|
PR DCMPRN FASCT LEG ANT&/LAT COMPARTMENTS ONLY
|
Professional
|
Both
|
$1,217.00
|
|
|
Service Code
|
HCPCS 27600
|
| Min. Negotiated Rate |
$256.88 |
| Max. Negotiated Rate |
$863.24 |
| Rate for Payer: Aetna Commercial |
$531.50
|
| Rate for Payer: Aetna Medicare |
$412.51
|
| Rate for Payer: BCBS Complete |
$269.72
|
| Rate for Payer: BCBS MAPPO |
$396.64
|
| Rate for Payer: BCBS Trust/PPO |
$863.24
|
| Rate for Payer: BCN Commercial |
$588.36
|
| Rate for Payer: BCN Medicare Advantage |
$396.64
|
| Rate for Payer: Cash Price |
$973.60
|
| Rate for Payer: Cash Price |
$973.60
|
| Rate for Payer: Cofinity Commercial |
$571.16
|
| Rate for Payer: Cofinity Commercial |
$531.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$396.64
|
| Rate for Payer: Mclaren Medicaid |
$256.88
|
| Rate for Payer: Meridian Medicaid |
$269.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$416.47
|
| Rate for Payer: PACE SWMI |
$396.64
|
| Rate for Payer: PHP Medicare Advantage |
$396.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$851.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$614.82
|
| Rate for Payer: Priority Health Medicare |
$396.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$614.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$396.64
|
| Rate for Payer: UHC Medicare Advantage |
$408.54
|
|
|
PR DCMPRN FASCT LEG ANT&/LAT&PST CMPRT
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 27602
|
| Min. Negotiated Rate |
$304.16 |
| Max. Negotiated Rate |
$1,903.46 |
| Rate for Payer: Aetna Commercial |
$633.82
|
| Rate for Payer: Aetna Medicare |
$491.92
|
| Rate for Payer: BCBS Complete |
$319.37
|
| Rate for Payer: BCBS MAPPO |
$473.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,903.46
|
| Rate for Payer: BCN Commercial |
$695.39
|
| Rate for Payer: BCN Medicare Advantage |
$473.00
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$681.12
|
| Rate for Payer: Cofinity Commercial |
$633.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$473.00
|
| Rate for Payer: Mclaren Medicaid |
$304.16
|
| Rate for Payer: Meridian Medicaid |
$319.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$496.65
|
| Rate for Payer: PACE SWMI |
$473.00
|
| Rate for Payer: PHP Medicare Advantage |
$473.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,213.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$726.65
|
| Rate for Payer: Priority Health Medicare |
$473.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$726.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$473.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$473.00
|
| Rate for Payer: UHC Medicare Advantage |
$487.19
|
|
|
PR DCMPRN FASCT LEG ANT&/LAT&PST W/DBRDMT MUS
|
Professional
|
Both
|
$2,197.00
|
|
|
Service Code
|
HCPCS 27894
|
| Min. Negotiated Rate |
$522.06 |
| Max. Negotiated Rate |
$2,785.73 |
| Rate for Payer: Aetna Commercial |
$1,077.27
|
| Rate for Payer: Aetna Medicare |
$836.09
|
| Rate for Payer: BCBS Complete |
$548.16
|
| Rate for Payer: BCBS MAPPO |
$803.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,785.73
|
| Rate for Payer: BCN Commercial |
$1,189.44
|
| Rate for Payer: BCN Medicare Advantage |
$803.93
|
| Rate for Payer: Cash Price |
$1,757.60
|
| Rate for Payer: Cash Price |
$1,757.60
|
| Rate for Payer: Cofinity Commercial |
$1,157.66
|
| Rate for Payer: Cofinity Commercial |
$1,077.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$803.93
|
| Rate for Payer: Mclaren Medicaid |
$522.06
|
| Rate for Payer: Meridian Medicaid |
$548.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$844.13
|
| Rate for Payer: PACE SWMI |
$803.93
|
| Rate for Payer: PHP Medicare Advantage |
$803.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$522.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,242.92
|
| Rate for Payer: Priority Health Medicare |
$803.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,242.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$803.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$803.93
|
| Rate for Payer: UHC Medicare Advantage |
$828.05
|
|
|
PR DCMPRN FASCT LEG ANT&/LAT W/DBRDMT MUSC&/NERVE
|
Professional
|
Both
|
$1,613.00
|
|
|
Service Code
|
HCPCS 27892
|
| Min. Negotiated Rate |
$345.27 |
| Max. Negotiated Rate |
$2,576.52 |
| Rate for Payer: Aetna Commercial |
$708.22
|
| Rate for Payer: Aetna Medicare |
$549.66
|
| Rate for Payer: BCBS Complete |
$362.53
|
| Rate for Payer: BCBS MAPPO |
$528.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,576.52
|
| Rate for Payer: BCN Commercial |
$784.82
|
| Rate for Payer: BCN Medicare Advantage |
$528.52
|
| Rate for Payer: Cash Price |
$1,290.40
|
| Rate for Payer: Cash Price |
$1,290.40
|
| Rate for Payer: Cofinity Commercial |
$708.22
|
| Rate for Payer: Cofinity Commercial |
$761.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$528.52
|
| Rate for Payer: Mclaren Medicaid |
$345.27
|
| Rate for Payer: Meridian Medicaid |
$362.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$554.95
|
| Rate for Payer: PACE SWMI |
$528.52
|
| Rate for Payer: PHP Medicare Advantage |
$528.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$820.11
|
| Rate for Payer: Priority Health Medicare |
$528.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$820.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$528.52
|
| Rate for Payer: UHC Medicare Advantage |
$544.38
|
|
|
PR DCMPRN FASCT LEG POST COMPARTMENT ONLY
|
Professional
|
Both
|
$1,361.00
|
|
|
Service Code
|
HCPCS 27601
|
| Min. Negotiated Rate |
$285.63 |
| Max. Negotiated Rate |
$2,076.22 |
| Rate for Payer: Aetna Commercial |
$582.16
|
| Rate for Payer: Aetna Medicare |
$451.83
|
| Rate for Payer: BCBS Complete |
$299.91
|
| Rate for Payer: BCBS MAPPO |
$434.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,076.22
|
| Rate for Payer: BCN Commercial |
$648.47
|
| Rate for Payer: BCN Medicare Advantage |
$434.45
|
| Rate for Payer: Cash Price |
$1,088.80
|
| Rate for Payer: Cash Price |
$1,088.80
|
| Rate for Payer: Cofinity Commercial |
$582.16
|
| Rate for Payer: Cofinity Commercial |
$625.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$434.45
|
| Rate for Payer: Mclaren Medicaid |
$285.63
|
| Rate for Payer: Meridian Medicaid |
$299.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$456.17
|
| Rate for Payer: PACE SWMI |
$434.45
|
| Rate for Payer: PHP Medicare Advantage |
$434.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$285.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$952.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$677.63
|
| Rate for Payer: Priority Health Medicare |
$434.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$677.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$434.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$434.45
|
| Rate for Payer: UHC Medicare Advantage |
$447.48
|
|
|
PR DCMPRN FASCT THIGH&/KNEE MLT DBRDMT NV MUSC&NRVE
|
Professional
|
Both
|
$1,133.00
|
|
|
Service Code
|
HCPCS 27499
|
| Min. Negotiated Rate |
$455.61 |
| Max. Negotiated Rate |
$2,735.54 |
| Rate for Payer: Aetna Commercial |
$929.41
|
| Rate for Payer: Aetna Medicare |
$721.33
|
| Rate for Payer: BCBS Complete |
$478.39
|
| Rate for Payer: BCBS MAPPO |
$693.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,735.54
|
| Rate for Payer: BCN Commercial |
$1,036.00
|
| Rate for Payer: BCN Medicare Advantage |
$693.59
|
| Rate for Payer: Cash Price |
$906.40
|
| Rate for Payer: Cash Price |
$906.40
|
| Rate for Payer: Cofinity Commercial |
$929.41
|
| Rate for Payer: Cofinity Commercial |
$998.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$693.59
|
| Rate for Payer: Mclaren Medicaid |
$455.61
|
| Rate for Payer: Meridian Medicaid |
$478.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$728.27
|
| Rate for Payer: PACE SWMI |
$693.59
|
| Rate for Payer: PHP Medicare Advantage |
$693.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$793.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,082.58
|
| Rate for Payer: Priority Health Medicare |
$693.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,082.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$693.59
|
| Rate for Payer: UHC Medicare Advantage |
$714.40
|
|
|
PR DCMPRN PX PERQ NUCLEUS PULPOSUS 1/MLT LVL LUMBAR
|
Professional
|
Both
|
$2,942.00
|
|
|
Service Code
|
HCPCS 62287
|
| Min. Negotiated Rate |
$385.32 |
| Max. Negotiated Rate |
$2,059.40 |
| Rate for Payer: Aetna Commercial |
$737.79
|
| Rate for Payer: Aetna Medicare |
$572.61
|
| Rate for Payer: BCBS Complete |
$404.59
|
| Rate for Payer: BCBS MAPPO |
$550.59
|
| Rate for Payer: BCBS Trust/PPO |
$573.21
|
| Rate for Payer: BCN Commercial |
$820.49
|
| Rate for Payer: BCN Medicare Advantage |
$550.59
|
| Rate for Payer: Cash Price |
$2,353.60
|
| Rate for Payer: Cash Price |
$2,353.60
|
| Rate for Payer: Cofinity Commercial |
$792.85
|
| Rate for Payer: Cofinity Commercial |
$737.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.59
|
| Rate for Payer: Mclaren Medicaid |
$385.32
|
| Rate for Payer: Meridian Medicaid |
$404.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$578.12
|
| Rate for Payer: PACE SWMI |
$550.59
|
| Rate for Payer: PHP Medicare Advantage |
$550.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,059.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$950.70
|
| Rate for Payer: Priority Health Medicare |
$550.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$950.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$550.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$550.59
|
| Rate for Payer: UHC Medicare Advantage |
$567.11
|
|
|
PR DEBRIDEMENT BONE 1ST 20 SQ CM/<
|
Facility
|
OP
|
$825.00
|
|
|
Service Code
|
CPT 11044
|
| Hospital Charge Code |
11044
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$195.94 |
| Max. Negotiated Rate |
$1,116.73 |
| Rate for Payer: Aetna Commercial |
$701.25
|
| Rate for Payer: Aetna Medicare |
$214.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$257.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$257.81
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$206.25
|
| Rate for Payer: BCBS Trust/PPO |
$641.44
|
| Rate for Payer: BCN Commercial |
$641.44
|
| Rate for Payer: BCN Medicare Advantage |
$206.25
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cofinity Commercial |
$709.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.25
|
| Rate for Payer: Healthscope Commercial |
$742.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$618.75
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$216.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$237.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$701.25
|
| Rate for Payer: PACE Senior Care Partners |
$195.94
|
| Rate for Payer: PACE SWMI |
$206.25
|
| Rate for Payer: PHP Commercial |
$701.25
|
| Rate for Payer: PHP Medicare Advantage |
$206.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$717.75
|
| Rate for Payer: Priority Health Medicare |
$206.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$503.17
|
| Rate for Payer: Railroad Medicare Medicare |
$206.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$726.00
|
| Rate for Payer: UHC Core |
$688.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$206.25
|
| Rate for Payer: UHC Medicare Advantage |
$212.44
|
| Rate for Payer: VA VA |
$206.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$618.75
|
|
|
PR DEBRIDEMENT BONE 1ST 20 SQ CM/<
|
Facility
|
IP
|
$825.00
|
|
|
Service Code
|
CPT 11044
|
| Hospital Charge Code |
11044
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$503.17 |
| Max. Negotiated Rate |
$742.50 |
| Rate for Payer: Aetna Commercial |
$701.25
|
| Rate for Payer: BCBS Trust/PPO |
$637.56
|
| Rate for Payer: BCN Commercial |
$637.56
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cofinity Commercial |
$709.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.00
|
| Rate for Payer: Healthscope Commercial |
$742.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$618.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$701.25
|
| Rate for Payer: PHP Commercial |
$701.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$717.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$503.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$726.00
|
| Rate for Payer: UHC Core |
$688.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$618.75
|
|
|
PR DEBRIDEMENT BONE EACH ADDITIONAL 20 SQ CM
|
Professional
|
Both
|
$360.00
|
|
|
Service Code
|
HCPCS 11047
|
| Min. Negotiated Rate |
$61.34 |
| Max. Negotiated Rate |
$252.00 |
| Rate for Payer: Aetna Commercial |
$128.63
|
| Rate for Payer: Aetna Medicare |
$99.83
|
| Rate for Payer: BCBS Complete |
$64.41
|
| Rate for Payer: BCBS MAPPO |
$95.99
|
| Rate for Payer: BCBS Trust/PPO |
$242.22
|
| Rate for Payer: BCN Commercial |
$175.93
|
| Rate for Payer: BCN Medicare Advantage |
$95.99
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cofinity Commercial |
$128.63
|
| Rate for Payer: Cofinity Commercial |
$138.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.99
|
| Rate for Payer: Mclaren Medicaid |
$61.34
|
| Rate for Payer: Meridian Medicaid |
$64.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.79
|
| Rate for Payer: PACE SWMI |
$95.99
|
| Rate for Payer: PHP Medicare Advantage |
$95.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.97
|
| Rate for Payer: Priority Health Medicare |
$95.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.99
|
| Rate for Payer: UHC Medicare Advantage |
$98.87
|
|
|
PR DEBRIDEMENT BONE MUSCLE &/FASCIA 20 SQ CM/<
|
Professional
|
Both
|
$825.00
|
|
|
Service Code
|
HCPCS 11044
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$577.50 |
| Rate for Payer: Aetna Commercial |
$297.36
|
| Rate for Payer: Aetna Medicare |
$230.79
|
| Rate for Payer: BCBS Complete |
$150.30
|
| Rate for Payer: BCBS MAPPO |
$221.91
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$452.52
|
| Rate for Payer: BCN Medicare Advantage |
$221.91
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cofinity Commercial |
$297.36
|
| Rate for Payer: Cofinity Commercial |
$319.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.91
|
| Rate for Payer: Mclaren Medicaid |
$143.14
|
| Rate for Payer: Meridian Medicaid |
$150.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$233.01
|
| Rate for Payer: PACE SWMI |
$221.91
|
| Rate for Payer: PHP Medicare Advantage |
$221.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$577.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$274.17
|
| Rate for Payer: Priority Health Medicare |
$221.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$274.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$221.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$221.91
|
| Rate for Payer: UHC Medicare Advantage |
$228.57
|
|
|
PR DEBRIDEMENT MASTOIDECTOMY CAVITY CMPLX
|
Professional
|
Both
|
$363.00
|
|
|
Service Code
|
HCPCS 69222
|
| Min. Negotiated Rate |
$88.18 |
| Max. Negotiated Rate |
$1,975.31 |
| Rate for Payer: Aetna Commercial |
$177.38
|
| Rate for Payer: Aetna Medicare |
$137.66
|
| Rate for Payer: BCBS Complete |
$92.59
|
| Rate for Payer: BCBS MAPPO |
$132.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,975.31
|
| Rate for Payer: BCN Commercial |
$319.60
|
| Rate for Payer: BCN Medicare Advantage |
$132.37
|
| Rate for Payer: Cash Price |
$290.40
|
| Rate for Payer: Cash Price |
$290.40
|
| Rate for Payer: Cofinity Commercial |
$177.38
|
| Rate for Payer: Cofinity Commercial |
$190.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.37
|
| Rate for Payer: Mclaren Medicaid |
$88.18
|
| Rate for Payer: Meridian Medicaid |
$92.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$138.99
|
| Rate for Payer: PACE SWMI |
$132.37
|
| Rate for Payer: PHP Medicare Advantage |
$132.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.77
|
| Rate for Payer: Priority Health Medicare |
$132.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$193.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$132.37
|
| Rate for Payer: UHC Medicare Advantage |
$136.34
|
|
|
PR DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
HCPCS 69220
|
| Min. Negotiated Rate |
$32.80 |
| Max. Negotiated Rate |
$1,803.09 |
| Rate for Payer: Aetna Commercial |
$67.55
|
| Rate for Payer: Aetna Medicare |
$52.43
|
| Rate for Payer: BCBS Complete |
$34.44
|
| Rate for Payer: BCBS MAPPO |
$50.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,803.09
|
| Rate for Payer: BCN Commercial |
$114.84
|
| Rate for Payer: BCN Medicare Advantage |
$50.41
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cofinity Commercial |
$72.59
|
| Rate for Payer: Cofinity Commercial |
$67.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.41
|
| Rate for Payer: Mclaren Medicaid |
$32.80
|
| Rate for Payer: Meridian Medicaid |
$34.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$52.93
|
| Rate for Payer: PACE SWMI |
$50.41
|
| Rate for Payer: PHP Medicare Advantage |
$50.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.14
|
| Rate for Payer: Priority Health Medicare |
$50.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.41
|
| Rate for Payer: UHC Medicare Advantage |
$51.92
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA 1ST 20 SQ CM/<
|
Facility
|
OP
|
$470.00
|
|
|
Service Code
|
CPT 11043
|
| Hospital Charge Code |
11043
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$111.62 |
| Max. Negotiated Rate |
$432.60 |
| Rate for Payer: Aetna Commercial |
$399.50
|
| Rate for Payer: Aetna Medicare |
$122.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$146.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$146.88
|
| Rate for Payer: BCBS Complete |
$432.60
|
| Rate for Payer: BCBS MAPPO |
$117.50
|
| Rate for Payer: BCBS Trust/PPO |
$365.42
|
| Rate for Payer: BCN Commercial |
$365.42
|
| Rate for Payer: BCN Medicare Advantage |
$117.50
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cofinity Commercial |
$404.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.50
|
| Rate for Payer: Healthscope Commercial |
$423.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$352.50
|
| Rate for Payer: Mclaren Medicaid |
$412.00
|
| Rate for Payer: Meridian Medicaid |
$432.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$123.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$399.50
|
| Rate for Payer: PACE Senior Care Partners |
$111.62
|
| Rate for Payer: PACE SWMI |
$117.50
|
| Rate for Payer: PHP Commercial |
$399.50
|
| Rate for Payer: PHP Medicare Advantage |
$117.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$408.90
|
| Rate for Payer: Priority Health Medicare |
$117.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$286.65
|
| Rate for Payer: Railroad Medicare Medicare |
$117.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$413.60
|
| Rate for Payer: UHC Core |
$392.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$117.50
|
| Rate for Payer: UHC Medicare Advantage |
$121.02
|
| Rate for Payer: VA VA |
$117.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$352.50
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA 1ST 20 SQ CM/<
|
Facility
|
IP
|
$470.00
|
|
|
Service Code
|
CPT 11043
|
| Hospital Charge Code |
11043
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$286.65 |
| Max. Negotiated Rate |
$423.00 |
| Rate for Payer: Aetna Commercial |
$399.50
|
| Rate for Payer: BCBS Trust/PPO |
$363.22
|
| Rate for Payer: BCN Commercial |
$363.22
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cofinity Commercial |
$404.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.00
|
| Rate for Payer: Healthscope Commercial |
$423.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$352.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$399.50
|
| Rate for Payer: PHP Commercial |
$399.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$408.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$286.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$413.60
|
| Rate for Payer: UHC Core |
$392.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$352.50
|
|
|
PR DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<
|
Professional
|
Both
|
$470.00
|
|
|
Service Code
|
HCPCS 11043
|
| Min. Negotiated Rate |
$97.55 |
| Max. Negotiated Rate |
$1,522.50 |
| Rate for Payer: Aetna Commercial |
$202.13
|
| Rate for Payer: Aetna Medicare |
$156.87
|
| Rate for Payer: BCBS Complete |
$102.43
|
| Rate for Payer: BCBS MAPPO |
$150.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,522.50
|
| Rate for Payer: BCN Commercial |
$338.65
|
| Rate for Payer: BCN Medicare Advantage |
$150.84
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Cofinity Commercial |
$217.21
|
| Rate for Payer: Cofinity Commercial |
$202.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.84
|
| Rate for Payer: Mclaren Medicaid |
$97.55
|
| Rate for Payer: Meridian Medicaid |
$102.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$158.38
|
| Rate for Payer: PACE SWMI |
$150.84
|
| Rate for Payer: PHP Medicare Advantage |
$150.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.03
|
| Rate for Payer: Priority Health Medicare |
$150.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.84
|
| Rate for Payer: UHC Medicare Advantage |
$155.37
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM
|
Facility
|
IP
|
$99.00
|
|
|
Service Code
|
CPT 11046
|
| Hospital Charge Code |
11046
|
| Min. Negotiated Rate |
$60.38 |
| Max. Negotiated Rate |
$89.10 |
| Rate for Payer: Aetna Commercial |
$84.15
|
| Rate for Payer: BCBS Trust/PPO |
$76.51
|
| Rate for Payer: BCN Commercial |
$76.51
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cofinity Commercial |
$85.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.20
|
| Rate for Payer: Healthscope Commercial |
$89.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.15
|
| Rate for Payer: PHP Commercial |
$84.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.12
|
| Rate for Payer: UHC Core |
$82.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.25
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM
|
Facility
|
OP
|
$99.00
|
|
|
Service Code
|
CPT 11046
|
| Hospital Charge Code |
11046
|
| Min. Negotiated Rate |
$23.51 |
| Max. Negotiated Rate |
$89.10 |
| Rate for Payer: Aetna Commercial |
$84.15
|
| Rate for Payer: Aetna Medicare |
$25.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.94
|
| Rate for Payer: BCBS Complete |
$39.60
|
| Rate for Payer: BCBS MAPPO |
$24.75
|
| Rate for Payer: BCBS Trust/PPO |
$76.97
|
| Rate for Payer: BCN Commercial |
$76.97
|
| Rate for Payer: BCN Medicare Advantage |
$24.75
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cofinity Commercial |
$85.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.75
|
| Rate for Payer: Healthscope Commercial |
$89.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.15
|
| Rate for Payer: PACE Senior Care Partners |
$23.51
|
| Rate for Payer: PACE SWMI |
$24.75
|
| Rate for Payer: PHP Commercial |
$84.15
|
| Rate for Payer: PHP Medicare Advantage |
$24.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.13
|
| Rate for Payer: Priority Health Medicare |
$24.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.38
|
| Rate for Payer: Railroad Medicare Medicare |
$24.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.12
|
| Rate for Payer: UHC Core |
$82.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.75
|
| Rate for Payer: UHC Medicare Advantage |
$25.49
|
| Rate for Payer: VA VA |
$24.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.25
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM
|
Professional
|
Both
|
$99.00
|
|
|
Service Code
|
HCPCS 11046
|
| Hospital Charge Code |
11046
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$2,430.00 |
| Rate for Payer: Aetna Commercial |
$72.60
|
| Rate for Payer: Aetna Medicare |
$56.35
|
| Rate for Payer: BCBS Complete |
$36.46
|
| Rate for Payer: BCBS MAPPO |
$54.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,430.00
|
| Rate for Payer: BCN Commercial |
$106.04
|
| Rate for Payer: BCN Medicare Advantage |
$54.18
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cofinity Commercial |
$78.02
|
| Rate for Payer: Cofinity Commercial |
$72.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.18
|
| Rate for Payer: Mclaren Medicaid |
$34.72
|
| Rate for Payer: Meridian Medicaid |
$36.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$56.89
|
| Rate for Payer: PACE SWMI |
$54.18
|
| Rate for Payer: PHP Medicare Advantage |
$54.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.59
|
| Rate for Payer: Priority Health Medicare |
$54.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.18
|
| Rate for Payer: UHC Medicare Advantage |
$55.81
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM
|
Professional
|
Both
|
$99.00
|
|
|
Service Code
|
HCPCS 11046
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$2,430.00 |
| Rate for Payer: Aetna Commercial |
$72.60
|
| Rate for Payer: Aetna Medicare |
$56.35
|
| Rate for Payer: BCBS Complete |
$36.46
|
| Rate for Payer: BCBS MAPPO |
$54.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,430.00
|
| Rate for Payer: BCN Commercial |
$106.04
|
| Rate for Payer: BCN Medicare Advantage |
$54.18
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cofinity Commercial |
$78.02
|
| Rate for Payer: Cofinity Commercial |
$72.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.18
|
| Rate for Payer: Mclaren Medicaid |
$34.72
|
| Rate for Payer: Meridian Medicaid |
$36.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$56.89
|
| Rate for Payer: PACE SWMI |
$54.18
|
| Rate for Payer: PHP Medicare Advantage |
$54.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.59
|
| Rate for Payer: Priority Health Medicare |
$54.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.18
|
| Rate for Payer: UHC Medicare Advantage |
$55.81
|
|
|
PR DEBRIDEMENT NAIL ANY METHOD 1-5
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 11720
|
| Min. Negotiated Rate |
$8.95 |
| Max. Negotiated Rate |
$57.48 |
| Rate for Payer: Aetna Commercial |
$19.38
|
| Rate for Payer: Aetna Medicare |
$15.04
|
| Rate for Payer: BCBS Complete |
$9.40
|
| Rate for Payer: BCBS MAPPO |
$14.46
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$38.48
|
| Rate for Payer: BCN Medicare Advantage |
$14.46
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$20.82
|
| Rate for Payer: Cofinity Commercial |
$19.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.46
|
| Rate for Payer: Mclaren Medicaid |
$8.95
|
| Rate for Payer: Meridian Medicaid |
$9.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.18
|
| Rate for Payer: PACE SWMI |
$14.46
|
| Rate for Payer: PHP Medicare Advantage |
$14.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.67
|
| Rate for Payer: Priority Health Medicare |
$14.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.46
|
| Rate for Payer: UHC Medicare Advantage |
$14.89
|
|
|
PR DEBRIDEMENT NAIL ANY METHOD 6/>
|
Professional
|
Both
|
$76.00
|
|
|
Service Code
|
HCPCS 11721
|
| Min. Negotiated Rate |
$14.91 |
| Max. Negotiated Rate |
$3,712.50 |
| Rate for Payer: Aetna Commercial |
$31.44
|
| Rate for Payer: Aetna Medicare |
$24.40
|
| Rate for Payer: BCBS Complete |
$15.66
|
| Rate for Payer: BCBS MAPPO |
$23.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,712.50
|
| Rate for Payer: BCN Commercial |
$51.83
|
| Rate for Payer: BCN Medicare Advantage |
$23.46
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cofinity Commercial |
$33.78
|
| Rate for Payer: Cofinity Commercial |
$31.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.46
|
| Rate for Payer: Mclaren Medicaid |
$14.91
|
| Rate for Payer: Meridian Medicaid |
$15.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.63
|
| Rate for Payer: PACE SWMI |
$23.46
|
| Rate for Payer: PHP Medicare Advantage |
$23.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.77
|
| Rate for Payer: Priority Health Medicare |
$23.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.46
|
| Rate for Payer: UHC Medicare Advantage |
$24.16
|
|
|
PR DEBRIDEMENT OPEN WOUND 20 SQ CM/<
|
Professional
|
Both
|
$118.00
|
|
|
Service Code
|
HCPCS 97597
|
| Min. Negotiated Rate |
$22.37 |
| Max. Negotiated Rate |
$839.47 |
| Rate for Payer: Aetna Commercial |
$46.99
|
| Rate for Payer: Aetna Medicare |
$36.47
|
| Rate for Payer: BCBS Complete |
$23.49
|
| Rate for Payer: BCBS MAPPO |
$35.07
|
| Rate for Payer: BCBS Trust/PPO |
$839.47
|
| Rate for Payer: BCN Commercial |
$147.09
|
| Rate for Payer: BCN Medicare Advantage |
$35.07
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cofinity Commercial |
$50.50
|
| Rate for Payer: Cofinity Commercial |
$46.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.07
|
| Rate for Payer: Mclaren Medicaid |
$22.37
|
| Rate for Payer: Meridian Medicaid |
$23.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.82
|
| Rate for Payer: PACE SWMI |
$35.07
|
| Rate for Payer: PHP Medicare Advantage |
$35.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.95
|
| Rate for Payer: Priority Health Medicare |
$35.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.07
|
| Rate for Payer: UHC Medicare Advantage |
$36.12
|
|
|
PR DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM
|
Professional
|
Both
|
$136.00
|
|
|
Service Code
|
HCPCS 97598
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$514.04 |
| Rate for Payer: Aetna Commercial |
$32.67
|
| Rate for Payer: Aetna Medicare |
$25.36
|
| Rate for Payer: BCBS Complete |
$16.33
|
| Rate for Payer: BCBS MAPPO |
$24.38
|
| Rate for Payer: BCBS Trust/PPO |
$514.04
|
| Rate for Payer: BCN Commercial |
$65.48
|
| Rate for Payer: BCN Medicare Advantage |
$24.38
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cofinity Commercial |
$32.67
|
| Rate for Payer: Cofinity Commercial |
$35.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.38
|
| Rate for Payer: Mclaren Medicaid |
$15.55
|
| Rate for Payer: Meridian Medicaid |
$16.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.60
|
| Rate for Payer: PACE SWMI |
$24.38
|
| Rate for Payer: PHP Medicare Advantage |
$24.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.51
|
| Rate for Payer: Priority Health Medicare |
$24.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.38
|
| Rate for Payer: UHC Medicare Advantage |
$25.11
|
|
|
PR DEBRIDEMENT, SKIN, PARTIAL THICKNESS
|
Professional
|
Both
|
$76.00
|
|
|
Service Code
|
HCPCS 11040
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$53.20 |
| Rate for Payer: BCBS Complete |
$30.40
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.20
|
|
