|
PR EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE
|
Professional
|
Both
|
$1,248.00
|
|
|
Service Code
|
HCPCS 15940
|
| Min. Negotiated Rate |
$459.65 |
| Max. Negotiated Rate |
$125,849.00 |
| Rate for Payer: Aetna Commercial |
$916.57
|
| Rate for Payer: Aetna Medicare |
$711.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$916.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$984.97
|
| Rate for Payer: BCBS Complete |
$482.63
|
| Rate for Payer: BCBS MAPPO |
$684.01
|
| Rate for Payer: BCBS Trust/PPO |
$540.00
|
| Rate for Payer: BCN Commercial |
$1,038.93
|
| Rate for Payer: BCN Medicare Advantage |
$684.01
|
| Rate for Payer: Cash Price |
$998.40
|
| Rate for Payer: Cash Price |
$998.40
|
| Rate for Payer: Cofinity Commercial |
$984.97
|
| Rate for Payer: Cofinity Commercial |
$916.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$684.01
|
| Rate for Payer: Healthscope Commercial |
$1,265.42
|
| Rate for Payer: Healthscope Commercial |
$1,094.42
|
| Rate for Payer: Mclaren Medicaid |
$459.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$718.21
|
| Rate for Payer: Meridian Medicaid |
$482.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125,849.00
|
| Rate for Payer: Nomi Health Commercial |
$820.81
|
| Rate for Payer: PACE SWMI |
$684.01
|
| Rate for Payer: PHP Medicare Advantage |
$684.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$459.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$811.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$965.35
|
| Rate for Payer: Priority Health Medicare |
$684.01
|
| Rate for Payer: Priority Health Narrow Network |
$965.35
|
| Rate for Payer: Priority Health SBD |
$965.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$662.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$684.01
|
| Rate for Payer: UHC Exchange |
$662.53
|
| Rate for Payer: UHC Medicare Advantage |
$684.01
|
| Rate for Payer: UHCCP Medicaid |
$459.65
|
|
|
PR EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE
|
Professional
|
Both
|
$1,617.00
|
|
|
Service Code
|
HCPCS 15944
|
| Min. Negotiated Rate |
$604.28 |
| Max. Negotiated Rate |
$164,720.00 |
| Rate for Payer: Aetna Commercial |
$1,194.11
|
| Rate for Payer: Aetna Medicare |
$926.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,194.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,283.23
|
| Rate for Payer: BCBS Complete |
$634.49
|
| Rate for Payer: BCBS MAPPO |
$891.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,275.40
|
| Rate for Payer: BCN Commercial |
$1,369.28
|
| Rate for Payer: BCN Medicare Advantage |
$891.13
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cash Price |
$1,293.60
|
| Rate for Payer: Cofinity Commercial |
$1,283.23
|
| Rate for Payer: Cofinity Commercial |
$1,194.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$891.13
|
| Rate for Payer: Healthscope Commercial |
$1,648.59
|
| Rate for Payer: Healthscope Commercial |
$1,425.81
|
| Rate for Payer: Mclaren Medicaid |
$604.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$935.69
|
| Rate for Payer: Meridian Medicaid |
$634.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164,720.00
|
| Rate for Payer: Nomi Health Commercial |
$1,069.36
|
| Rate for Payer: PACE SWMI |
$891.13
|
| Rate for Payer: PHP Medicare Advantage |
$891.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$604.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,269.66
|
| Rate for Payer: Priority Health Medicare |
$891.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,269.66
|
| Rate for Payer: Priority Health SBD |
$1,269.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,000.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$891.13
|
| Rate for Payer: UHC Exchange |
$1,000.00
|
| Rate for Payer: UHC Medicare Advantage |
$891.13
|
| Rate for Payer: UHCCP Medicaid |
$604.28
|
|
|
PR EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN
|
Professional
|
Both
|
$3,352.00
|
|
|
Service Code
|
HCPCS 15946
|
| Min. Negotiated Rate |
$1,030.92 |
| Max. Negotiated Rate |
$286,522.00 |
| Rate for Payer: Aetna Commercial |
$2,058.15
|
| Rate for Payer: Aetna Medicare |
$1,597.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,058.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,211.74
|
| Rate for Payer: BCBS Complete |
$1,082.47
|
| Rate for Payer: BCBS MAPPO |
$1,535.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,664.35
|
| Rate for Payer: BCN Commercial |
$2,363.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,535.93
|
| Rate for Payer: Cash Price |
$2,681.60
|
| Rate for Payer: Cash Price |
$2,681.60
|
| Rate for Payer: Cofinity Commercial |
$2,211.74
|
| Rate for Payer: Cofinity Commercial |
$2,058.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,535.93
|
| Rate for Payer: Healthscope Commercial |
$2,841.47
|
| Rate for Payer: Healthscope Commercial |
$2,457.49
|
| Rate for Payer: Mclaren Medicaid |
$1,030.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,612.73
|
| Rate for Payer: Meridian Medicaid |
$1,082.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286,522.00
|
| Rate for Payer: Nomi Health Commercial |
$1,843.12
|
| Rate for Payer: PACE SWMI |
$1,535.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,535.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,030.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,178.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,182.63
|
| Rate for Payer: Priority Health Medicare |
$1,535.93
|
| Rate for Payer: Priority Health Narrow Network |
$2,182.63
|
| Rate for Payer: Priority Health SBD |
$2,182.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,800.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,535.93
|
| Rate for Payer: UHC Exchange |
$1,800.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,535.93
|
| Rate for Payer: UHCCP Medicaid |
$1,030.92
|
|
|
PR EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT
|
Professional
|
Both
|
$1,616.00
|
|
|
Service Code
|
HCPCS 15941
|
| Min. Negotiated Rate |
$562.50 |
| Max. Negotiated Rate |
$165,314.00 |
| Rate for Payer: Aetna Commercial |
$1,209.28
|
| Rate for Payer: Aetna Medicare |
$938.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,209.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,299.53
|
| Rate for Payer: BCBS Complete |
$643.22
|
| Rate for Payer: BCBS MAPPO |
$902.45
|
| Rate for Payer: BCBS Trust/PPO |
$562.50
|
| Rate for Payer: BCN Commercial |
$1,372.69
|
| Rate for Payer: BCN Medicare Advantage |
$902.45
|
| Rate for Payer: Cash Price |
$1,292.80
|
| Rate for Payer: Cash Price |
$1,292.80
|
| Rate for Payer: Cofinity Commercial |
$1,299.53
|
| Rate for Payer: Cofinity Commercial |
$1,209.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$902.45
|
| Rate for Payer: Healthscope Commercial |
$1,669.53
|
| Rate for Payer: Healthscope Commercial |
$1,443.92
|
| Rate for Payer: Mclaren Medicaid |
$612.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$947.57
|
| Rate for Payer: Meridian Medicaid |
$643.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165,314.00
|
| Rate for Payer: Nomi Health Commercial |
$1,082.94
|
| Rate for Payer: PACE SWMI |
$902.45
|
| Rate for Payer: PHP Medicare Advantage |
$902.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$612.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,050.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,261.53
|
| Rate for Payer: Priority Health Medicare |
$902.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,261.53
|
| Rate for Payer: Priority Health SBD |
$1,261.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$909.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$902.45
|
| Rate for Payer: UHC Exchange |
$909.43
|
| Rate for Payer: UHC Medicare Advantage |
$902.45
|
| Rate for Payer: UHCCP Medicaid |
$612.59
|
|
|
PR EXCISION 1ST &/CERVICAL RIB
|
Professional
|
Both
|
$1,202.00
|
|
|
Service Code
|
HCPCS 21615
|
| Min. Negotiated Rate |
$400.23 |
| Max. Negotiated Rate |
$111,026.00 |
| Rate for Payer: Aetna Commercial |
$810.99
|
| Rate for Payer: Aetna Medicare |
$629.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$810.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$871.52
|
| Rate for Payer: BCBS Complete |
$420.24
|
| Rate for Payer: BCBS MAPPO |
$605.22
|
| Rate for Payer: BCBS Trust/PPO |
$3,350.93
|
| Rate for Payer: BCN Commercial |
$904.54
|
| Rate for Payer: BCN Medicare Advantage |
$605.22
|
| Rate for Payer: Cash Price |
$961.60
|
| Rate for Payer: Cash Price |
$961.60
|
| Rate for Payer: Cofinity Commercial |
$871.52
|
| Rate for Payer: Cofinity Commercial |
$810.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$605.22
|
| Rate for Payer: Healthscope Commercial |
$968.35
|
| Rate for Payer: Healthscope Commercial |
$1,119.66
|
| Rate for Payer: Mclaren Medicaid |
$400.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$635.48
|
| Rate for Payer: Meridian Medicaid |
$420.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111,026.00
|
| Rate for Payer: Nomi Health Commercial |
$726.26
|
| Rate for Payer: PACE SWMI |
$605.22
|
| Rate for Payer: PHP Medicare Advantage |
$605.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$781.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$949.53
|
| Rate for Payer: Priority Health Medicare |
$605.22
|
| Rate for Payer: Priority Health Narrow Network |
$949.53
|
| Rate for Payer: Priority Health SBD |
$949.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$816.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$605.22
|
| Rate for Payer: UHC Exchange |
$816.26
|
| Rate for Payer: UHC Medicare Advantage |
$605.22
|
| Rate for Payer: UHCCP Medicaid |
$400.23
|
|
|
PR EXCISION AMPULLA VATER
|
Professional
|
Both
|
$1,847.00
|
|
|
Service Code
|
HCPCS 48148
|
| Min. Negotiated Rate |
$804.29 |
| Max. Negotiated Rate |
$224,104.00 |
| Rate for Payer: Aetna Commercial |
$1,628.50
|
| Rate for Payer: Aetna Medicare |
$1,263.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,628.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,750.03
|
| Rate for Payer: BCBS Complete |
$844.50
|
| Rate for Payer: BCBS MAPPO |
$1,215.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,258.41
|
| Rate for Payer: BCN Commercial |
$1,828.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,215.30
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cofinity Commercial |
$1,750.03
|
| Rate for Payer: Cofinity Commercial |
$1,628.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,215.30
|
| Rate for Payer: Healthscope Commercial |
$2,248.30
|
| Rate for Payer: Healthscope Commercial |
$1,944.48
|
| Rate for Payer: Mclaren Medicaid |
$804.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,276.06
|
| Rate for Payer: Meridian Medicaid |
$844.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224,104.00
|
| Rate for Payer: Nomi Health Commercial |
$1,458.36
|
| Rate for Payer: PACE SWMI |
$1,215.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,215.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$804.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,200.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,241.40
|
| Rate for Payer: Priority Health Medicare |
$1,215.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,241.40
|
| Rate for Payer: Priority Health SBD |
$2,241.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,194.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,215.30
|
| Rate for Payer: UHC Exchange |
$1,194.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,215.30
|
| Rate for Payer: UHCCP Medicaid |
$804.29
|
|
|
PR EXCISION AURAL POLYP
|
Professional
|
Both
|
$376.00
|
|
|
Service Code
|
HCPCS 69540
|
| Min. Negotiated Rate |
$83.28 |
| Max. Negotiated Rate |
$22,763.00 |
| Rate for Payer: Aetna Commercial |
$161.26
|
| Rate for Payer: Aetna Medicare |
$125.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.29
|
| Rate for Payer: BCBS Complete |
$87.44
|
| Rate for Payer: BCBS MAPPO |
$120.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,401.65
|
| Rate for Payer: BCN Commercial |
$313.73
|
| Rate for Payer: BCN Medicare Advantage |
$120.34
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cofinity Commercial |
$173.29
|
| Rate for Payer: Cofinity Commercial |
$161.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.34
|
| Rate for Payer: Healthscope Commercial |
$222.63
|
| Rate for Payer: Healthscope Commercial |
$192.54
|
| Rate for Payer: Mclaren Medicaid |
$83.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.36
|
| Rate for Payer: Meridian Medicaid |
$87.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,763.00
|
| Rate for Payer: Nomi Health Commercial |
$144.41
|
| Rate for Payer: PACE SWMI |
$120.34
|
| Rate for Payer: PHP Medicare Advantage |
$120.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$192.12
|
| Rate for Payer: Priority Health Medicare |
$120.34
|
| Rate for Payer: Priority Health Narrow Network |
$192.12
|
| Rate for Payer: Priority Health SBD |
$192.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.34
|
| Rate for Payer: UHC Exchange |
$197.49
|
| Rate for Payer: UHC Medicare Advantage |
$120.34
|
| Rate for Payer: UHCCP Medicaid |
$83.28
|
|
|
PR EXCISION BARTHOLINS GLAND OR CYST
|
Professional
|
Both
|
$929.00
|
|
|
Service Code
|
HCPCS 56740
|
| Min. Negotiated Rate |
$201.71 |
| Max. Negotiated Rate |
$56,153.00 |
| Rate for Payer: Aetna Commercial |
$402.08
|
| Rate for Payer: Aetna Medicare |
$312.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$432.09
|
| Rate for Payer: BCBS Complete |
$211.80
|
| Rate for Payer: BCBS MAPPO |
$300.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,879.16
|
| Rate for Payer: BCN Commercial |
$463.27
|
| Rate for Payer: BCN Medicare Advantage |
$300.06
|
| Rate for Payer: Cash Price |
$743.20
|
| Rate for Payer: Cash Price |
$743.20
|
| Rate for Payer: Cofinity Commercial |
$432.09
|
| Rate for Payer: Cofinity Commercial |
$402.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.06
|
| Rate for Payer: Healthscope Commercial |
$555.11
|
| Rate for Payer: Healthscope Commercial |
$480.10
|
| Rate for Payer: Mclaren Medicaid |
$201.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$315.06
|
| Rate for Payer: Meridian Medicaid |
$211.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56,153.00
|
| Rate for Payer: Nomi Health Commercial |
$360.07
|
| Rate for Payer: PACE SWMI |
$300.06
|
| Rate for Payer: PHP Medicare Advantage |
$300.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$603.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$472.24
|
| Rate for Payer: Priority Health Medicare |
$300.06
|
| Rate for Payer: Priority Health Narrow Network |
$472.24
|
| Rate for Payer: Priority Health SBD |
$472.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$382.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$300.06
|
| Rate for Payer: UHC Exchange |
$382.50
|
| Rate for Payer: UHC Medicare Advantage |
$300.06
|
| Rate for Payer: UHCCP Medicaid |
$201.71
|
|
|
PR EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT
|
Professional
|
Both
|
$976.00
|
|
|
Service Code
|
HCPCS 21040
|
| Min. Negotiated Rate |
$235.58 |
| Max. Negotiated Rate |
$63,506.00 |
| Rate for Payer: Aetna Commercial |
$461.34
|
| Rate for Payer: Aetna Medicare |
$358.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$495.76
|
| Rate for Payer: BCBS Complete |
$247.36
|
| Rate for Payer: BCBS MAPPO |
$344.28
|
| Rate for Payer: BCBS Trust/PPO |
$332.62
|
| Rate for Payer: BCN Commercial |
$681.71
|
| Rate for Payer: BCN Medicare Advantage |
$344.28
|
| Rate for Payer: Cash Price |
$780.80
|
| Rate for Payer: Cash Price |
$780.80
|
| Rate for Payer: Cofinity Commercial |
$495.76
|
| Rate for Payer: Cofinity Commercial |
$461.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.28
|
| Rate for Payer: Healthscope Commercial |
$636.92
|
| Rate for Payer: Healthscope Commercial |
$550.85
|
| Rate for Payer: Mclaren Medicaid |
$235.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$361.49
|
| Rate for Payer: Meridian Medicaid |
$247.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63,506.00
|
| Rate for Payer: Nomi Health Commercial |
$413.14
|
| Rate for Payer: PACE SWMI |
$344.28
|
| Rate for Payer: PHP Medicare Advantage |
$344.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$553.64
|
| Rate for Payer: Priority Health Medicare |
$344.28
|
| Rate for Payer: Priority Health Narrow Network |
$553.64
|
| Rate for Payer: Priority Health SBD |
$553.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$458.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$344.28
|
| Rate for Payer: UHC Exchange |
$458.70
|
| Rate for Payer: UHC Medicare Advantage |
$344.28
|
| Rate for Payer: UHCCP Medicaid |
$235.58
|
|
|
PR EXCISION BONE CYST/BENIGN TUMOR DEEP
|
Professional
|
Both
|
$1,497.00
|
|
|
Service Code
|
HCPCS 27066
|
| Min. Negotiated Rate |
$80.30 |
| Max. Negotiated Rate |
$145,694.00 |
| Rate for Payer: Aetna Commercial |
$1,059.31
|
| Rate for Payer: Aetna Medicare |
$822.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,059.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,138.36
|
| Rate for Payer: BCBS Complete |
$560.91
|
| Rate for Payer: BCBS MAPPO |
$790.53
|
| Rate for Payer: BCBS Trust/PPO |
$80.30
|
| Rate for Payer: BCN Commercial |
$1,207.52
|
| Rate for Payer: BCN Medicare Advantage |
$790.53
|
| Rate for Payer: Cash Price |
$1,197.60
|
| Rate for Payer: Cash Price |
$1,197.60
|
| Rate for Payer: Cofinity Commercial |
$1,138.36
|
| Rate for Payer: Cofinity Commercial |
$1,059.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$790.53
|
| Rate for Payer: Healthscope Commercial |
$1,462.48
|
| Rate for Payer: Healthscope Commercial |
$1,264.85
|
| Rate for Payer: Mclaren Medicaid |
$534.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$830.06
|
| Rate for Payer: Meridian Medicaid |
$560.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145,694.00
|
| Rate for Payer: Nomi Health Commercial |
$948.64
|
| Rate for Payer: PACE SWMI |
$790.53
|
| Rate for Payer: PHP Medicare Advantage |
$790.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$534.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$973.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,259.94
|
| Rate for Payer: Priority Health Medicare |
$790.53
|
| Rate for Payer: Priority Health Narrow Network |
$1,259.94
|
| Rate for Payer: Priority Health SBD |
$1,259.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$959.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$790.53
|
| Rate for Payer: UHC Exchange |
$959.66
|
| Rate for Payer: UHC Medicare Advantage |
$790.53
|
| Rate for Payer: UHCCP Medicaid |
$534.20
|
|
|
PR EXCISION BONE CYST/BNIGN TUMOR SUPERFICIAL
|
Professional
|
Both
|
$905.00
|
|
|
Service Code
|
HCPCS 27065
|
| Min. Negotiated Rate |
$344.00 |
| Max. Negotiated Rate |
$93,647.00 |
| Rate for Payer: Aetna Commercial |
$677.75
|
| Rate for Payer: Aetna Medicare |
$526.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$677.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$728.32
|
| Rate for Payer: BCBS Complete |
$361.20
|
| Rate for Payer: BCBS MAPPO |
$505.78
|
| Rate for Payer: BCBS Trust/PPO |
$4,717.19
|
| Rate for Payer: BCN Commercial |
$780.42
|
| Rate for Payer: BCN Medicare Advantage |
$505.78
|
| Rate for Payer: Cash Price |
$724.00
|
| Rate for Payer: Cash Price |
$724.00
|
| Rate for Payer: Cofinity Commercial |
$728.32
|
| Rate for Payer: Cofinity Commercial |
$677.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$505.78
|
| Rate for Payer: Healthscope Commercial |
$935.69
|
| Rate for Payer: Healthscope Commercial |
$809.25
|
| Rate for Payer: Mclaren Medicaid |
$344.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$531.07
|
| Rate for Payer: Meridian Medicaid |
$361.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93,647.00
|
| Rate for Payer: Nomi Health Commercial |
$606.94
|
| Rate for Payer: PACE SWMI |
$505.78
|
| Rate for Payer: PHP Medicare Advantage |
$505.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$344.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$588.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$813.67
|
| Rate for Payer: Priority Health Medicare |
$505.78
|
| Rate for Payer: Priority Health Narrow Network |
$813.67
|
| Rate for Payer: Priority Health SBD |
$813.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$608.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$505.78
|
| Rate for Payer: UHC Exchange |
$608.39
|
| Rate for Payer: UHC Medicare Advantage |
$505.78
|
| Rate for Payer: UHCCP Medicaid |
$344.00
|
|
|
PR EXCISION BONE MANDIBLE
|
Professional
|
Both
|
$1,596.00
|
|
|
Service Code
|
HCPCS 21025
|
| Min. Negotiated Rate |
$103.02 |
| Max. Negotiated Rate |
$115,895.00 |
| Rate for Payer: Aetna Commercial |
$851.64
|
| Rate for Payer: Aetna Medicare |
$660.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$851.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$915.19
|
| Rate for Payer: BCBS Complete |
$453.56
|
| Rate for Payer: BCBS MAPPO |
$635.55
|
| Rate for Payer: BCBS Trust/PPO |
$103.02
|
| Rate for Payer: BCN Commercial |
$1,154.25
|
| Rate for Payer: BCN Medicare Advantage |
$635.55
|
| Rate for Payer: Cash Price |
$1,276.80
|
| Rate for Payer: Cash Price |
$1,276.80
|
| Rate for Payer: Cofinity Commercial |
$915.19
|
| Rate for Payer: Cofinity Commercial |
$851.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$635.55
|
| Rate for Payer: Healthscope Commercial |
$1,175.77
|
| Rate for Payer: Healthscope Commercial |
$1,016.88
|
| Rate for Payer: Mclaren Medicaid |
$431.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$667.33
|
| Rate for Payer: Meridian Medicaid |
$453.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115,895.00
|
| Rate for Payer: Nomi Health Commercial |
$762.66
|
| Rate for Payer: PACE SWMI |
$635.55
|
| Rate for Payer: PHP Medicare Advantage |
$635.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,037.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,012.13
|
| Rate for Payer: Priority Health Medicare |
$635.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,012.13
|
| Rate for Payer: Priority Health SBD |
$1,012.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$838.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$635.55
|
| Rate for Payer: UHC Exchange |
$838.65
|
| Rate for Payer: UHC Medicare Advantage |
$635.55
|
| Rate for Payer: UHCCP Medicaid |
$431.96
|
|
|
PR EXCISION CHALAZION MULTIPLE SAME LID
|
Professional
|
Both
|
$291.00
|
|
|
Service Code
|
HCPCS 67801
|
| Min. Negotiated Rate |
$83.50 |
| Max. Negotiated Rate |
$22,824.00 |
| Rate for Payer: Aetna Commercial |
$163.98
|
| Rate for Payer: Aetna Medicare |
$127.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.21
|
| Rate for Payer: BCBS Complete |
$87.68
|
| Rate for Payer: BCBS MAPPO |
$122.37
|
| Rate for Payer: BCBS Trust/PPO |
$552.60
|
| Rate for Payer: BCN Commercial |
$237.49
|
| Rate for Payer: BCN Medicare Advantage |
$122.37
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$176.21
|
| Rate for Payer: Cofinity Commercial |
$163.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.37
|
| Rate for Payer: Healthscope Commercial |
$226.38
|
| Rate for Payer: Healthscope Commercial |
$195.79
|
| Rate for Payer: Mclaren Medicaid |
$83.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.49
|
| Rate for Payer: Meridian Medicaid |
$87.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,824.00
|
| Rate for Payer: Nomi Health Commercial |
$146.84
|
| Rate for Payer: PACE SWMI |
$122.37
|
| Rate for Payer: PHP Medicare Advantage |
$122.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.11
|
| Rate for Payer: Priority Health Medicare |
$122.37
|
| Rate for Payer: Priority Health Narrow Network |
$228.11
|
| Rate for Payer: Priority Health SBD |
$228.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$398.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.37
|
| Rate for Payer: UHC Exchange |
$398.49
|
| Rate for Payer: UHC Medicare Advantage |
$122.37
|
| Rate for Payer: UHCCP Medicaid |
$83.50
|
|
|
PR EXCISION CHALAZION SINGLE
|
Professional
|
Both
|
$197.00
|
|
|
Service Code
|
HCPCS 67800
|
| Min. Negotiated Rate |
$65.18 |
| Max. Negotiated Rate |
$17,602.00 |
| Rate for Payer: Aetna Commercial |
$127.64
|
| Rate for Payer: Aetna Medicare |
$99.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.16
|
| Rate for Payer: BCBS Complete |
$68.44
|
| Rate for Payer: BCBS MAPPO |
$95.25
|
| Rate for Payer: BCBS Trust/PPO |
$552.07
|
| Rate for Payer: BCN Commercial |
$150.39
|
| Rate for Payer: BCN Medicare Advantage |
$95.25
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$137.16
|
| Rate for Payer: Cofinity Commercial |
$127.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.25
|
| Rate for Payer: Healthscope Commercial |
$176.21
|
| Rate for Payer: Healthscope Commercial |
$152.40
|
| Rate for Payer: Mclaren Medicaid |
$65.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.01
|
| Rate for Payer: Meridian Medicaid |
$68.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,602.00
|
| Rate for Payer: Nomi Health Commercial |
$114.30
|
| Rate for Payer: PACE SWMI |
$95.25
|
| Rate for Payer: PHP Medicare Advantage |
$95.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$177.80
|
| Rate for Payer: Priority Health Medicare |
$95.25
|
| Rate for Payer: Priority Health Narrow Network |
$177.80
|
| Rate for Payer: Priority Health SBD |
$177.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.25
|
| Rate for Payer: UHC Exchange |
$164.57
|
| Rate for Payer: UHC Medicare Advantage |
$95.25
|
| Rate for Payer: UHCCP Medicaid |
$65.18
|
|
|
PR EXCISION CHEST WALL TUMOR INCLUDING RIBS
|
Professional
|
Both
|
$2,439.00
|
|
|
Service Code
|
HCPCS 21601
|
| Min. Negotiated Rate |
$267.70 |
| Max. Negotiated Rate |
$203,301.00 |
| Rate for Payer: Aetna Commercial |
$1,479.32
|
| Rate for Payer: Aetna Medicare |
$1,148.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,479.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,589.72
|
| Rate for Payer: BCBS Complete |
$770.92
|
| Rate for Payer: BCBS MAPPO |
$1,103.97
|
| Rate for Payer: BCBS Trust/PPO |
$267.70
|
| Rate for Payer: BCN Commercial |
$1,664.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,103.97
|
| Rate for Payer: Cash Price |
$1,951.20
|
| Rate for Payer: Cash Price |
$1,951.20
|
| Rate for Payer: Cofinity Commercial |
$1,589.72
|
| Rate for Payer: Cofinity Commercial |
$1,479.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,103.97
|
| Rate for Payer: Healthscope Commercial |
$1,766.35
|
| Rate for Payer: Healthscope Commercial |
$2,042.34
|
| Rate for Payer: Mclaren Medicaid |
$734.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,159.17
|
| Rate for Payer: Meridian Medicaid |
$770.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$203,301.00
|
| Rate for Payer: Nomi Health Commercial |
$1,324.76
|
| Rate for Payer: PACE SWMI |
$1,103.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,103.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$734.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,585.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,753.54
|
| Rate for Payer: Priority Health Medicare |
$1,103.97
|
| Rate for Payer: Priority Health Narrow Network |
$1,753.54
|
| Rate for Payer: Priority Health SBD |
$1,753.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,103.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,103.97
|
| Rate for Payer: UHCCP Medicaid |
$734.21
|
|
|
PR EXCISION CHOLEDOCHAL CYST
|
Professional
|
Both
|
$2,307.00
|
|
|
Service Code
|
HCPCS 47715
|
| Min. Negotiated Rate |
$380.38 |
| Max. Negotiated Rate |
$238,230.00 |
| Rate for Payer: Aetna Commercial |
$1,730.99
|
| Rate for Payer: Aetna Medicare |
$1,343.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,730.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,860.16
|
| Rate for Payer: BCBS Complete |
$897.96
|
| Rate for Payer: BCBS MAPPO |
$1,291.78
|
| Rate for Payer: BCBS Trust/PPO |
$380.38
|
| Rate for Payer: BCN Commercial |
$1,944.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,291.78
|
| Rate for Payer: Cash Price |
$1,845.60
|
| Rate for Payer: Cash Price |
$1,845.60
|
| Rate for Payer: Cofinity Commercial |
$1,860.16
|
| Rate for Payer: Cofinity Commercial |
$1,730.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,291.78
|
| Rate for Payer: Healthscope Commercial |
$2,389.79
|
| Rate for Payer: Healthscope Commercial |
$2,066.85
|
| Rate for Payer: Mclaren Medicaid |
$855.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,356.37
|
| Rate for Payer: Meridian Medicaid |
$897.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238,230.00
|
| Rate for Payer: Nomi Health Commercial |
$1,550.14
|
| Rate for Payer: PACE SWMI |
$1,291.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,291.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$855.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,499.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,383.99
|
| Rate for Payer: Priority Health Medicare |
$1,291.78
|
| Rate for Payer: Priority Health Narrow Network |
$2,383.99
|
| Rate for Payer: Priority Health SBD |
$2,383.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,213.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,291.78
|
| Rate for Payer: UHC Exchange |
$1,213.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,291.78
|
| Rate for Payer: UHCCP Medicaid |
$855.20
|
|
|
PR EXCISION CH WAL TUM W/RIB W/MEDSTNL LYMPHADEC
|
Professional
|
Both
|
$3,746.00
|
|
|
Service Code
|
HCPCS 21603
|
| Min. Negotiated Rate |
$1,073.09 |
| Max. Negotiated Rate |
$297,938.00 |
| Rate for Payer: Aetna Commercial |
$2,156.27
|
| Rate for Payer: Aetna Medicare |
$1,673.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,156.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,317.19
|
| Rate for Payer: BCBS Complete |
$1,126.74
|
| Rate for Payer: BCBS MAPPO |
$1,609.16
|
| Rate for Payer: BCBS Trust/PPO |
$8,162.77
|
| Rate for Payer: BCN Commercial |
$2,446.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,609.16
|
| Rate for Payer: Cash Price |
$2,996.80
|
| Rate for Payer: Cash Price |
$2,996.80
|
| Rate for Payer: Cofinity Commercial |
$2,317.19
|
| Rate for Payer: Cofinity Commercial |
$2,156.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,609.16
|
| Rate for Payer: Healthscope Commercial |
$2,574.66
|
| Rate for Payer: Healthscope Commercial |
$2,976.95
|
| Rate for Payer: Mclaren Medicaid |
$1,073.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,689.62
|
| Rate for Payer: Meridian Medicaid |
$1,126.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$297,938.00
|
| Rate for Payer: Nomi Health Commercial |
$1,930.99
|
| Rate for Payer: PACE SWMI |
$1,609.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,609.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,073.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,434.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,559.57
|
| Rate for Payer: Priority Health Medicare |
$1,609.16
|
| Rate for Payer: Priority Health Narrow Network |
$2,559.57
|
| Rate for Payer: Priority Health SBD |
$2,559.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,609.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,609.16
|
| Rate for Payer: UHCCP Medicaid |
$1,073.09
|
|
|
PR EXCISION CH WAL TUM W/RIB W/O MEDSTNL LYMPHADEC
|
Professional
|
Both
|
$3,125.00
|
|
|
Service Code
|
HCPCS 21602
|
| Min. Negotiated Rate |
$989.60 |
| Max. Negotiated Rate |
$272,540.00 |
| Rate for Payer: Aetna Commercial |
$1,980.91
|
| Rate for Payer: Aetna Medicare |
$1,537.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,980.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,128.74
|
| Rate for Payer: BCBS Complete |
$1,039.08
|
| Rate for Payer: BCBS MAPPO |
$1,478.29
|
| Rate for Payer: BCBS Trust/PPO |
$32,076.33
|
| Rate for Payer: BCN Commercial |
$2,244.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,478.29
|
| Rate for Payer: Cash Price |
$2,500.00
|
| Rate for Payer: Cash Price |
$2,500.00
|
| Rate for Payer: Cofinity Commercial |
$2,128.74
|
| Rate for Payer: Cofinity Commercial |
$1,980.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,478.29
|
| Rate for Payer: Healthscope Commercial |
$2,365.26
|
| Rate for Payer: Healthscope Commercial |
$2,734.84
|
| Rate for Payer: Mclaren Medicaid |
$989.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,552.20
|
| Rate for Payer: Meridian Medicaid |
$1,039.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272,540.00
|
| Rate for Payer: Nomi Health Commercial |
$1,773.95
|
| Rate for Payer: PACE SWMI |
$1,478.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,478.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$989.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,031.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,335.16
|
| Rate for Payer: Priority Health Medicare |
$1,478.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,335.16
|
| Rate for Payer: Priority Health SBD |
$2,335.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,478.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,478.29
|
| Rate for Payer: UHCCP Medicaid |
$989.60
|
|
|
PR EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA
|
Professional
|
Both
|
$2,082.00
|
|
|
Service Code
|
HCPCS 27635
|
| Min. Negotiated Rate |
$376.37 |
| Max. Negotiated Rate |
$102,649.00 |
| Rate for Payer: Aetna Commercial |
$744.38
|
| Rate for Payer: Aetna Medicare |
$577.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$744.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$799.93
|
| Rate for Payer: BCBS Complete |
$395.19
|
| Rate for Payer: BCBS MAPPO |
$555.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,055.54
|
| Rate for Payer: BCN Commercial |
$852.26
|
| Rate for Payer: BCN Medicare Advantage |
$555.51
|
| Rate for Payer: Cash Price |
$1,665.60
|
| Rate for Payer: Cash Price |
$1,665.60
|
| Rate for Payer: Cofinity Commercial |
$799.93
|
| Rate for Payer: Cofinity Commercial |
$744.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$555.51
|
| Rate for Payer: Healthscope Commercial |
$888.82
|
| Rate for Payer: Healthscope Commercial |
$1,027.69
|
| Rate for Payer: Mclaren Medicaid |
$376.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$583.29
|
| Rate for Payer: Meridian Medicaid |
$395.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102,649.00
|
| Rate for Payer: Nomi Health Commercial |
$666.61
|
| Rate for Payer: PACE SWMI |
$555.51
|
| Rate for Payer: PHP Medicare Advantage |
$555.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$376.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,353.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$896.10
|
| Rate for Payer: Priority Health Medicare |
$555.51
|
| Rate for Payer: Priority Health Narrow Network |
$896.10
|
| Rate for Payer: Priority Health SBD |
$896.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$894.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$555.51
|
| Rate for Payer: UHC Exchange |
$894.80
|
| Rate for Payer: UHC Medicare Advantage |
$555.51
|
| Rate for Payer: UHCCP Medicaid |
$376.37
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR CARPAL BONES
|
Professional
|
Both
|
$1,621.00
|
|
|
Service Code
|
HCPCS 25130
|
| Min. Negotiated Rate |
$299.27 |
| Max. Negotiated Rate |
$80,118.00 |
| Rate for Payer: Aetna Commercial |
$587.20
|
| Rate for Payer: Aetna Medicare |
$455.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$587.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$631.02
|
| Rate for Payer: BCBS Complete |
$314.23
|
| Rate for Payer: BCBS MAPPO |
$438.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,161.73
|
| Rate for Payer: BCN Commercial |
$669.98
|
| Rate for Payer: BCN Medicare Advantage |
$438.21
|
| Rate for Payer: Cash Price |
$1,296.80
|
| Rate for Payer: Cash Price |
$1,296.80
|
| Rate for Payer: Cofinity Commercial |
$631.02
|
| Rate for Payer: Cofinity Commercial |
$587.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$438.21
|
| Rate for Payer: Healthscope Commercial |
$810.69
|
| Rate for Payer: Healthscope Commercial |
$701.14
|
| Rate for Payer: Mclaren Medicaid |
$299.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$460.12
|
| Rate for Payer: Meridian Medicaid |
$314.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80,118.00
|
| Rate for Payer: Nomi Health Commercial |
$525.85
|
| Rate for Payer: PACE SWMI |
$438.21
|
| Rate for Payer: PHP Medicare Advantage |
$438.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$299.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,053.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$705.79
|
| Rate for Payer: Priority Health Medicare |
$438.21
|
| Rate for Payer: Priority Health Narrow Network |
$705.79
|
| Rate for Payer: Priority Health SBD |
$705.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$553.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$438.21
|
| Rate for Payer: UHC Exchange |
$553.61
|
| Rate for Payer: UHC Medicare Advantage |
$438.21
|
| Rate for Payer: UHCCP Medicaid |
$299.27
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR FEMUR
|
Professional
|
Both
|
$2,287.00
|
|
|
Service Code
|
HCPCS 27355
|
| Min. Negotiated Rate |
$400.01 |
| Max. Negotiated Rate |
$108,144.00 |
| Rate for Payer: Aetna Commercial |
$791.04
|
| Rate for Payer: Aetna Medicare |
$613.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$791.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$850.08
|
| Rate for Payer: BCBS Complete |
$420.01
|
| Rate for Payer: BCBS MAPPO |
$590.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,489.35
|
| Rate for Payer: BCN Commercial |
$898.67
|
| Rate for Payer: BCN Medicare Advantage |
$590.33
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cofinity Commercial |
$850.08
|
| Rate for Payer: Cofinity Commercial |
$791.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$590.33
|
| Rate for Payer: Healthscope Commercial |
$944.53
|
| Rate for Payer: Healthscope Commercial |
$1,092.11
|
| Rate for Payer: Mclaren Medicaid |
$400.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.85
|
| Rate for Payer: Meridian Medicaid |
$420.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108,144.00
|
| Rate for Payer: Nomi Health Commercial |
$708.40
|
| Rate for Payer: PACE SWMI |
$590.33
|
| Rate for Payer: PHP Medicare Advantage |
$590.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,486.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$943.93
|
| Rate for Payer: Priority Health Medicare |
$590.33
|
| Rate for Payer: Priority Health Narrow Network |
$943.93
|
| Rate for Payer: Priority Health SBD |
$943.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$773.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$590.33
|
| Rate for Payer: UHC Exchange |
$773.63
|
| Rate for Payer: UHC Medicare Advantage |
$590.33
|
| Rate for Payer: UHCCP Medicaid |
$400.01
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR FEMUR INT FIXATION
|
Professional
|
Both
|
$1,070.00
|
|
|
Service Code
|
HCPCS 27358
|
| Min. Negotiated Rate |
$174.66 |
| Max. Negotiated Rate |
$48,757.00 |
| Rate for Payer: Aetna Commercial |
$353.05
|
| Rate for Payer: Aetna Medicare |
$274.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$353.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.40
|
| Rate for Payer: BCBS Complete |
$183.39
|
| Rate for Payer: BCBS MAPPO |
$263.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,110.56
|
| Rate for Payer: BCN Commercial |
$397.79
|
| 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: Mclaren Medicaid |
$174.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.64
|
| Rate for Payer: Meridian Medicaid |
$183.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48,757.00
|
| 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 Choice Medicaid |
$174.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$414.72
|
| Rate for Payer: Priority Health Medicare |
$263.47
|
| Rate for Payer: Priority Health Narrow Network |
$414.72
|
| Rate for Payer: Priority Health SBD |
$414.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$347.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.47
|
| Rate for Payer: UHC Exchange |
$347.22
|
| Rate for Payer: UHC Medicare Advantage |
$263.47
|
| Rate for Payer: UHCCP Medicaid |
$174.66
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR FEMUR W/ALLOGRAFT
|
Professional
|
Both
|
$2,215.00
|
|
|
Service Code
|
HCPCS 27356
|
| Min. Negotiated Rate |
$484.15 |
| Max. Negotiated Rate |
$131,605.00 |
| Rate for Payer: Aetna Commercial |
$959.96
|
| Rate for Payer: Aetna Medicare |
$745.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$959.96
|
| Rate for Payer: BCBS Complete |
$508.36
|
| Rate for Payer: BCBS MAPPO |
$716.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,244.15
|
| Rate for Payer: BCN Commercial |
$1,091.21
|
| 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 |
$1,325.32
|
| Rate for Payer: Healthscope Commercial |
$1,146.22
|
| Rate for Payer: Mclaren Medicaid |
$484.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$752.21
|
| Rate for Payer: Meridian Medicaid |
$508.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131,605.00
|
| 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 Choice Medicaid |
$484.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,439.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,146.47
|
| Rate for Payer: Priority Health Medicare |
$716.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,146.47
|
| Rate for Payer: Priority Health SBD |
$1,146.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$883.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$716.39
|
| Rate for Payer: UHC Exchange |
$883.80
|
| Rate for Payer: UHC Medicare Advantage |
$716.39
|
| Rate for Payer: UHCCP Medicaid |
$484.15
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR FEMUR W/AUTOGRAFT
|
Professional
|
Both
|
$2,018.00
|
|
|
Service Code
|
HCPCS 27357
|
| Min. Negotiated Rate |
$532.29 |
| Max. Negotiated Rate |
$145,465.00 |
| Rate for Payer: Aetna Commercial |
$1,055.37
|
| Rate for Payer: Aetna Medicare |
$819.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,055.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,134.13
|
| Rate for Payer: BCBS Complete |
$558.90
|
| Rate for Payer: BCBS MAPPO |
$787.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,740.22
|
| Rate for Payer: BCN Commercial |
$1,206.05
|
| 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: Mclaren Medicaid |
$532.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.97
|
| Rate for Payer: Meridian Medicaid |
$558.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145,465.00
|
| 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 Choice Medicaid |
$532.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,311.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,265.03
|
| Rate for Payer: Priority Health Medicare |
$787.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,265.03
|
| Rate for Payer: Priority Health SBD |
$1,265.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$967.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$787.59
|
| Rate for Payer: UHC Exchange |
$967.13
|
| Rate for Payer: UHC Medicare Advantage |
$787.59
|
| Rate for Payer: UHCCP Medicaid |
$532.29
|
|
|
PR EXCISION/CURETTAGE CYST/TUMOR METACARPAL
|
Professional
|
Both
|
$1,294.00
|
|
|
Service Code
|
HCPCS 26200
|
| Min. Negotiated Rate |
$66.57 |
| Max. Negotiated Rate |
$80,318.00 |
| Rate for Payer: Aetna Commercial |
$585.35
|
| Rate for Payer: Aetna Medicare |
$454.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$585.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$629.04
|
| Rate for Payer: BCBS Complete |
$312.44
|
| Rate for Payer: BCBS MAPPO |
$436.83
|
| Rate for Payer: BCBS Trust/PPO |
$66.57
|
| Rate for Payer: BCN Commercial |
$669.98
|
| 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 |
$808.14
|
| Rate for Payer: Healthscope Commercial |
$698.93
|
| Rate for Payer: Mclaren Medicaid |
$297.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$458.67
|
| Rate for Payer: Meridian Medicaid |
$312.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80,318.00
|
| 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 Choice Medicaid |
$297.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$841.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$704.26
|
| Rate for Payer: Priority Health Medicare |
$436.83
|
| Rate for Payer: Priority Health Narrow Network |
$704.26
|
| Rate for Payer: Priority Health SBD |
$704.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$483.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$436.83
|
| Rate for Payer: UHC Exchange |
$483.54
|
| Rate for Payer: UHC Medicare Advantage |
$436.83
|
| Rate for Payer: UHCCP Medicaid |
$297.56
|
|
