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48,751.00
|
| Rate for Payer: Nomi Health Commercial |
$316.56
|
| Rate for Payer: PACE SWMI |
$263.80
|
| Rate for Payer: PHP Medicare Advantage |
$263.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$177.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$532.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$372.95
|
| Rate for Payer: Priority Health Medicare |
$263.80
|
| Rate for Payer: Priority Health Narrow Network |
$372.95
|
| Rate for Payer: Priority Health SBD |
$372.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$453.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.80
|
| Rate for Payer: UHC Exchange |
$453.96
|
| Rate for Payer: UHC Medicare Advantage |
$263.80
|
| Rate for Payer: UHCCP Medicaid |
$177.43
|
|
|
PR DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC
|
Professional
|
Both
|
$889.00
|
|
|
Service Code
|
HCPCS 11011
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$52,483.00 |
| Rate for Payer: Aetna Commercial |
$384.27
|
| Rate for Payer: Aetna Medicare |
$298.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$384.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.95
|
| Rate for Payer: BCBS Complete |
$200.61
|
| Rate for Payer: BCBS MAPPO |
$286.77
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$729.59
|
| Rate for Payer: BCN Medicare Advantage |
$286.77
|
| Rate for Payer: Cash Price |
$711.20
|
| Rate for Payer: Cash Price |
$711.20
|
| Rate for Payer: Cofinity Commercial |
$412.95
|
| Rate for Payer: Cofinity Commercial |
$384.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.77
|
| Rate for Payer: Healthscope Commercial |
$530.52
|
| Rate for Payer: Healthscope Commercial |
$458.83
|
| Rate for Payer: Mclaren Medicaid |
$191.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$301.11
|
| Rate for Payer: Meridian Medicaid |
$200.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52,483.00
|
| Rate for Payer: Nomi Health Commercial |
$344.12
|
| Rate for Payer: PACE SWMI |
$286.77
|
| Rate for Payer: PHP Medicare Advantage |
$286.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$400.94
|
| Rate for Payer: Priority Health Medicare |
$286.77
|
| Rate for Payer: Priority Health Narrow Network |
$400.94
|
| Rate for Payer: Priority Health SBD |
$400.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$286.77
|
| Rate for Payer: UHC Exchange |
$538.65
|
| Rate for Payer: UHC Medicare Advantage |
$286.77
|
| Rate for Payer: UHCCP Medicaid |
$191.06
|
|
|
PR DCMPRN FASCIOTOMY PELVIC CMPRT DBRDMT MUSCLE UNI
|
Professional
|
Both
|
$1,751.00
|
|
|
Service Code
|
HCPCS 27057
|
| Min. Negotiated Rate |
$652.85 |
| Max. Negotiated Rate |
$179,152.00 |
| Rate for Payer: Aetna Commercial |
$1,302.31
|
| Rate for Payer: Aetna Medicare |
$1,010.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,302.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,399.49
|
| Rate for Payer: BCBS Complete |
$685.49
|
| Rate for Payer: BCBS MAPPO |
$971.87
|
| Rate for Payer: BCBS Trust/PPO |
$4,478.93
|
| Rate for Payer: BCN Commercial |
$1,477.76
|
| Rate for Payer: BCN Medicare Advantage |
$971.87
|
| Rate for Payer: Cash Price |
$1,400.80
|
| Rate for Payer: Cash Price |
$1,400.80
|
| Rate for Payer: Cofinity Commercial |
$1,399.49
|
| Rate for Payer: Cofinity Commercial |
$1,302.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$971.87
|
| Rate for Payer: Healthscope Commercial |
$1,554.99
|
| Rate for Payer: Healthscope Commercial |
$1,797.96
|
| Rate for Payer: Mclaren Medicaid |
$652.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,020.46
|
| Rate for Payer: Meridian Medicaid |
$685.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179,152.00
|
| Rate for Payer: Nomi Health Commercial |
$1,166.24
|
| Rate for Payer: PACE SWMI |
$971.87
|
| Rate for Payer: PHP Medicare Advantage |
$971.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$652.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,138.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,547.96
|
| Rate for Payer: Priority Health Medicare |
$971.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,547.96
|
| Rate for Payer: Priority Health SBD |
$1,547.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$971.87
|
| Rate for Payer: UHC Medicare Advantage |
$971.87
|
| Rate for Payer: UHCCP Medicaid |
$652.85
|
|
|
PR DCMPRN FASCIOTOMY THIGH&/KNEE MLT COMPARTMENTS
|
Professional
|
Both
|
$1,340.00
|
|
|
Service Code
|
HCPCS 27498
|
| Min. Negotiated Rate |
$431.54 |
| Max. Negotiated Rate |
$116,755.00 |
| Rate for Payer: Aetna Commercial |
$853.62
|
| Rate for Payer: Aetna Medicare |
$662.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$853.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$917.32
|
| Rate for Payer: BCBS Complete |
$453.12
|
| Rate for Payer: BCBS MAPPO |
$637.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,135.85
|
| Rate for Payer: BCN Commercial |
$970.03
|
| Rate for Payer: BCN Medicare Advantage |
$637.03
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cofinity Commercial |
$917.32
|
| Rate for Payer: Cofinity Commercial |
$853.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.03
|
| Rate for Payer: Healthscope Commercial |
$1,178.51
|
| Rate for Payer: Healthscope Commercial |
$1,019.25
|
| Rate for Payer: Mclaren Medicaid |
$431.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$668.88
|
| Rate for Payer: Meridian Medicaid |
$453.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116,755.00
|
| Rate for Payer: Nomi Health Commercial |
$764.44
|
| Rate for Payer: PACE SWMI |
$637.03
|
| Rate for Payer: PHP Medicare Advantage |
$637.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$871.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,020.26
|
| Rate for Payer: Priority Health Medicare |
$637.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,020.26
|
| Rate for Payer: Priority Health SBD |
$1,020.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$687.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$637.03
|
| Rate for Payer: UHC Exchange |
$687.15
|
| Rate for Payer: UHC Medicare Advantage |
$637.03
|
| Rate for Payer: UHCCP Medicaid |
$431.54
|
|
|
PR DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR DBRDMT
|
Professional
|
Both
|
$2,181.00
|
|
|
Service Code
|
HCPCS 25025
|
| Min. Negotiated Rate |
$795.34 |
| Max. Negotiated Rate |
$217,687.00 |
| Rate for Payer: Aetna Commercial |
$1,585.21
|
| Rate for Payer: Aetna Medicare |
$1,230.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,585.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,703.51
|
| Rate for Payer: BCBS Complete |
$835.11
|
| Rate for Payer: BCBS MAPPO |
$1,182.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,086.18
|
| Rate for Payer: BCN Commercial |
$1,796.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,182.99
|
| Rate for Payer: Cash Price |
$1,744.80
|
| Rate for Payer: Cash Price |
$1,744.80
|
| Rate for Payer: Cofinity Commercial |
$1,703.51
|
| Rate for Payer: Cofinity Commercial |
$1,585.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,182.99
|
| Rate for Payer: Healthscope Commercial |
$2,188.53
|
| Rate for Payer: Healthscope Commercial |
$1,892.78
|
| Rate for Payer: Mclaren Medicaid |
$795.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,242.14
|
| Rate for Payer: Meridian Medicaid |
$835.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217,687.00
|
| Rate for Payer: Nomi Health Commercial |
$1,419.59
|
| Rate for Payer: PACE SWMI |
$1,182.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,182.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$795.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,884.82
|
| Rate for Payer: Priority Health Medicare |
$1,182.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,884.82
|
| Rate for Payer: Priority Health SBD |
$1,884.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,281.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,182.99
|
| Rate for Payer: UHC Exchange |
$1,281.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,182.99
|
| Rate for Payer: UHCCP Medicaid |
$795.34
|
|
|
PR DCMPRN FASCT F/ARM&/WRST FLXR/XTNSR W/DBRDMT
|
Professional
|
Both
|
$1,969.00
|
|
|
Service Code
|
HCPCS 25023
|
| Min. Negotiated Rate |
$841.35 |
| Max. Negotiated Rate |
$229,568.00 |
| Rate for Payer: Aetna Commercial |
$1,644.19
|
| Rate for Payer: Aetna Medicare |
$1,276.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,644.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,766.89
|
| Rate for Payer: BCBS Complete |
$883.42
|
| Rate for Payer: BCBS MAPPO |
$1,227.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,085.13
|
| Rate for Payer: BCN Commercial |
$1,928.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,227.01
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cofinity Commercial |
$1,766.89
|
| Rate for Payer: Cofinity Commercial |
$1,644.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,227.01
|
| Rate for Payer: Healthscope Commercial |
$2,269.97
|
| Rate for Payer: Healthscope Commercial |
$1,963.22
|
| Rate for Payer: Mclaren Medicaid |
$841.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,288.36
|
| Rate for Payer: Meridian Medicaid |
$883.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$229,568.00
|
| Rate for Payer: Nomi Health Commercial |
$1,472.41
|
| Rate for Payer: PACE SWMI |
$1,227.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,227.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$841.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,279.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,013.05
|
| Rate for Payer: Priority Health Medicare |
$1,227.01
|
| Rate for Payer: Priority Health Narrow Network |
$2,013.05
|
| Rate for Payer: Priority Health SBD |
$2,013.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,231.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,227.01
|
| Rate for Payer: UHC Exchange |
$1,231.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,227.01
|
| Rate for Payer: UHCCP Medicaid |
$841.35
|
|
|
PR DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR W/O DB
|
Professional
|
Both
|
$1,823.00
|
|
|
Service Code
|
HCPCS 25024
|
| Min. Negotiated Rate |
$218.72 |
| Max. Negotiated Rate |
$137,556.00 |
| Rate for Payer: Aetna Commercial |
$1,006.33
|
| Rate for Payer: Aetna Medicare |
$781.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,006.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,081.43
|
| Rate for Payer: BCBS Complete |
$532.51
|
| Rate for Payer: BCBS MAPPO |
$750.99
|
| Rate for Payer: BCBS Trust/PPO |
$218.72
|
| Rate for Payer: BCN Commercial |
$1,139.60
|
| Rate for Payer: BCN Medicare Advantage |
$750.99
|
| Rate for Payer: Cash Price |
$1,458.40
|
| Rate for Payer: Cash Price |
$1,458.40
|
| Rate for Payer: Cofinity Commercial |
$1,081.43
|
| Rate for Payer: Cofinity Commercial |
$1,006.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$750.99
|
| Rate for Payer: Healthscope Commercial |
$1,389.33
|
| Rate for Payer: Healthscope Commercial |
$1,201.58
|
| Rate for Payer: Mclaren Medicaid |
$507.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$788.54
|
| Rate for Payer: Meridian Medicaid |
$532.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137,556.00
|
| Rate for Payer: Nomi Health Commercial |
$901.19
|
| Rate for Payer: PACE SWMI |
$750.99
|
| Rate for Payer: PHP Medicare Advantage |
$750.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$507.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,184.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,205.49
|
| Rate for Payer: Priority Health Medicare |
$750.99
|
| Rate for Payer: Priority Health Narrow Network |
$1,205.49
|
| Rate for Payer: Priority Health SBD |
$1,205.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$791.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$750.99
|
| Rate for Payer: UHC Exchange |
$791.79
|
| Rate for Payer: UHC Medicare Advantage |
$750.99
|
| Rate for Payer: UHCCP Medicaid |
$507.15
|
|
|
PR DCMPRN FASCT F/ARM&WRST FLXR/XTNSR W/O DBRDMT
|
Professional
|
Both
|
$1,418.00
|
|
|
Service Code
|
HCPCS 25020
|
| Min. Negotiated Rate |
$160.07 |
| Max. Negotiated Rate |
$129,622.00 |
| Rate for Payer: Aetna Commercial |
$913.83
|
| Rate for Payer: Aetna Medicare |
$709.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$913.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$982.02
|
| Rate for Payer: BCBS Complete |
$496.95
|
| Rate for Payer: BCBS MAPPO |
$681.96
|
| Rate for Payer: BCBS Trust/PPO |
$160.07
|
| Rate for Payer: BCN Commercial |
$1,100.99
|
| Rate for Payer: BCN Medicare Advantage |
$681.96
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cofinity Commercial |
$982.02
|
| Rate for Payer: Cofinity Commercial |
$913.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$681.96
|
| Rate for Payer: Healthscope Commercial |
$1,261.63
|
| Rate for Payer: Healthscope Commercial |
$1,091.14
|
| Rate for Payer: Mclaren Medicaid |
$473.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$716.06
|
| Rate for Payer: Meridian Medicaid |
$496.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129,622.00
|
| Rate for Payer: Nomi Health Commercial |
$818.35
|
| Rate for Payer: PACE SWMI |
$681.96
|
| Rate for Payer: PHP Medicare Advantage |
$681.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$473.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$921.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,140.35
|
| Rate for Payer: Priority Health Medicare |
$681.96
|
| Rate for Payer: Priority Health Narrow Network |
$1,140.35
|
| Rate for Payer: Priority Health SBD |
$1,140.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$692.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$681.96
|
| Rate for Payer: UHC Exchange |
$692.92
|
| Rate for Payer: UHC Medicare Advantage |
$681.96
|
| Rate for Payer: UHCCP Medicaid |
$473.29
|
|
|
PR DCMPRN FASCT LEG ANT&/LAT COMPARTMENTS ONLY
|
Professional
|
Both
|
$1,241.00
|
|
|
Service Code
|
HCPCS 27600
|
| Min. Negotiated Rate |
$259.65 |
| Max. Negotiated Rate |
$71,395.00 |
| Rate for Payer: Aetna Commercial |
$518.69
|
| Rate for Payer: Aetna Medicare |
$402.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$518.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.40
|
| Rate for Payer: BCBS Complete |
$272.63
|
| Rate for Payer: BCBS MAPPO |
$387.08
|
| Rate for Payer: BCBS Trust/PPO |
$863.24
|
| Rate for Payer: BCN Commercial |
$588.36
|
| Rate for Payer: BCN Medicare Advantage |
$387.08
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Cofinity Commercial |
$557.40
|
| Rate for Payer: Cofinity Commercial |
$518.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.08
|
| Rate for Payer: Healthscope Commercial |
$716.10
|
| Rate for Payer: Healthscope Commercial |
$619.33
|
| Rate for Payer: Mclaren Medicaid |
$259.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.43
|
| Rate for Payer: Meridian Medicaid |
$272.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71,395.00
|
| Rate for Payer: Nomi Health Commercial |
$464.50
|
| Rate for Payer: PACE SWMI |
$387.08
|
| Rate for Payer: PHP Medicare Advantage |
$387.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$806.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$613.69
|
| Rate for Payer: Priority Health Medicare |
$387.08
|
| Rate for Payer: Priority Health Narrow Network |
$613.69
|
| Rate for Payer: Priority Health SBD |
$613.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$548.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$387.08
|
| Rate for Payer: UHC Exchange |
$548.42
|
| Rate for Payer: UHC Medicare Advantage |
$387.08
|
| Rate for Payer: UHCCP Medicaid |
$259.65
|
|
|
PR DCMPRN FASCT LEG ANT&/LAT&PST CMPRT
|
Professional
|
Both
|
$1,769.00
|
|
|
Service Code
|
HCPCS 27602
|
| Min. Negotiated Rate |
$305.23 |
| Max. Negotiated Rate |
$85,140.00 |
| Rate for Payer: Aetna Commercial |
$617.36
|
| Rate for Payer: Aetna Medicare |
$479.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$617.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.44
|
| Rate for Payer: BCBS Complete |
$320.49
|
| Rate for Payer: BCBS MAPPO |
$460.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,903.46
|
| Rate for Payer: BCN Commercial |
$695.39
|
| Rate for Payer: BCN Medicare Advantage |
$460.72
|
| Rate for Payer: Cash Price |
$1,415.20
|
| Rate for Payer: Cash Price |
$1,415.20
|
| Rate for Payer: Cofinity Commercial |
$663.44
|
| Rate for Payer: Cofinity Commercial |
$617.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$460.72
|
| Rate for Payer: Healthscope Commercial |
$852.33
|
| Rate for Payer: Healthscope Commercial |
$737.15
|
| Rate for Payer: Mclaren Medicaid |
$305.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$483.76
|
| Rate for Payer: Meridian Medicaid |
$320.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85,140.00
|
| Rate for Payer: Nomi Health Commercial |
$552.86
|
| Rate for Payer: PACE SWMI |
$460.72
|
| Rate for Payer: PHP Medicare Advantage |
$460.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,149.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$726.66
|
| Rate for Payer: Priority Health Medicare |
$460.72
|
| Rate for Payer: Priority Health Narrow Network |
$726.66
|
| Rate for Payer: Priority Health SBD |
$726.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$635.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$460.72
|
| Rate for Payer: UHC Exchange |
$635.16
|
| Rate for Payer: UHC Medicare Advantage |
$460.72
|
| Rate for Payer: UHCCP Medicaid |
$305.23
|
|
|
PR DCMPRN FASCT LEG ANT&/LAT&PST W/DBRDMT MUS
|
Professional
|
Both
|
$2,241.00
|
|
|
Service Code
|
HCPCS 27894
|
| Min. Negotiated Rate |
$530.16 |
| Max. Negotiated Rate |
$144,707.00 |
| Rate for Payer: Aetna Commercial |
$1,062.82
|
| Rate for Payer: Aetna Medicare |
$824.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,062.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,142.14
|
| Rate for Payer: BCBS Complete |
$556.67
|
| Rate for Payer: BCBS MAPPO |
$793.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,785.73
|
| Rate for Payer: BCN Commercial |
$1,189.44
|
| Rate for Payer: BCN Medicare Advantage |
$793.15
|
| Rate for Payer: Cash Price |
$1,792.80
|
| Rate for Payer: Cash Price |
$1,792.80
|
| Rate for Payer: Cofinity Commercial |
$1,142.14
|
| Rate for Payer: Cofinity Commercial |
$1,062.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$793.15
|
| Rate for Payer: Healthscope Commercial |
$1,467.33
|
| Rate for Payer: Healthscope Commercial |
$1,269.04
|
| Rate for Payer: Mclaren Medicaid |
$530.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$832.81
|
| Rate for Payer: Meridian Medicaid |
$556.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144,707.00
|
| Rate for Payer: Nomi Health Commercial |
$951.78
|
| Rate for Payer: PACE SWMI |
$793.15
|
| Rate for Payer: PHP Medicare Advantage |
$793.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$530.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,247.22
|
| Rate for Payer: Priority Health Medicare |
$793.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,247.22
|
| Rate for Payer: Priority Health SBD |
$1,247.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$834.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$793.15
|
| Rate for Payer: UHC Exchange |
$834.04
|
| Rate for Payer: UHC Medicare Advantage |
$793.15
|
| Rate for Payer: UHCCP Medicaid |
$530.16
|
|
|
PR DCMPRN FASCT LEG ANT&/LAT W/DBRDMT MUSC&/NERVE
|
Professional
|
Both
|
$1,645.00
|
|
|
Service Code
|
HCPCS 27892
|
| Min. Negotiated Rate |
$351.66 |
| Max. Negotiated Rate |
$95,134.00 |
| Rate for Payer: Aetna Commercial |
$700.61
|
| Rate for Payer: Aetna Medicare |
$543.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$700.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$752.89
|
| Rate for Payer: BCBS Complete |
$369.24
|
| Rate for Payer: BCBS MAPPO |
$522.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,576.52
|
| Rate for Payer: BCN Commercial |
$784.82
|
| Rate for Payer: BCN Medicare Advantage |
$522.84
|
| Rate for Payer: Cash Price |
$1,316.00
|
| Rate for Payer: Cash Price |
$1,316.00
|
| Rate for Payer: Cofinity Commercial |
$752.89
|
| Rate for Payer: Cofinity Commercial |
$700.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$522.84
|
| Rate for Payer: Healthscope Commercial |
$967.25
|
| Rate for Payer: Healthscope Commercial |
$836.54
|
| Rate for Payer: Mclaren Medicaid |
$351.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$548.98
|
| Rate for Payer: Meridian Medicaid |
$369.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95,134.00
|
| Rate for Payer: Nomi Health Commercial |
$627.41
|
| Rate for Payer: PACE SWMI |
$522.84
|
| Rate for Payer: PHP Medicare Advantage |
$522.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,069.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$824.86
|
| Rate for Payer: Priority Health Medicare |
$522.84
|
| Rate for Payer: Priority Health Narrow Network |
$824.86
|
| Rate for Payer: Priority Health SBD |
$824.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$642.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$522.84
|
| Rate for Payer: UHC Exchange |
$642.08
|
| Rate for Payer: UHC Medicare Advantage |
$522.84
|
| Rate for Payer: UHCCP Medicaid |
$351.66
|
|
|
PR DCMPRN FASCT LEG POST COMPARTMENT ONLY
|
Professional
|
Both
|
$1,388.00
|
|
|
Service Code
|
HCPCS 27601
|
| Min. Negotiated Rate |
$284.99 |
| Max. Negotiated Rate |
$78,201.00 |
| Rate for Payer: Aetna Commercial |
$564.73
|
| Rate for Payer: Aetna Medicare |
$438.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$564.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.87
|
| Rate for Payer: BCBS Complete |
$299.24
|
| Rate for Payer: BCBS MAPPO |
$421.44
|
| Rate for Payer: BCBS Trust/PPO |
$2,076.22
|
| Rate for Payer: BCN Commercial |
$648.47
|
| Rate for Payer: BCN Medicare Advantage |
$421.44
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cofinity Commercial |
$606.87
|
| Rate for Payer: Cofinity Commercial |
$564.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.44
|
| Rate for Payer: Healthscope Commercial |
$779.66
|
| Rate for Payer: Healthscope Commercial |
$674.30
|
| Rate for Payer: Mclaren Medicaid |
$284.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$442.51
|
| Rate for Payer: Meridian Medicaid |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78,201.00
|
| Rate for Payer: Nomi Health Commercial |
$505.73
|
| Rate for Payer: PACE SWMI |
$421.44
|
| Rate for Payer: PHP Medicare Advantage |
$421.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$902.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$682.39
|
| Rate for Payer: Priority Health Medicare |
$421.44
|
| Rate for Payer: Priority Health Narrow Network |
$682.39
|
| Rate for Payer: Priority Health SBD |
$682.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$546.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$421.44
|
| Rate for Payer: UHC Exchange |
$546.45
|
| Rate for Payer: UHC Medicare Advantage |
$421.44
|
| Rate for Payer: UHCCP Medicaid |
$284.99
|
|
|
PR DCMPRN FASCT THIGH&/KNEE MLT DBRDMT NV MUSC&NRVE
|
Professional
|
Both
|
$1,156.00
|
|
|
Service Code
|
HCPCS 27499
|
| Min. Negotiated Rate |
$459.44 |
| Max. Negotiated Rate |
$124,846.00 |
| Rate for Payer: Aetna Commercial |
$909.91
|
| Rate for Payer: Aetna Medicare |
$706.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$909.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$977.82
|
| Rate for Payer: BCBS Complete |
$482.41
|
| Rate for Payer: BCBS MAPPO |
$679.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,735.54
|
| Rate for Payer: BCN Commercial |
$1,036.00
|
| Rate for Payer: BCN Medicare Advantage |
$679.04
|
| Rate for Payer: Cash Price |
$924.80
|
| Rate for Payer: Cash Price |
$924.80
|
| Rate for Payer: Cofinity Commercial |
$977.82
|
| Rate for Payer: Cofinity Commercial |
$909.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$679.04
|
| Rate for Payer: Healthscope Commercial |
$1,256.22
|
| Rate for Payer: Healthscope Commercial |
$1,086.46
|
| Rate for Payer: Mclaren Medicaid |
$459.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$712.99
|
| Rate for Payer: Meridian Medicaid |
$482.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124,846.00
|
| Rate for Payer: Nomi Health Commercial |
$814.85
|
| Rate for Payer: PACE SWMI |
$679.04
|
| Rate for Payer: PHP Medicare Advantage |
$679.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$459.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$751.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,088.45
|
| Rate for Payer: Priority Health Medicare |
$679.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,088.45
|
| Rate for Payer: Priority Health SBD |
$1,088.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$784.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$679.04
|
| Rate for Payer: UHC Exchange |
$784.90
|
| Rate for Payer: UHC Medicare Advantage |
$679.04
|
| Rate for Payer: UHCCP Medicaid |
$459.44
|
|
