|
PR EXCISION/CURETTAGE CYST/TUMOR FEMUR INT FIXATION
|
Professional
|
Both
|
$1,070.00
|
|
|
Service Code
|
HCPCS 27358
|
| Min. Negotiated Rate |
$263.47 |
| Max. Negotiated Rate |
$695.50 |
| Rate for Payer: Aetna Commercial |
$353.05
|
| Rate for Payer: Aetna Medicare |
$274.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$353.05
|
| Rate for Payer: BCBS Complete |
$428.00
|
| Rate for Payer: BCBS MAPPO |
$263.47
|
| Rate for Payer: BCN Medicare Advantage |
$263.47
|
| Rate for Payer: Cash Price |
$856.00
|
| Rate for Payer: Cash Price |
$856.00
|
| Rate for Payer: Cofinity Commercial |
$379.40
|
| Rate for Payer: Cofinity Commercial |
$353.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.47
|
| Rate for Payer: Healthscope Commercial |
$487.42
|
| Rate for Payer: Healthscope Commercial |
$421.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$695.50
|
| Rate for Payer: Nomi Health Commercial |
$316.16
|
| Rate for Payer: PACE SWMI |
$263.47
|
| Rate for Payer: PHP Medicare Advantage |
$263.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.50
|
| Rate for Payer: Priority Health Medicare |
$263.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.47
|
| Rate for Payer: UHC Medicare Advantage |
$263.47
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR FEMUR W/ALLOGRAFT
|
Professional
|
Both
|
$2,215.00
|
|
|
Service Code
|
HCPCS 27356
|
| Min. Negotiated Rate |
$716.39 |
| Max. Negotiated Rate |
$1,439.75 |
| Rate for Payer: Aetna Commercial |
$959.96
|
| Rate for Payer: Aetna Medicare |
$745.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$959.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.60
|
| Rate for Payer: BCBS Complete |
$886.00
|
| Rate for Payer: BCBS MAPPO |
$716.39
|
| Rate for Payer: BCN Medicare Advantage |
$716.39
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cash Price |
$1,772.00
|
| Rate for Payer: Cofinity Commercial |
$959.96
|
| Rate for Payer: Cofinity Commercial |
$1,031.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$716.39
|
| Rate for Payer: Healthscope Commercial |
$1,146.22
|
| Rate for Payer: Healthscope Commercial |
$1,325.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$752.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,439.75
|
| Rate for Payer: Nomi Health Commercial |
$859.67
|
| Rate for Payer: PACE SWMI |
$716.39
|
| Rate for Payer: PHP Medicare Advantage |
$716.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,439.75
|
| Rate for Payer: Priority Health Medicare |
$716.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$716.39
|
| Rate for Payer: UHC Medicare Advantage |
$716.39
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR FEMUR W/AUTOGRAFT
|
Professional
|
Both
|
$2,018.00
|
|
|
Service Code
|
HCPCS 27357
|
| Min. Negotiated Rate |
$787.59 |
| Max. Negotiated Rate |
$1,457.04 |
| Rate for Payer: Aetna Commercial |
$1,055.37
|
| Rate for Payer: Aetna Medicare |
$819.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,134.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.37
|
| Rate for Payer: BCBS Complete |
$807.20
|
| Rate for Payer: BCBS MAPPO |
$787.59
|
| Rate for Payer: BCN Medicare Advantage |
$787.59
|
| Rate for Payer: Cash Price |
$1,614.40
|
| Rate for Payer: Cash Price |
$1,614.40
|
| Rate for Payer: Cofinity Commercial |
$1,134.13
|
| Rate for Payer: Cofinity Commercial |
$1,055.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.59
|
| Rate for Payer: Healthscope Commercial |
$1,457.04
|
| Rate for Payer: Healthscope Commercial |
$1,260.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,311.70
|
| Rate for Payer: Nomi Health Commercial |
$945.11
|
| Rate for Payer: PACE SWMI |
$787.59
|
| Rate for Payer: PHP Medicare Advantage |
$787.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,311.70
|
| Rate for Payer: Priority Health Medicare |
$787.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$787.59
|
| Rate for Payer: UHC Medicare Advantage |
$787.59
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR METACARPAL
|
Professional
|
Both
|
$1,294.00
|
|
|
Service Code
|
HCPCS 26200
|
| Min. Negotiated Rate |
$436.83 |
| Max. Negotiated Rate |
$841.10 |
| Rate for Payer: Aetna Commercial |
$585.35
|
| Rate for Payer: Aetna Medicare |
$454.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$629.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$585.35
|
| Rate for Payer: BCBS Complete |
$517.60
|
| Rate for Payer: BCBS MAPPO |
$436.83
|
| Rate for Payer: BCN Medicare Advantage |
$436.83
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cash Price |
$1,035.20
|
| Rate for Payer: Cofinity Commercial |
$629.04
|
| Rate for Payer: Cofinity Commercial |
$585.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.83
|
| Rate for Payer: Healthscope Commercial |
$698.93
|
| Rate for Payer: Healthscope Commercial |
$808.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$458.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$841.10
|
| Rate for Payer: Nomi Health Commercial |
$524.20
|
| Rate for Payer: PACE SWMI |
$436.83
|
| Rate for Payer: PHP Medicare Advantage |
$436.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$841.10
|
| Rate for Payer: Priority Health Medicare |
$436.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$436.83
|
| Rate for Payer: UHC Medicare Advantage |
$436.83
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER
|
Professional
|
Both
|
$1,272.00
|
|
|
Service Code
|
HCPCS 26210
|
| Min. Negotiated Rate |
$433.90 |
| Max. Negotiated Rate |
$826.80 |
| Rate for Payer: Aetna Commercial |
$581.43
|
| Rate for Payer: Aetna Medicare |
$451.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.43
|
| Rate for Payer: BCBS Complete |
$508.80
|
| Rate for Payer: BCBS MAPPO |
$433.90
|
| Rate for Payer: BCN Medicare Advantage |
$433.90
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cofinity Commercial |
$624.82
|
| Rate for Payer: Cofinity Commercial |
$581.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.90
|
| Rate for Payer: Healthscope Commercial |
$802.72
|
| Rate for Payer: Healthscope Commercial |
$694.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$826.80
|
| Rate for Payer: Nomi Health Commercial |
$520.68
|
| Rate for Payer: PACE SWMI |
$433.90
|
| Rate for Payer: PHP Medicare Advantage |
$433.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.80
|
| Rate for Payer: Priority Health Medicare |
$433.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.90
|
| Rate for Payer: UHC Medicare Advantage |
$433.90
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA
|
Professional
|
Both
|
$2,206.00
|
|
|
Service Code
|
HCPCS 25120
|
| Min. Negotiated Rate |
$486.23 |
| Max. Negotiated Rate |
$1,433.90 |
| Rate for Payer: Aetna Commercial |
$651.55
|
| Rate for Payer: Aetna Medicare |
$505.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$700.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$651.55
|
| Rate for Payer: BCBS Complete |
$882.40
|
| Rate for Payer: BCBS MAPPO |
$486.23
|
| Rate for Payer: BCN Medicare Advantage |
$486.23
|
| Rate for Payer: Cash Price |
$1,764.80
|
| Rate for Payer: Cash Price |
$1,764.80
|
| Rate for Payer: Cofinity Commercial |
$700.17
|
| Rate for Payer: Cofinity Commercial |
$651.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$486.23
|
| Rate for Payer: Healthscope Commercial |
$777.97
|
| Rate for Payer: Healthscope Commercial |
$899.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$510.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,433.90
|
| Rate for Payer: Nomi Health Commercial |
$583.48
|
| Rate for Payer: PACE SWMI |
$486.23
|
| Rate for Payer: PHP Medicare Advantage |
$486.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.90
|
| Rate for Payer: Priority Health Medicare |
$486.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$486.23
|
| Rate for Payer: UHC Medicare Advantage |
$486.23
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR TALUS/CALCANEUS
|
Professional
|
Both
|
$1,135.00
|
|
|
Service Code
|
HCPCS 28100
|
| Min. Negotiated Rate |
$401.80 |
| Max. Negotiated Rate |
$743.33 |
| Rate for Payer: Aetna Commercial |
$538.41
|
| Rate for Payer: Aetna Medicare |
$417.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$578.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$538.41
|
| Rate for Payer: BCBS Complete |
$454.00
|
| Rate for Payer: BCBS MAPPO |
$401.80
|
| Rate for Payer: BCN Medicare Advantage |
$401.80
|
| Rate for Payer: Cash Price |
$908.00
|
| Rate for Payer: Cash Price |
$908.00
|
| Rate for Payer: Cofinity Commercial |
$578.59
|
| Rate for Payer: Cofinity Commercial |
$538.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$401.80
|
| Rate for Payer: Healthscope Commercial |
$743.33
|
| Rate for Payer: Healthscope Commercial |
$642.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$421.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.75
|
| Rate for Payer: Nomi Health Commercial |
$482.16
|
| Rate for Payer: PACE SWMI |
$401.80
|
| Rate for Payer: PHP Medicare Advantage |
$401.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$737.75
|
| Rate for Payer: Priority Health Medicare |
$401.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$401.80
|
| Rate for Payer: UHC Medicare Advantage |
$401.80
|
|
|
PR EXCISION/CURTG BONE CYST/BENIGN TUMOR HUMERUS
|
Professional
|
Both
|
$1,195.00
|
|
|
Service Code
|
HCPCS 24110
|
| Min. Negotiated Rate |
$478.00 |
| Max. Negotiated Rate |
$1,059.74 |
| Rate for Payer: Aetna Commercial |
$767.59
|
| Rate for Payer: Aetna Medicare |
$595.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$824.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.59
|
| Rate for Payer: BCBS Complete |
$478.00
|
| Rate for Payer: BCBS MAPPO |
$572.83
|
| Rate for Payer: BCN Medicare Advantage |
$572.83
|
| Rate for Payer: Cash Price |
$956.00
|
| Rate for Payer: Cash Price |
$956.00
|
| Rate for Payer: Cofinity Commercial |
$824.88
|
| Rate for Payer: Cofinity Commercial |
$767.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.83
|
| Rate for Payer: Healthscope Commercial |
$1,059.74
|
| Rate for Payer: Healthscope Commercial |
$916.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$601.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$776.75
|
| Rate for Payer: Nomi Health Commercial |
$687.40
|
| Rate for Payer: PACE SWMI |
$572.83
|
| Rate for Payer: PHP Medicare Advantage |
$572.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$776.75
|
| Rate for Payer: Priority Health Medicare |
$572.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$572.83
|
| Rate for Payer: UHC Medicare Advantage |
$572.83
|
|
|
PR EXCISION/DESTRUCTION INTRANASAL LESION INT APPR
|
Professional
|
Both
|
$1,689.00
|
|
|
Service Code
|
HCPCS 30117
|
| Min. Negotiated Rate |
$380.22 |
| Max. Negotiated Rate |
$1,097.85 |
| Rate for Payer: Aetna Commercial |
$509.49
|
| Rate for Payer: Aetna Medicare |
$395.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$547.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$509.49
|
| Rate for Payer: BCBS Complete |
$675.60
|
| Rate for Payer: BCBS MAPPO |
$380.22
|
| Rate for Payer: BCN Medicare Advantage |
$380.22
|
| Rate for Payer: Cash Price |
$1,351.20
|
| Rate for Payer: Cash Price |
$1,351.20
|
| Rate for Payer: Cofinity Commercial |
$547.52
|
| Rate for Payer: Cofinity Commercial |
$509.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.22
|
| Rate for Payer: Healthscope Commercial |
$703.41
|
| Rate for Payer: Healthscope Commercial |
$608.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,097.85
|
| Rate for Payer: Nomi Health Commercial |
$456.26
|
| Rate for Payer: PACE SWMI |
$380.22
|
| Rate for Payer: PHP Medicare Advantage |
$380.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,097.85
|
| Rate for Payer: Priority Health Medicare |
$380.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$380.22
|
| Rate for Payer: UHC Medicare Advantage |
$380.22
|
|
|
PR EXCISION/DESTRUCTION LESION PHARYNX ANY METHOD
|
Professional
|
Both
|
$412.00
|
|
|
Service Code
|
HCPCS 42808
|
| Min. Negotiated Rate |
$159.13 |
| Max. Negotiated Rate |
$294.39 |
| Rate for Payer: Aetna Commercial |
$213.23
|
| Rate for Payer: Aetna Medicare |
$165.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.23
|
| Rate for Payer: BCBS Complete |
$164.80
|
| Rate for Payer: BCBS MAPPO |
$159.13
|
| Rate for Payer: BCN Medicare Advantage |
$159.13
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cofinity Commercial |
$229.15
|
| Rate for Payer: Cofinity Commercial |
$213.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.13
|
| Rate for Payer: Healthscope Commercial |
$254.61
|
| Rate for Payer: Healthscope Commercial |
$294.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$267.80
|
| Rate for Payer: Nomi Health Commercial |
$190.96
|
| Rate for Payer: PACE SWMI |
$159.13
|
| Rate for Payer: PHP Medicare Advantage |
$159.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.80
|
| Rate for Payer: Priority Health Medicare |
$159.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.13
|
| Rate for Payer: UHC Medicare Advantage |
$159.13
|
|
|
PR EXCISION/DESTRUCTION OPEN ABDOMINAL TUMOR 5 CM/<
|
Professional
|
Both
|
$3,287.00
|
|
|
Service Code
|
HCPCS 49203
|
| Min. Negotiated Rate |
$1,314.80 |
| Max. Negotiated Rate |
$2,136.55 |
| Rate for Payer: Aetna Medicare |
$1,643.50
|
| Rate for Payer: BCBS Complete |
$1,314.80
|
| Rate for Payer: Cash Price |
$2,629.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,136.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,136.55
|
|
|
PR EXCISION DISTAL ULNA PARTIAL/COMPLETE
|
Professional
|
Both
|
$1,560.00
|
|
|
Service Code
|
HCPCS 25240
|
| Min. Negotiated Rate |
$417.74 |
| Max. Negotiated Rate |
$1,014.00 |
| Rate for Payer: Aetna Commercial |
$559.77
|
| Rate for Payer: Aetna Medicare |
$434.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$559.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$601.55
|
| Rate for Payer: BCBS Complete |
$624.00
|
| Rate for Payer: BCBS MAPPO |
$417.74
|
| Rate for Payer: BCN Medicare Advantage |
$417.74
|
| Rate for Payer: Cash Price |
$1,248.00
|
| Rate for Payer: Cash Price |
$1,248.00
|
| Rate for Payer: Cofinity Commercial |
$601.55
|
| Rate for Payer: Cofinity Commercial |
$559.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$417.74
|
| Rate for Payer: Healthscope Commercial |
$772.82
|
| Rate for Payer: Healthscope Commercial |
$668.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$438.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,014.00
|
| Rate for Payer: Nomi Health Commercial |
$501.29
|
| Rate for Payer: PACE SWMI |
$417.74
|
| Rate for Payer: PHP Medicare Advantage |
$417.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.00
|
| Rate for Payer: Priority Health Medicare |
$417.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$417.74
|
| Rate for Payer: UHC Medicare Advantage |
$417.74
|
|
|
PR EXCISION EPIPHYSEAL BAR
|
Professional
|
Both
|
$1,959.00
|
|
|
Service Code
|
HCPCS 20150
|
| Min. Negotiated Rate |
$783.60 |
| Max. Negotiated Rate |
$1,790.63 |
| Rate for Payer: Aetna Commercial |
$1,297.00
|
| Rate for Payer: Aetna Medicare |
$1,006.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,297.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,393.79
|
| Rate for Payer: BCBS Complete |
$783.60
|
| Rate for Payer: BCBS MAPPO |
$967.91
|
| Rate for Payer: BCN Medicare Advantage |
$967.91
|
| Rate for Payer: Cash Price |
$1,567.20
|
| Rate for Payer: Cash Price |
$1,567.20
|
| Rate for Payer: Cofinity Commercial |
$1,297.00
|
| Rate for Payer: Cofinity Commercial |
$1,393.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$967.91
|
| Rate for Payer: Healthscope Commercial |
$1,548.66
|
| Rate for Payer: Healthscope Commercial |
$1,790.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,016.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,273.35
|
| Rate for Payer: Nomi Health Commercial |
$1,161.49
|
| Rate for Payer: PACE SWMI |
$967.91
|
| Rate for Payer: PHP Medicare Advantage |
$967.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.35
|
| Rate for Payer: Priority Health Medicare |
$967.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$967.91
|
| Rate for Payer: UHC Medicare Advantage |
$967.91
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE ABDOMEN
|
Professional
|
Both
|
$869.00
|
|
|
Service Code
|
HCPCS 15847
|
| Min. Negotiated Rate |
$347.60 |
| Max. Negotiated Rate |
$564.85 |
| Rate for Payer: Aetna Medicare |
$434.50
|
| Rate for Payer: BCBS Complete |
$347.60
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$564.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.85
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE ARM
|
Professional
|
Both
|
$4,590.00
|
|
|
Service Code
|
HCPCS 15836
|
| Min. Negotiated Rate |
$761.37 |
| Max. Negotiated Rate |
$2,983.50 |
| Rate for Payer: Aetna Commercial |
$1,020.24
|
| Rate for Payer: Aetna Medicare |
$791.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,020.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,096.37
|
| Rate for Payer: BCBS Complete |
$1,836.00
|
| Rate for Payer: BCBS MAPPO |
$761.37
|
| Rate for Payer: BCN Medicare Advantage |
$761.37
|
| Rate for Payer: Cash Price |
$3,672.00
|
| Rate for Payer: Cash Price |
$3,672.00
|
| Rate for Payer: Cofinity Commercial |
$1,096.37
|
| Rate for Payer: Cofinity Commercial |
$1,020.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$761.37
|
| Rate for Payer: Healthscope Commercial |
$1,408.53
|
| Rate for Payer: Healthscope Commercial |
$1,218.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$799.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,983.50
|
| Rate for Payer: Nomi Health Commercial |
$913.64
|
| Rate for Payer: PACE SWMI |
$761.37
|
| Rate for Payer: PHP Medicare Advantage |
$761.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,983.50
|
| Rate for Payer: Priority Health Medicare |
$761.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$761.37
|
| Rate for Payer: UHC Medicare Advantage |
$761.37
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE OTHER AREA
|
Professional
|
Both
|
$2,192.00
|
|
|
Service Code
|
HCPCS 15839
|
| Min. Negotiated Rate |
$707.67 |
| Max. Negotiated Rate |
$1,424.80 |
| Rate for Payer: Aetna Commercial |
$948.28
|
| Rate for Payer: Aetna Medicare |
$735.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,019.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$948.28
|
| Rate for Payer: BCBS Complete |
$876.80
|
| Rate for Payer: BCBS MAPPO |
$707.67
|
| Rate for Payer: BCN Medicare Advantage |
$707.67
|
| Rate for Payer: Cash Price |
$1,753.60
|
| Rate for Payer: Cash Price |
$1,753.60
|
| Rate for Payer: Cofinity Commercial |
$1,019.04
|
| Rate for Payer: Cofinity Commercial |
$948.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$707.67
|
| Rate for Payer: Healthscope Commercial |
$1,132.27
|
| Rate for Payer: Healthscope Commercial |
$1,309.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$743.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,424.80
|
| Rate for Payer: Nomi Health Commercial |
$849.20
|
| Rate for Payer: PACE SWMI |
$707.67
|
| Rate for Payer: PHP Medicare Advantage |
$707.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,424.80
|
| Rate for Payer: Priority Health Medicare |
$707.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$707.67
|
| Rate for Payer: UHC Medicare Advantage |
$707.67
|
|
|
PR EXCISION EXCESSIVE SKIN & SUBQ TISSUE THIGH
|
Professional
|
Both
|
$4,590.00
|
|
|
Service Code
|
HCPCS 15832
|
| Min. Negotiated Rate |
$887.99 |
| Max. Negotiated Rate |
$2,983.50 |
| Rate for Payer: Aetna Commercial |
$1,189.91
|
| Rate for Payer: Aetna Medicare |
$923.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,278.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,189.91
|
| Rate for Payer: BCBS Complete |
$1,836.00
|
| Rate for Payer: BCBS MAPPO |
$887.99
|
| Rate for Payer: BCN Medicare Advantage |
$887.99
|
| Rate for Payer: Cash Price |
$3,672.00
|
| Rate for Payer: Cash Price |
$3,672.00
|
| Rate for Payer: Cofinity Commercial |
$1,278.71
|
| Rate for Payer: Cofinity Commercial |
$1,189.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$887.99
|
| Rate for Payer: Healthscope Commercial |
$1,642.78
|
| Rate for Payer: Healthscope Commercial |
$1,420.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$932.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,983.50
|
| Rate for Payer: Nomi Health Commercial |
$1,065.59
|
| Rate for Payer: PACE SWMI |
$887.99
|
| Rate for Payer: PHP Medicare Advantage |
$887.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,983.50
|
| Rate for Payer: Priority Health Medicare |
$887.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$887.99
|
| Rate for Payer: UHC Medicare Advantage |
$887.99
|
|
|
PR EXCISION EXOSTOSIS EXTERNAL AUDITORY CANAL
|
Professional
|
Both
|
$1,581.00
|
|
|
Service Code
|
HCPCS 69140
|
| Min. Negotiated Rate |
$632.40 |
| Max. Negotiated Rate |
$1,536.87 |
| Rate for Payer: Aetna Commercial |
$1,113.19
|
| Rate for Payer: Aetna Medicare |
$863.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,196.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,113.19
|
| Rate for Payer: BCBS Complete |
$632.40
|
| Rate for Payer: BCBS MAPPO |
$830.74
|
| Rate for Payer: BCN Medicare Advantage |
$830.74
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cofinity Commercial |
$1,196.27
|
| Rate for Payer: Cofinity Commercial |
$1,113.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$830.74
|
| Rate for Payer: Healthscope Commercial |
$1,329.18
|
| Rate for Payer: Healthscope Commercial |
$1,536.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$872.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,027.65
|
| Rate for Payer: Nomi Health Commercial |
$996.89
|
| Rate for Payer: PACE SWMI |
$830.74
|
| Rate for Payer: PHP Medicare Advantage |
$830.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,027.65
|
| Rate for Payer: Priority Health Medicare |
$830.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$830.74
|
| Rate for Payer: UHC Medicare Advantage |
$830.74
|
|
|
PR EXCISION EXTERNAL EAR COMPLETE AMPUTATION
|
Professional
|
Both
|
$724.00
|
|
|
Service Code
|
HCPCS 69120
|
| Min. Negotiated Rate |
$289.60 |
| Max. Negotiated Rate |
$667.11 |
| Rate for Payer: Aetna Commercial |
$483.20
|
| Rate for Payer: Aetna Medicare |
$375.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$483.20
|
| Rate for Payer: BCBS Complete |
$289.60
|
| Rate for Payer: BCBS MAPPO |
$360.60
|
| Rate for Payer: BCN Medicare Advantage |
$360.60
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cofinity Commercial |
$519.26
|
| Rate for Payer: Cofinity Commercial |
$483.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$360.60
|
| Rate for Payer: Healthscope Commercial |
$667.11
|
| Rate for Payer: Healthscope Commercial |
$576.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$378.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$470.60
|
| Rate for Payer: Nomi Health Commercial |
$432.72
|
| Rate for Payer: PACE SWMI |
$360.60
|
| Rate for Payer: PHP Medicare Advantage |
$360.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$470.60
|
| Rate for Payer: Priority Health Medicare |
$360.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$360.60
|
| Rate for Payer: UHC Medicare Advantage |
$360.60
|
|
|
PR EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Professional
|
Both
|
$624.00
|
|
|
Service Code
|
HCPCS 69110
|
| Min. Negotiated Rate |
$249.60 |
| Max. Negotiated Rate |
$566.27 |
| Rate for Payer: Aetna Commercial |
$410.16
|
| Rate for Payer: Aetna Medicare |
$318.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$440.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$410.16
|
| Rate for Payer: BCBS Complete |
$249.60
|
| Rate for Payer: BCBS MAPPO |
$306.09
|
| Rate for Payer: BCN Medicare Advantage |
$306.09
|
| Rate for Payer: Cash Price |
$499.20
|
| Rate for Payer: Cash Price |
$499.20
|
| Rate for Payer: Cofinity Commercial |
$440.77
|
| Rate for Payer: Cofinity Commercial |
$410.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.09
|
| Rate for Payer: Healthscope Commercial |
$489.74
|
| Rate for Payer: Healthscope Commercial |
$566.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$405.60
|
| Rate for Payer: Nomi Health Commercial |
$367.31
|
| Rate for Payer: PACE SWMI |
$306.09
|
| Rate for Payer: PHP Medicare Advantage |
$306.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$405.60
|
| Rate for Payer: Priority Health Medicare |
$306.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.09
|
| Rate for Payer: UHC Medicare Advantage |
$306.09
|
|
|
PR EXCISION FACIAL BONE
|
Professional
|
Both
|
$998.00
|
|
|
Service Code
|
HCPCS 21026
|
| Min. Negotiated Rate |
$399.20 |
| Max. Negotiated Rate |
$765.51 |
| Rate for Payer: Aetna Commercial |
$554.48
|
| Rate for Payer: Aetna Medicare |
$430.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$595.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.48
|
| Rate for Payer: BCBS Complete |
$399.20
|
| Rate for Payer: BCBS MAPPO |
$413.79
|
| Rate for Payer: BCN Medicare Advantage |
$413.79
|
| Rate for Payer: Cash Price |
$798.40
|
| Rate for Payer: Cash Price |
$798.40
|
| Rate for Payer: Cofinity Commercial |
$595.86
|
| Rate for Payer: Cofinity Commercial |
$554.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.79
|
| Rate for Payer: Healthscope Commercial |
$765.51
|
| Rate for Payer: Healthscope Commercial |
$662.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$434.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$648.70
|
| Rate for Payer: Nomi Health Commercial |
$496.55
|
| Rate for Payer: PACE SWMI |
$413.79
|
| Rate for Payer: PHP Medicare Advantage |
$413.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$648.70
|
| Rate for Payer: Priority Health Medicare |
$413.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$413.79
|
| Rate for Payer: UHC Medicare Advantage |
$413.79
|
|
|
PR EXCISION/FULGURATION URETHRAL PROLAPSE
|
Professional
|
Both
|
$864.00
|
|
|
Service Code
|
HCPCS 53275
|
| Min. Negotiated Rate |
$251.04 |
| Max. Negotiated Rate |
$561.60 |
| Rate for Payer: Aetna Commercial |
$336.39
|
| Rate for Payer: Aetna Medicare |
$261.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$361.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.39
|
| Rate for Payer: BCBS Complete |
$345.60
|
| Rate for Payer: BCBS MAPPO |
$251.04
|
| Rate for Payer: BCN Medicare Advantage |
$251.04
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cofinity Commercial |
$361.50
|
| Rate for Payer: Cofinity Commercial |
$336.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$251.04
|
| Rate for Payer: Healthscope Commercial |
$401.66
|
| Rate for Payer: Healthscope Commercial |
$464.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$263.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$561.60
|
| Rate for Payer: Nomi Health Commercial |
$301.25
|
| Rate for Payer: PACE SWMI |
$251.04
|
| Rate for Payer: PHP Medicare Advantage |
$251.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.60
|
| Rate for Payer: Priority Health Medicare |
$251.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$251.04
|
| Rate for Payer: UHC Medicare Advantage |
$251.04
|
|
|
PR EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY
|
Professional
|
Both
|
$1,106.00
|
|
|
Service Code
|
HCPCS 25111
|
| Min. Negotiated Rate |
$315.15 |
| Max. Negotiated Rate |
$718.90 |
| Rate for Payer: Aetna Commercial |
$422.30
|
| Rate for Payer: Aetna Medicare |
$327.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$453.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.30
|
| Rate for Payer: BCBS Complete |
$442.40
|
| Rate for Payer: BCBS MAPPO |
$315.15
|
| Rate for Payer: BCN Medicare Advantage |
$315.15
|
| Rate for Payer: Cash Price |
$884.80
|
| Rate for Payer: Cash Price |
$884.80
|
| Rate for Payer: Cofinity Commercial |
$453.82
|
| Rate for Payer: Cofinity Commercial |
$422.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$315.15
|
| Rate for Payer: Healthscope Commercial |
$583.03
|
| Rate for Payer: Healthscope Commercial |
$504.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$718.90
|
| Rate for Payer: Nomi Health Commercial |
$378.18
|
| Rate for Payer: PACE SWMI |
$315.15
|
| Rate for Payer: PHP Medicare Advantage |
$315.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$718.90
|
| Rate for Payer: Priority Health Medicare |
$315.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$315.15
|
| Rate for Payer: UHC Medicare Advantage |
$315.15
|
|
|
PR EXCISION GANGLION WRIST DORSAL/VOLAR RECURRENT
|
Professional
|
Both
|
$1,150.00
|
|
|
Service Code
|
HCPCS 25112
|
| Min. Negotiated Rate |
$379.52 |
| Max. Negotiated Rate |
$747.50 |
| Rate for Payer: Aetna Commercial |
$508.56
|
| Rate for Payer: Aetna Medicare |
$394.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$546.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$508.56
|
| Rate for Payer: BCBS Complete |
$460.00
|
| Rate for Payer: BCBS MAPPO |
$379.52
|
| Rate for Payer: BCN Medicare Advantage |
$379.52
|
| Rate for Payer: Cash Price |
$920.00
|
| Rate for Payer: Cash Price |
$920.00
|
| Rate for Payer: Cofinity Commercial |
$546.51
|
| Rate for Payer: Cofinity Commercial |
$508.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$379.52
|
| Rate for Payer: Healthscope Commercial |
$607.23
|
| Rate for Payer: Healthscope Commercial |
$702.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$398.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$747.50
|
| Rate for Payer: Nomi Health Commercial |
$455.42
|
| Rate for Payer: PACE SWMI |
$379.52
|
| Rate for Payer: PHP Medicare Advantage |
$379.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$747.50
|
| Rate for Payer: Priority Health Medicare |
$379.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$379.52
|
| Rate for Payer: UHC Medicare Advantage |
$379.52
|
|
|
PR EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR
|
Professional
|
Both
|
$837.00
|
|
|
Service Code
|
HCPCS 11451
|
| Hospital Charge Code |
11451
|
| Min. Negotiated Rate |
$319.61 |
| Max. Negotiated Rate |
$591.28 |
| Rate for Payer: Aetna Commercial |
$428.28
|
| Rate for Payer: Aetna Medicare |
$332.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$428.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$460.24
|
| Rate for Payer: BCBS Complete |
$334.80
|
| Rate for Payer: BCBS MAPPO |
$319.61
|
| Rate for Payer: BCN Medicare Advantage |
$319.61
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cofinity Commercial |
$460.24
|
| Rate for Payer: Cofinity Commercial |
$428.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.61
|
| Rate for Payer: Healthscope Commercial |
$511.38
|
| Rate for Payer: Healthscope Commercial |
$591.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$335.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$544.05
|
| Rate for Payer: Nomi Health Commercial |
$383.53
|
| Rate for Payer: PACE SWMI |
$319.61
|
| Rate for Payer: PHP Medicare Advantage |
$319.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.05
|
| Rate for Payer: Priority Health Medicare |
$319.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$319.61
|
| Rate for Payer: UHC Medicare Advantage |
$319.61
|
|
