|
PR NEUROPLASTY NERVE HAND/FOOT
|
Professional
|
Both
|
$1,888.00
|
|
|
Service Code
|
HCPCS 64704
|
| Min. Negotiated Rate |
$211.72 |
| Max. Negotiated Rate |
$57,046.00 |
| Rate for Payer: Aetna Commercial |
$416.95
|
| Rate for Payer: Aetna Medicare |
$323.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$448.07
|
| Rate for Payer: BCBS Complete |
$222.31
|
| Rate for Payer: BCBS MAPPO |
$311.16
|
| Rate for Payer: BCBS Trust/PPO |
$6,889.56
|
| Rate for Payer: BCN Commercial |
$474.51
|
| Rate for Payer: BCN Medicare Advantage |
$311.16
|
| Rate for Payer: Cash Price |
$1,510.40
|
| Rate for Payer: Cash Price |
$1,510.40
|
| Rate for Payer: Cofinity Commercial |
$448.07
|
| Rate for Payer: Cofinity Commercial |
$416.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.16
|
| Rate for Payer: Healthscope Commercial |
$575.65
|
| Rate for Payer: Healthscope Commercial |
$497.86
|
| Rate for Payer: Mclaren Medicaid |
$211.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$326.72
|
| Rate for Payer: Meridian Medicaid |
$222.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57,046.00
|
| Rate for Payer: Nomi Health Commercial |
$373.39
|
| Rate for Payer: PACE SWMI |
$311.16
|
| Rate for Payer: PHP Medicare Advantage |
$311.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,227.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$559.62
|
| Rate for Payer: Priority Health Medicare |
$311.16
|
| Rate for Payer: Priority Health Narrow Network |
$559.62
|
| Rate for Payer: Priority Health SBD |
$559.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$406.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$311.16
|
| Rate for Payer: UHC Exchange |
$406.65
|
| Rate for Payer: UHC Medicare Advantage |
$311.16
|
| Rate for Payer: UHCCP Medicaid |
$211.72
|
|
|
PR NEUROPLASTY &/TRANSPOSITION CRANIAL NERVE
|
Professional
|
Both
|
$960.00
|
|
|
Service Code
|
HCPCS 64716
|
| Min. Negotiated Rate |
$330.79 |
| Max. Negotiated Rate |
$90,396.00 |
| Rate for Payer: Aetna Commercial |
$653.25
|
| Rate for Payer: Aetna Medicare |
$507.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$653.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$702.00
|
| Rate for Payer: BCBS Complete |
$347.33
|
| Rate for Payer: BCBS MAPPO |
$487.50
|
| Rate for Payer: BCBS Trust/PPO |
$5,621.64
|
| Rate for Payer: BCN Commercial |
$751.59
|
| Rate for Payer: BCN Medicare Advantage |
$487.50
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cofinity Commercial |
$702.00
|
| Rate for Payer: Cofinity Commercial |
$653.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.50
|
| Rate for Payer: Healthscope Commercial |
$901.88
|
| Rate for Payer: Healthscope Commercial |
$780.00
|
| Rate for Payer: Mclaren Medicaid |
$330.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$511.88
|
| Rate for Payer: Meridian Medicaid |
$347.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90,396.00
|
| Rate for Payer: Nomi Health Commercial |
$585.00
|
| Rate for Payer: PACE SWMI |
$487.50
|
| Rate for Payer: PHP Medicare Advantage |
$487.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$330.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$624.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$880.93
|
| Rate for Payer: Priority Health Medicare |
$487.50
|
| Rate for Payer: Priority Health Narrow Network |
$880.93
|
| Rate for Payer: Priority Health SBD |
$880.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$541.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$487.50
|
| Rate for Payer: UHC Exchange |
$541.74
|
| Rate for Payer: UHC Medicare Advantage |
$487.50
|
| Rate for Payer: UHCCP Medicaid |
$330.79
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW
|
Professional
|
Both
|
$3,146.00
|
|
|
Service Code
|
HCPCS 64718
|
| Hospital Charge Code |
64718
|
| Min. Negotiated Rate |
$396.18 |
| Max. Negotiated Rate |
$106,535.00 |
| Rate for Payer: Aetna Commercial |
$779.04
|
| Rate for Payer: Aetna Medicare |
$604.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$837.17
|
| Rate for Payer: BCBS Complete |
$415.99
|
| Rate for Payer: BCBS MAPPO |
$581.37
|
| Rate for Payer: BCBS Trust/PPO |
$4,438.25
|
| Rate for Payer: BCN Commercial |
$889.40
|
| Rate for Payer: BCN Medicare Advantage |
$581.37
|
| Rate for Payer: Cash Price |
$2,516.80
|
| Rate for Payer: Cash Price |
$2,516.80
|
| Rate for Payer: Cofinity Commercial |
$837.17
|
| Rate for Payer: Cofinity Commercial |
$779.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$581.37
|
| Rate for Payer: Healthscope Commercial |
$930.19
|
| Rate for Payer: Healthscope Commercial |
$1,075.53
|
| Rate for Payer: Mclaren Medicaid |
$396.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$610.44
|
| Rate for Payer: Meridian Medicaid |
$415.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106,535.00
|
| Rate for Payer: Nomi Health Commercial |
$697.64
|
| Rate for Payer: PACE SWMI |
$581.37
|
| Rate for Payer: PHP Medicare Advantage |
$581.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,044.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,047.00
|
| Rate for Payer: Priority Health Medicare |
$581.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,047.00
|
| Rate for Payer: Priority Health SBD |
$1,047.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$588.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$581.37
|
| Rate for Payer: UHC Exchange |
$588.69
|
| Rate for Payer: UHC Medicare Advantage |
$581.37
|
| Rate for Payer: UHCCP Medicaid |
$396.18
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW
|
Professional
|
Both
|
$3,146.00
|
|
|
Service Code
|
HCPCS 64718
|
| Min. Negotiated Rate |
$396.18 |
| Max. Negotiated Rate |
$106,535.00 |
| Rate for Payer: Aetna Commercial |
$779.04
|
| Rate for Payer: Aetna Medicare |
$604.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$837.17
|
| Rate for Payer: BCBS Complete |
$415.99
|
| Rate for Payer: BCBS MAPPO |
$581.37
|
| Rate for Payer: BCBS Trust/PPO |
$4,438.25
|
| Rate for Payer: BCN Commercial |
$889.40
|
| Rate for Payer: BCN Medicare Advantage |
$581.37
|
| Rate for Payer: Cash Price |
$2,516.80
|
| Rate for Payer: Cash Price |
$2,516.80
|
| Rate for Payer: Cofinity Commercial |
$837.17
|
| Rate for Payer: Cofinity Commercial |
$779.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$581.37
|
| Rate for Payer: Healthscope Commercial |
$930.19
|
| Rate for Payer: Healthscope Commercial |
$1,075.53
|
| Rate for Payer: Mclaren Medicaid |
$396.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$610.44
|
| Rate for Payer: Meridian Medicaid |
$415.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106,535.00
|
| Rate for Payer: Nomi Health Commercial |
$697.64
|
| Rate for Payer: PACE SWMI |
$581.37
|
| Rate for Payer: PHP Medicare Advantage |
$581.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,044.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,047.00
|
| Rate for Payer: Priority Health Medicare |
$581.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,047.00
|
| Rate for Payer: Priority Health SBD |
$1,047.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$588.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$581.37
|
| Rate for Payer: UHC Exchange |
$588.69
|
| Rate for Payer: UHC Medicare Advantage |
$581.37
|
| Rate for Payer: UHCCP Medicaid |
$396.18
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW
|
Facility
|
OP
|
$3,146.00
|
|
|
Service Code
|
CPT 64718
|
| Hospital Charge Code |
64718
|
| Min. Negotiated Rate |
$641.32 |
| Max. Negotiated Rate |
$6,013.44 |
| Rate for Payer: Aetna Commercial |
$2,674.10
|
| Rate for Payer: Aetna Medicare |
$1,989.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,044.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,391.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,391.60
|
| Rate for Payer: BCBS Complete |
$1,076.79
|
| Rate for Payer: BCBS MAPPO |
$1,913.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,820.90
|
| Rate for Payer: BCN Commercial |
$1,820.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,913.28
|
| Rate for Payer: Cash Price |
$2,516.80
|
| Rate for Payer: Cash Price |
$2,516.80
|
| Rate for Payer: Cash Price |
$2,516.80
|
| Rate for Payer: Cofinity Commercial |
$2,705.56
|
| Rate for Payer: Cofinity Commercial |
$2,202.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,202.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,516.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,913.28
|
| Rate for Payer: Healthscope Commercial |
$2,831.40
|
| Rate for Payer: Mclaren Medicaid |
$1,025.52
|
| Rate for Payer: Mclaren Medicare |
$1,913.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,008.94
|
| Rate for Payer: Meridian Medicaid |
$1,076.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,200.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,674.10
|
| Rate for Payer: Nomi Health Commercial |
$4,017.89
|
| Rate for Payer: PACE Medicare |
$1,817.62
|
| Rate for Payer: PACE SWMI |
$1,913.28
|
| Rate for Payer: PHP Commercial |
$2,674.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,913.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,025.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,044.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,013.44
|
| Rate for Payer: Priority Health Medicare |
$1,913.28
|
| Rate for Payer: Priority Health Narrow Network |
$4,810.75
|
| Rate for Payer: Priority Health SBD |
$1,981.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,913.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$641.32
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,913.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,913.28
|
| Rate for Payer: UHCCP Medicaid |
$1,077.18
|
| Rate for Payer: VA VA |
$1,913.28
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW
|
Facility
|
IP
|
$3,146.00
|
|
|
Service Code
|
CPT 64718
|
| Hospital Charge Code |
64718
|
| Min. Negotiated Rate |
$1,981.98 |
| Max. Negotiated Rate |
$2,831.40 |
| Rate for Payer: Aetna Commercial |
$2,674.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,044.90
|
| Rate for Payer: Cash Price |
$2,516.80
|
| Rate for Payer: Cofinity Commercial |
$2,202.20
|
| Rate for Payer: Cofinity Commercial |
$2,705.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,202.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,516.80
|
| Rate for Payer: Healthscope Commercial |
$2,831.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,674.10
|
| Rate for Payer: PHP Commercial |
$2,674.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,044.90
|
| Rate for Payer: Priority Health SBD |
$1,981.98
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE WRIST
|
Facility
|
OP
|
$1,572.00
|
|
|
Service Code
|
CPT 64719
|
| Hospital Charge Code |
64719
|
| Min. Negotiated Rate |
$433.94 |
| Max. Negotiated Rate |
$6,013.44 |
| Rate for Payer: Aetna Commercial |
$1,336.20
|
| Rate for Payer: Aetna Medicare |
$1,989.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,021.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,391.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,391.60
|
| Rate for Payer: BCBS Complete |
$1,076.79
|
| Rate for Payer: BCBS MAPPO |
$1,913.28
|
| Rate for Payer: BCBS Trust/PPO |
$822.71
|
| Rate for Payer: BCN Commercial |
$822.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,913.28
|
| Rate for Payer: Cash Price |
$1,257.60
|
| Rate for Payer: Cash Price |
$1,257.60
|
| Rate for Payer: Cash Price |
$1,257.60
|
| Rate for Payer: Cofinity Commercial |
$1,351.92
|
| Rate for Payer: Cofinity Commercial |
$1,100.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,100.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,257.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,913.28
|
| Rate for Payer: Healthscope Commercial |
$1,414.80
|
| Rate for Payer: Mclaren Medicaid |
$1,025.52
|
| Rate for Payer: Mclaren Medicare |
$1,913.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,008.94
|
| Rate for Payer: Meridian Medicaid |
$1,076.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,200.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,336.20
|
| Rate for Payer: Nomi Health Commercial |
$4,017.89
|
| Rate for Payer: PACE Medicare |
$1,817.62
|
| Rate for Payer: PACE SWMI |
$1,913.28
|
| Rate for Payer: PHP Commercial |
$1,336.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,913.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,025.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,021.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,013.44
|
| Rate for Payer: Priority Health Medicare |
$1,913.28
|
| Rate for Payer: Priority Health Narrow Network |
$4,810.75
|
| Rate for Payer: Priority Health SBD |
$990.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1,913.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$433.94
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,913.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,913.28
|
| Rate for Payer: UHCCP Medicaid |
$1,077.18
|
| Rate for Payer: VA VA |
$1,913.28
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE WRIST
|
Professional
|
Both
|
$1,572.00
|
|
|
Service Code
|
HCPCS 64719
|
| Min. Negotiated Rate |
$267.74 |
| Max. Negotiated Rate |
$72,104.00 |
| Rate for Payer: Aetna Commercial |
$526.31
|
| Rate for Payer: Aetna Medicare |
$408.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$526.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$565.59
|
| Rate for Payer: BCBS Complete |
$281.13
|
| Rate for Payer: BCBS MAPPO |
$392.77
|
| Rate for Payer: BCBS Trust/PPO |
$3,989.19
|
| Rate for Payer: BCN Commercial |
$602.05
|
| Rate for Payer: BCN Medicare Advantage |
$392.77
|
| Rate for Payer: Cash Price |
$1,257.60
|
| Rate for Payer: Cash Price |
$1,257.60
|
| Rate for Payer: Cofinity Commercial |
$565.59
|
| Rate for Payer: Cofinity Commercial |
$526.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.77
|
| Rate for Payer: Healthscope Commercial |
$726.62
|
| Rate for Payer: Healthscope Commercial |
$628.43
|
| Rate for Payer: Mclaren Medicaid |
$267.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$412.41
|
| Rate for Payer: Meridian Medicaid |
$281.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72,104.00
|
| Rate for Payer: Nomi Health Commercial |
$471.32
|
| Rate for Payer: PACE SWMI |
$392.77
|
| Rate for Payer: PHP Medicare Advantage |
$392.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,021.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$708.62
|
| Rate for Payer: Priority Health Medicare |
$392.77
|
| Rate for Payer: Priority Health Narrow Network |
$708.62
|
| Rate for Payer: Priority Health SBD |
$708.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$492.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.77
|
| Rate for Payer: UHC Exchange |
$492.53
|
| Rate for Payer: UHC Medicare Advantage |
$392.77
|
| Rate for Payer: UHCCP Medicaid |
$267.74
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE WRIST
|
Professional
|
Both
|
$1,572.00
|
|
|
Service Code
|
HCPCS 64719
|
| Hospital Charge Code |
64719
|
| Min. Negotiated Rate |
$267.74 |
| Max. Negotiated Rate |
$72,104.00 |
| Rate for Payer: Aetna Commercial |
$526.31
|
| Rate for Payer: Aetna Medicare |
$408.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$526.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$565.59
|
| Rate for Payer: BCBS Complete |
$281.13
|
| Rate for Payer: BCBS MAPPO |
$392.77
|
| Rate for Payer: BCBS Trust/PPO |
$3,989.19
|
| Rate for Payer: BCN Commercial |
$602.05
|
| Rate for Payer: BCN Medicare Advantage |
$392.77
|
| Rate for Payer: Cash Price |
$1,257.60
|
| Rate for Payer: Cash Price |
$1,257.60
|
| Rate for Payer: Cofinity Commercial |
$565.59
|
| Rate for Payer: Cofinity Commercial |
$526.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.77
|
| Rate for Payer: Healthscope Commercial |
$726.62
|
| Rate for Payer: Healthscope Commercial |
$628.43
|
| Rate for Payer: Mclaren Medicaid |
$267.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$412.41
|
| Rate for Payer: Meridian Medicaid |
$281.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72,104.00
|
| Rate for Payer: Nomi Health Commercial |
$471.32
|
| Rate for Payer: PACE SWMI |
$392.77
|
| Rate for Payer: PHP Medicare Advantage |
$392.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,021.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$708.62
|
| Rate for Payer: Priority Health Medicare |
$392.77
|
| Rate for Payer: Priority Health Narrow Network |
$708.62
|
| Rate for Payer: Priority Health SBD |
$708.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$492.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.77
|
| Rate for Payer: UHC Exchange |
$492.53
|
| Rate for Payer: UHC Medicare Advantage |
$392.77
|
| Rate for Payer: UHCCP Medicaid |
$267.74
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE WRIST
|
Facility
|
IP
|
$1,572.00
|
|
|
Service Code
|
CPT 64719
|
| Hospital Charge Code |
64719
|
| Min. Negotiated Rate |
$990.36 |
| Max. Negotiated Rate |
$1,414.80 |
| Rate for Payer: Aetna Commercial |
$1,336.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,021.80
|
| Rate for Payer: Cash Price |
$1,257.60
|
| Rate for Payer: Cofinity Commercial |
$1,100.40
|
| Rate for Payer: Cofinity Commercial |
$1,351.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,100.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,257.60
|
| Rate for Payer: Healthscope Commercial |
$1,414.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,336.20
|
| Rate for Payer: PHP Commercial |
$1,336.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,021.80
|
| Rate for Payer: Priority Health SBD |
$990.36
|
|
|
PR NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE
|
Facility
|
IP
|
$2,254.00
|
|
|
Service Code
|
CPT 64721
|
| Hospital Charge Code |
64721
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,420.02 |
| Max. Negotiated Rate |
$2,028.60 |
| Rate for Payer: Aetna Commercial |
$1,915.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,465.10
|
| Rate for Payer: Cash Price |
$1,803.20
|
| Rate for Payer: Cofinity Commercial |
$1,577.80
|
| Rate for Payer: Cofinity Commercial |
$1,938.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,577.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,803.20
|
| Rate for Payer: Healthscope Commercial |
$2,028.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,915.90
|
| Rate for Payer: PHP Commercial |
$1,915.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,465.10
|
| Rate for Payer: Priority Health SBD |
$1,420.02
|
|
|
PR NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE
|
Facility
|
OP
|
$2,254.00
|
|
|
Service Code
|
CPT 64721
|
| Hospital Charge Code |
64721
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$464.18 |
| Max. Negotiated Rate |
$6,013.44 |
| Rate for Payer: Aetna Commercial |
$1,915.90
|
| Rate for Payer: Aetna Medicare |
$1,989.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,465.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,391.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,391.60
|
| Rate for Payer: BCBS Complete |
$1,076.79
|
| Rate for Payer: BCBS MAPPO |
$1,913.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,147.58
|
| Rate for Payer: BCN Commercial |
$1,147.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,913.28
|
| Rate for Payer: Cash Price |
$1,803.20
|
| Rate for Payer: Cash Price |
$1,803.20
|
| Rate for Payer: Cash Price |
$1,803.20
|
| Rate for Payer: Cofinity Commercial |
$1,938.44
|
| Rate for Payer: Cofinity Commercial |
$1,577.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,577.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,803.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,913.28
|
| Rate for Payer: Healthscope Commercial |
$2,028.60
|
| Rate for Payer: Mclaren Medicaid |
$1,025.52
|
| Rate for Payer: Mclaren Medicare |
$1,913.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,008.94
|
| Rate for Payer: Meridian Medicaid |
$1,076.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,200.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,915.90
|
| Rate for Payer: Nomi Health Commercial |
$4,017.89
|
| Rate for Payer: PACE Medicare |
$1,817.62
|
| Rate for Payer: PACE SWMI |
$1,913.28
|
| Rate for Payer: PHP Commercial |
$1,915.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,913.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,025.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,465.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,013.44
|
| Rate for Payer: Priority Health Medicare |
$1,913.28
|
| Rate for Payer: Priority Health Narrow Network |
$4,810.75
|
| Rate for Payer: Priority Health SBD |
$1,420.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,913.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$464.18
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,913.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,913.28
|
| Rate for Payer: UHCCP Medicaid |
$1,077.18
|
| Rate for Payer: VA VA |
$1,913.28
|
|
|
PR NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE
|
Professional
|
Both
|
$2,254.00
|
|
|
Service Code
|
HCPCS 64721
|
| Min. Negotiated Rate |
$287.34 |
| Max. Negotiated Rate |
$77,024.00 |
| Rate for Payer: Aetna Commercial |
$563.09
|
| Rate for Payer: Aetna Medicare |
$437.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$563.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$605.12
|
| Rate for Payer: BCBS Complete |
$301.71
|
| Rate for Payer: BCBS MAPPO |
$420.22
|
| Rate for Payer: BCBS Trust/PPO |
$6,985.18
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: BCN Medicare Advantage |
$420.22
|
| Rate for Payer: Cash Price |
$1,803.20
|
| Rate for Payer: Cash Price |
$1,803.20
|
| Rate for Payer: Cofinity Commercial |
$605.12
|
| Rate for Payer: Cofinity Commercial |
$563.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.22
|
| Rate for Payer: Healthscope Commercial |
$777.41
|
| Rate for Payer: Healthscope Commercial |
$672.35
|
| Rate for Payer: Mclaren Medicaid |
$287.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.23
|
| Rate for Payer: Meridian Medicaid |
$301.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77,024.00
|
| Rate for Payer: Nomi Health Commercial |
$504.26
|
| Rate for Payer: PACE SWMI |
$420.22
|
| Rate for Payer: PHP Medicare Advantage |
$420.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$287.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,465.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.37
|
| Rate for Payer: Priority Health Medicare |
$420.22
|
| Rate for Payer: Priority Health Narrow Network |
$760.37
|
| Rate for Payer: Priority Health SBD |
$760.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$516.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$420.22
|
| Rate for Payer: UHC Exchange |
$516.66
|
| Rate for Payer: UHC Medicare Advantage |
$420.22
|
| Rate for Payer: UHCCP Medicaid |
$287.34
|
|
|
PR NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE
|
Professional
|
Both
|
$2,254.00
|
|
|
Service Code
|
HCPCS 64721
|
| Hospital Charge Code |
64721
|
| Min. Negotiated Rate |
$287.34 |
| Max. Negotiated Rate |
$77,024.00 |
| Rate for Payer: Aetna Commercial |
$563.09
|
| Rate for Payer: Aetna Medicare |
$437.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$563.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$605.12
|
| Rate for Payer: BCBS Complete |
$301.71
|
| Rate for Payer: BCBS MAPPO |
$420.22
|
| Rate for Payer: BCBS Trust/PPO |
$6,985.18
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: BCN Medicare Advantage |
$420.22
|
| Rate for Payer: Cash Price |
$1,803.20
|
| Rate for Payer: Cash Price |
$1,803.20
|
| Rate for Payer: Cofinity Commercial |
$605.12
|
| Rate for Payer: Cofinity Commercial |
$563.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.22
|
| Rate for Payer: Healthscope Commercial |
$777.41
|
| Rate for Payer: Healthscope Commercial |
$672.35
|
| Rate for Payer: Mclaren Medicaid |
$287.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.23
|
| Rate for Payer: Meridian Medicaid |
$301.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77,024.00
|
| Rate for Payer: Nomi Health Commercial |
$504.26
|
| Rate for Payer: PACE SWMI |
$420.22
|
| Rate for Payer: PHP Medicare Advantage |
$420.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$287.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,465.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.37
|
| Rate for Payer: Priority Health Medicare |
$420.22
|
| Rate for Payer: Priority Health Narrow Network |
$760.37
|
| Rate for Payer: Priority Health SBD |
$760.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$516.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$420.22
|
| Rate for Payer: UHC Exchange |
$516.66
|
| Rate for Payer: UHC Medicare Advantage |
$420.22
|
| Rate for Payer: UHCCP Medicaid |
$287.34
|
|
|
PR NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR
|
Professional
|
Both
|
$266.00
|
|
|
Service Code
|
HCPCS 96132
|
| Min. Negotiated Rate |
$67.73 |
| Max. Negotiated Rate |
$15,737.00 |
| Rate for Payer: Aetna Commercial |
$136.57
|
| Rate for Payer: Aetna Medicare |
$106.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.76
|
| Rate for Payer: BCBS Complete |
$71.12
|
| Rate for Payer: BCBS MAPPO |
$101.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,343.54
|
| Rate for Payer: BCN Commercial |
$187.65
|
| Rate for Payer: BCN Medicare Advantage |
$101.92
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cofinity Commercial |
$146.76
|
| Rate for Payer: Cofinity Commercial |
$136.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.92
|
| Rate for Payer: Healthscope Commercial |
$163.07
|
| Rate for Payer: Healthscope Commercial |
$188.55
|
| Rate for Payer: Mclaren Medicaid |
$67.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.02
|
| Rate for Payer: Meridian Medicaid |
$71.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,737.00
|
| Rate for Payer: Nomi Health Commercial |
$122.30
|
| Rate for Payer: PACE SWMI |
$101.92
|
| Rate for Payer: PHP Medicare Advantage |
$101.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.02
|
| Rate for Payer: Priority Health Medicare |
$101.92
|
| Rate for Payer: Priority Health Narrow Network |
$142.02
|
| Rate for Payer: Priority Health SBD |
$142.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.92
|
| Rate for Payer: UHC Medicare Advantage |
$101.92
|
| Rate for Payer: UHCCP Medicaid |
$67.73
|
|
|
PR NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR
|
Professional
|
Both
|
$203.00
|
|
|
Service Code
|
HCPCS 96133
|
| Min. Negotiated Rate |
$47.93 |
| Max. Negotiated Rate |
$11,385.00 |
| Rate for Payer: Aetna Commercial |
$96.86
|
| Rate for Payer: Aetna Medicare |
$75.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.86
|
| Rate for Payer: BCBS Complete |
$50.33
|
| Rate for Payer: BCBS MAPPO |
$72.28
|
| Rate for Payer: BCBS Trust/PPO |
$150.57
|
| Rate for Payer: BCN Commercial |
$142.69
|
| Rate for Payer: BCN Medicare Advantage |
$72.28
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cofinity Commercial |
$96.86
|
| Rate for Payer: Cofinity Commercial |
$104.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.28
|
| Rate for Payer: Healthscope Commercial |
$115.65
|
| Rate for Payer: Healthscope Commercial |
$133.72
|
| Rate for Payer: Mclaren Medicaid |
$47.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.89
|
| Rate for Payer: Meridian Medicaid |
$50.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,385.00
|
| Rate for Payer: Nomi Health Commercial |
$86.74
|
| Rate for Payer: PACE SWMI |
$72.28
|
| Rate for Payer: PHP Medicare Advantage |
$72.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$102.22
|
| Rate for Payer: Priority Health Medicare |
$72.28
|
| Rate for Payer: Priority Health Narrow Network |
$102.22
|
| Rate for Payer: Priority Health SBD |
$102.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.28
|
| Rate for Payer: UHC Medicare Advantage |
$72.28
|
| Rate for Payer: UHCCP Medicaid |
$47.93
|
|
|
PR NEUROPSYCH TESTING BY COMPUTER
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 96120
|
| Min. Negotiated Rate |
$68.80 |
| Max. Negotiated Rate |
$111.80 |
| Rate for Payer: Aetna Medicare |
$86.00
|
| Rate for Payer: BCBS Complete |
$68.80
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.80
|
|
|
PR NEUROPSYCH TESTING BY PSYCH/PHYS
|
Professional
|
Both
|
$223.00
|
|
|
Service Code
|
HCPCS 96118
|
| Min. Negotiated Rate |
$89.20 |
| Max. Negotiated Rate |
$144.95 |
| Rate for Payer: Aetna Medicare |
$111.50
|
| Rate for Payer: BCBS Complete |
$89.20
|
| Rate for Payer: Cash Price |
$178.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.95
|
|
|
PR NEUROPSYCH TESTING BY TECHNICIAN
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 96119
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$81.25 |
| Rate for Payer: Aetna Medicare |
$62.50
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
|
|
PR NEURP MAJOR PRPH NRV ARM/LEG OPN OTH/THN SPEC
|
Professional
|
Both
|
$2,646.00
|
|
|
Service Code
|
HCPCS 64708
|
| Min. Negotiated Rate |
$330.36 |
| Max. Negotiated Rate |
$88,261.00 |
| Rate for Payer: Aetna Commercial |
$647.42
|
| Rate for Payer: Aetna Medicare |
$502.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$647.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$695.74
|
| Rate for Payer: BCBS Complete |
$346.88
|
| Rate for Payer: BCBS MAPPO |
$483.15
|
| Rate for Payer: BCBS Trust/PPO |
$5,401.87
|
| Rate for Payer: BCN Commercial |
$736.44
|
| Rate for Payer: BCN Medicare Advantage |
$483.15
|
| Rate for Payer: Cash Price |
$2,116.80
|
| Rate for Payer: Cash Price |
$2,116.80
|
| Rate for Payer: Cofinity Commercial |
$695.74
|
| Rate for Payer: Cofinity Commercial |
$647.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$483.15
|
| Rate for Payer: Healthscope Commercial |
$893.83
|
| Rate for Payer: Healthscope Commercial |
$773.04
|
| Rate for Payer: Mclaren Medicaid |
$330.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$507.31
|
| Rate for Payer: Meridian Medicaid |
$346.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88,261.00
|
| Rate for Payer: Nomi Health Commercial |
$579.78
|
| Rate for Payer: PACE SWMI |
$483.15
|
| Rate for Payer: PHP Medicare Advantage |
$483.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$330.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,719.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$879.81
|
| Rate for Payer: Priority Health Medicare |
$483.15
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health SBD |
$879.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$583.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$483.15
|
| Rate for Payer: UHC Exchange |
$583.06
|
| Rate for Payer: UHC Medicare Advantage |
$483.15
|
| Rate for Payer: UHCCP Medicaid |
$330.36
|
|
|
PR NEURP MAJOR PRPH NRV OPN ARM/LEG BRACH PLEXUS
|
Professional
|
Both
|
$2,774.00
|
|
|
Service Code
|
HCPCS 64713
|
| Min. Negotiated Rate |
$519.93 |
| Max. Negotiated Rate |
$141,709.00 |
| Rate for Payer: Aetna Commercial |
$1,038.06
|
| Rate for Payer: Aetna Medicare |
$805.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,038.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,115.52
|
| Rate for Payer: BCBS Complete |
$545.93
|
| Rate for Payer: BCBS MAPPO |
$774.67
|
| Rate for Payer: BCBS Trust/PPO |
$7,702.61
|
| Rate for Payer: BCN Commercial |
$1,168.43
|
| Rate for Payer: BCN Medicare Advantage |
$774.67
|
| Rate for Payer: Cash Price |
$2,219.20
|
| Rate for Payer: Cash Price |
$2,219.20
|
| Rate for Payer: Cofinity Commercial |
$1,115.52
|
| Rate for Payer: Cofinity Commercial |
$1,038.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.67
|
| Rate for Payer: Healthscope Commercial |
$1,433.14
|
| Rate for Payer: Healthscope Commercial |
$1,239.47
|
| Rate for Payer: Mclaren Medicaid |
$519.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$813.40
|
| Rate for Payer: Meridian Medicaid |
$545.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141,709.00
|
| Rate for Payer: Nomi Health Commercial |
$929.60
|
| Rate for Payer: PACE SWMI |
$774.67
|
| Rate for Payer: PHP Medicare Advantage |
$774.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$519.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,803.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,381.40
|
| Rate for Payer: Priority Health Medicare |
$774.67
|
| Rate for Payer: Priority Health Narrow Network |
$1,381.40
|
| Rate for Payer: Priority Health SBD |
$1,381.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$860.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.67
|
| Rate for Payer: UHC Exchange |
$860.50
|
| Rate for Payer: UHC Medicare Advantage |
$774.67
|
| Rate for Payer: UHCCP Medicaid |
$519.93
|
|
|
PR NEURP MAJOR PRPH NRV OPN ARM/LEG LMBR PLEXUS
|
Professional
|
Both
|
$3,408.00
|
|
|
Service Code
|
HCPCS 64714
|
| Min. Negotiated Rate |
$499.06 |
| Max. Negotiated Rate |
$134,894.00 |
| Rate for Payer: Aetna Commercial |
$994.04
|
| Rate for Payer: Aetna Medicare |
$771.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,068.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.04
|
| Rate for Payer: BCBS Complete |
$524.01
|
| Rate for Payer: BCBS MAPPO |
$741.82
|
| Rate for Payer: BCBS Trust/PPO |
$5,064.28
|
| Rate for Payer: BCN Commercial |
$1,115.65
|
| Rate for Payer: BCN Medicare Advantage |
$741.82
|
| Rate for Payer: Cash Price |
$2,726.40
|
| Rate for Payer: Cash Price |
$2,726.40
|
| Rate for Payer: Cofinity Commercial |
$994.04
|
| Rate for Payer: Cofinity Commercial |
$1,068.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$741.82
|
| Rate for Payer: Healthscope Commercial |
$1,372.37
|
| Rate for Payer: Healthscope Commercial |
$1,186.91
|
| Rate for Payer: Mclaren Medicaid |
$499.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$778.91
|
| Rate for Payer: Meridian Medicaid |
$524.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134,894.00
|
| Rate for Payer: Nomi Health Commercial |
$890.18
|
| Rate for Payer: PACE SWMI |
$741.82
|
| Rate for Payer: PHP Medicare Advantage |
$741.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,215.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,320.56
|
| Rate for Payer: Priority Health Medicare |
$741.82
|
| Rate for Payer: Priority Health Narrow Network |
$1,320.56
|
| Rate for Payer: Priority Health SBD |
$1,320.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$729.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$741.82
|
| Rate for Payer: UHC Exchange |
$729.89
|
| Rate for Payer: UHC Medicare Advantage |
$741.82
|
| Rate for Payer: UHCCP Medicaid |
$499.06
|
|
|
PR NEURP MAJOR PRPH NRV OPN ARM/LEG SCIATIC NRV
|
Professional
|
Both
|
$997.00
|
|
|
Service Code
|
HCPCS 64712
|
| Min. Negotiated Rate |
$387.02 |
| Max. Negotiated Rate |
$105,377.00 |
| Rate for Payer: Aetna Commercial |
$767.79
|
| Rate for Payer: Aetna Medicare |
$595.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$825.09
|
| Rate for Payer: BCBS Complete |
$406.37
|
| Rate for Payer: BCBS MAPPO |
$572.98
|
| Rate for Payer: BCBS Trust/PPO |
$6,738.47
|
| Rate for Payer: BCN Commercial |
$873.76
|
| Rate for Payer: BCN Medicare Advantage |
$572.98
|
| Rate for Payer: Cash Price |
$797.60
|
| Rate for Payer: Cash Price |
$797.60
|
| Rate for Payer: Cofinity Commercial |
$825.09
|
| Rate for Payer: Cofinity Commercial |
$767.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.98
|
| Rate for Payer: Healthscope Commercial |
$916.77
|
| Rate for Payer: Healthscope Commercial |
$1,060.01
|
| Rate for Payer: Mclaren Medicaid |
$387.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$601.63
|
| Rate for Payer: Meridian Medicaid |
$406.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105,377.00
|
| Rate for Payer: Nomi Health Commercial |
$687.58
|
| Rate for Payer: PACE SWMI |
$572.98
|
| Rate for Payer: PHP Medicare Advantage |
$572.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$648.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,027.10
|
| Rate for Payer: Priority Health Medicare |
$572.98
|
| Rate for Payer: Priority Health Narrow Network |
$1,027.10
|
| Rate for Payer: Priority Health SBD |
$1,027.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$646.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$572.98
|
| Rate for Payer: UHC Exchange |
$646.46
|
| Rate for Payer: UHC Medicare Advantage |
$572.98
|
| Rate for Payer: UHCCP Medicaid |
$387.02
|
|
|
PR N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI
|
Professional
|
Both
|
$319.00
|
|
|
Service Code
|
HCPCS 93924
|
| Min. Negotiated Rate |
$14.91 |
| Max. Negotiated Rate |
$22,167.00 |
| Rate for Payer: Aetna Commercial |
$191.19
|
| Rate for Payer: Aetna Medicare |
$148.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.46
|
| Rate for Payer: BCBS Complete |
$15.66
|
| Rate for Payer: BCBS MAPPO |
$142.68
|
| Rate for Payer: BCBS Trust/PPO |
$577.96
|
| Rate for Payer: BCN Commercial |
$230.66
|
| Rate for Payer: BCN Medicare Advantage |
$142.68
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cofinity Commercial |
$205.46
|
| Rate for Payer: Cofinity Commercial |
$191.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.68
|
| Rate for Payer: Healthscope Commercial |
$263.96
|
| Rate for Payer: Healthscope Commercial |
$228.29
|
| Rate for Payer: Mclaren Medicaid |
$14.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.81
|
| Rate for Payer: Meridian Medicaid |
$15.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,167.00
|
| Rate for Payer: Nomi Health Commercial |
$171.22
|
| Rate for Payer: PACE SWMI |
$142.68
|
| Rate for Payer: PHP Medicare Advantage |
$142.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.11
|
| Rate for Payer: Priority Health Medicare |
$142.68
|
| Rate for Payer: Priority Health Narrow Network |
$217.11
|
| Rate for Payer: Priority Health SBD |
$31.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.68
|
| Rate for Payer: UHC Exchange |
$180.87
|
| Rate for Payer: UHC Medicare Advantage |
$142.68
|
| Rate for Payer: UHCCP Medicaid |
$14.91
|
|
|
PR NIPPLE/AREOLA RECONSTRUCTION
|
Professional
|
Both
|
$1,530.00
|
|
|
Service Code
|
HCPCS 19350
|
| Min. Negotiated Rate |
$436.65 |
| Max. Negotiated Rate |
$118,753.00 |
| Rate for Payer: Aetna Commercial |
$863.92
|
| Rate for Payer: Aetna Medicare |
$670.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$863.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$928.40
|
| Rate for Payer: BCBS Complete |
$458.48
|
| Rate for Payer: BCBS MAPPO |
$644.72
|
| Rate for Payer: BCBS Trust/PPO |
$596.25
|
| Rate for Payer: BCN Commercial |
$1,219.25
|
| Rate for Payer: BCN Medicare Advantage |
$644.72
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$928.40
|
| Rate for Payer: Cofinity Commercial |
$863.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.72
|
| Rate for Payer: Healthscope Commercial |
$1,192.73
|
| Rate for Payer: Healthscope Commercial |
$1,031.55
|
| Rate for Payer: Mclaren Medicaid |
$436.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$676.96
|
| Rate for Payer: Meridian Medicaid |
$458.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118,753.00
|
| Rate for Payer: Nomi Health Commercial |
$773.66
|
| Rate for Payer: PACE SWMI |
$644.72
|
| Rate for Payer: PHP Medicare Advantage |
$644.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$436.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$916.12
|
| Rate for Payer: Priority Health Medicare |
$644.72
|
| Rate for Payer: Priority Health Narrow Network |
$916.12
|
| Rate for Payer: Priority Health SBD |
$916.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$960.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$644.72
|
| Rate for Payer: UHC Exchange |
$960.16
|
| Rate for Payer: UHC Medicare Advantage |
$644.72
|
| Rate for Payer: UHCCP Medicaid |
$436.65
|
|
