|
PR AORTIC SUSPENSION TRACHEAL DECOMPRESSION SPX
|
Professional
|
Both
|
$1,864.00
|
|
|
Service Code
|
HCPCS 33800
|
| Min. Negotiated Rate |
$623.66 |
| Max. Negotiated Rate |
$1,550.79 |
| Rate for Payer: Aetna Commercial |
$1,270.98
|
| Rate for Payer: Aetna Medicare |
$986.43
|
| Rate for Payer: BCBS Complete |
$654.84
|
| Rate for Payer: BCBS MAPPO |
$948.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,416.90
|
| Rate for Payer: BCN Commercial |
$1,417.16
|
| Rate for Payer: BCN Medicare Advantage |
$948.49
|
| Rate for Payer: Cash Price |
$1,491.20
|
| Rate for Payer: Cash Price |
$1,491.20
|
| Rate for Payer: Cofinity Commercial |
$1,365.83
|
| Rate for Payer: Cofinity Commercial |
$1,270.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$948.49
|
| Rate for Payer: Mclaren Medicaid |
$623.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$995.91
|
| Rate for Payer: Meridian Medicaid |
$654.84
|
| Rate for Payer: Nomi Health Commercial |
$1,138.19
|
| Rate for Payer: PACE SWMI |
$948.49
|
| Rate for Payer: PHP Medicare Advantage |
$948.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,211.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,550.79
|
| Rate for Payer: Priority Health Medicare |
$957.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,550.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$948.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$948.49
|
| Rate for Payer: UHC Exchange |
$948.49
|
| Rate for Payer: UHC Medicare Advantage |
$948.49
|
| Rate for Payer: UHCCP Medicaid |
$623.66
|
|
|
PR AORTOPLASTY SUPRAVALVULAR STENOSIS
|
Professional
|
Both
|
$9,378.00
|
|
|
Service Code
|
HCPCS 33417
|
| Min. Negotiated Rate |
$918.19 |
| Max. Negotiated Rate |
$6,095.70 |
| Rate for Payer: Aetna Commercial |
$2,148.37
|
| Rate for Payer: Aetna Medicare |
$1,667.39
|
| Rate for Payer: BCBS Complete |
$1,106.62
|
| Rate for Payer: BCBS MAPPO |
$1,603.26
|
| Rate for Payer: BCBS Trust/PPO |
$918.19
|
| Rate for Payer: BCN Commercial |
$2,397.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,603.26
|
| Rate for Payer: Cash Price |
$7,502.40
|
| Rate for Payer: Cash Price |
$7,502.40
|
| Rate for Payer: Cofinity Commercial |
$2,308.69
|
| Rate for Payer: Cofinity Commercial |
$2,148.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,603.26
|
| Rate for Payer: Mclaren Medicaid |
$1,053.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,683.42
|
| Rate for Payer: Meridian Medicaid |
$1,106.62
|
| Rate for Payer: Nomi Health Commercial |
$1,923.91
|
| Rate for Payer: PACE SWMI |
$1,603.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,603.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,053.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,095.70
|
| Rate for Payer: Priority Health HMO/PPO |
$2,623.49
|
| Rate for Payer: Priority Health Medicare |
$1,619.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,623.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,603.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,603.26
|
| Rate for Payer: UHC Exchange |
$1,603.26
|
| Rate for Payer: UHC Medicare Advantage |
$1,603.26
|
| Rate for Payer: UHCCP Medicaid |
$1,053.92
|
|
|
PR APNEALINK
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS 00020
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Aetna Medicare |
$5.00
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
|
|
PR APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX
|
Professional
|
Both
|
$865.00
|
|
|
Service Code
|
HCPCS 44955
|
| Hospital Charge Code |
44955
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$566.34 |
| Rate for Payer: Aetna Commercial |
$108.08
|
| Rate for Payer: Aetna Medicare |
$83.89
|
| Rate for Payer: BCBS Complete |
$55.69
|
| Rate for Payer: BCBS MAPPO |
$80.66
|
| Rate for Payer: BCBS Trust/PPO |
$566.34
|
| Rate for Payer: BCN Commercial |
$121.19
|
| Rate for Payer: BCN Medicare Advantage |
$80.66
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cofinity Commercial |
$116.15
|
| Rate for Payer: Cofinity Commercial |
$108.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.66
|
| Rate for Payer: Mclaren Medicaid |
$53.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.69
|
| Rate for Payer: Meridian Medicaid |
$55.69
|
| Rate for Payer: Nomi Health Commercial |
$96.79
|
| Rate for Payer: PACE SWMI |
$80.66
|
| Rate for Payer: PHP Medicare Advantage |
$80.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.25
|
| Rate for Payer: Priority Health HMO/PPO |
$147.95
|
| Rate for Payer: Priority Health Medicare |
$81.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.66
|
| Rate for Payer: UHC Exchange |
$80.66
|
| Rate for Payer: UHC Medicare Advantage |
$80.66
|
| Rate for Payer: UHCCP Medicaid |
$53.04
|
|
|
PR APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX
|
Professional
|
Both
|
$865.00
|
|
|
Service Code
|
HCPCS 44955
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$566.34 |
| Rate for Payer: Aetna Commercial |
$108.08
|
| Rate for Payer: Aetna Medicare |
$83.89
|
| Rate for Payer: BCBS Complete |
$55.69
|
| Rate for Payer: BCBS MAPPO |
$80.66
|
| Rate for Payer: BCBS Trust/PPO |
$566.34
|
| Rate for Payer: BCN Commercial |
$121.19
|
| Rate for Payer: BCN Medicare Advantage |
$80.66
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cofinity Commercial |
$116.15
|
| Rate for Payer: Cofinity Commercial |
$108.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.66
|
| Rate for Payer: Mclaren Medicaid |
$53.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.69
|
| Rate for Payer: Meridian Medicaid |
$55.69
|
| Rate for Payer: Nomi Health Commercial |
$96.79
|
| Rate for Payer: PACE SWMI |
$80.66
|
| Rate for Payer: PHP Medicare Advantage |
$80.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.25
|
| Rate for Payer: Priority Health HMO/PPO |
$147.95
|
| Rate for Payer: Priority Health Medicare |
$81.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.66
|
| Rate for Payer: UHC Exchange |
$80.66
|
| Rate for Payer: UHC Medicare Advantage |
$80.66
|
| Rate for Payer: UHCCP Medicaid |
$53.04
|
|
|
PR APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX
|
Facility
|
IP
|
$865.00
|
|
|
Service Code
|
CPT 44955
|
| Hospital Charge Code |
44955
|
| Min. Negotiated Rate |
$562.25 |
| Max. Negotiated Rate |
$778.50 |
| Rate for Payer: Aetna Commercial |
$735.25
|
| Rate for Payer: BCBS Trust/PPO |
$706.10
|
| Rate for Payer: BCN Commercial |
$668.47
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cofinity Commercial |
$743.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$692.00
|
| Rate for Payer: Healthscope Commercial |
$778.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$648.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$735.25
|
| Rate for Payer: Nomi Health Commercial |
$709.30
|
| Rate for Payer: PHP Commercial |
$735.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.25
|
| Rate for Payer: Priority Health HMO/PPO |
$752.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$579.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$761.20
|
| Rate for Payer: UHC Core |
$722.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$648.75
|
|
|
PR APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX
|
Facility
|
OP
|
$865.00
|
|
|
Service Code
|
CPT 44955
|
| Hospital Charge Code |
44955
|
| Min. Negotiated Rate |
$205.44 |
| Max. Negotiated Rate |
$778.50 |
| Rate for Payer: Aetna Commercial |
$735.25
|
| Rate for Payer: Aetna Medicare |
$224.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$270.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$270.31
|
| Rate for Payer: BCBS Complete |
$346.00
|
| Rate for Payer: BCBS MAPPO |
$216.25
|
| Rate for Payer: BCBS Trust/PPO |
$711.12
|
| Rate for Payer: BCN Commercial |
$672.54
|
| Rate for Payer: BCN Medicare Advantage |
$216.25
|
| Rate for Payer: Cash Price |
$692.00
|
| Rate for Payer: Cofinity Commercial |
$743.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$692.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.25
|
| Rate for Payer: Healthscope Commercial |
$778.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$648.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$248.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$735.25
|
| Rate for Payer: Nomi Health Commercial |
$709.30
|
| Rate for Payer: PACE Senior Care Partners |
$205.44
|
| Rate for Payer: PACE SWMI |
$216.25
|
| Rate for Payer: PHP Commercial |
$735.25
|
| Rate for Payer: PHP Medicare Advantage |
$216.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.25
|
| Rate for Payer: Priority Health HMO/PPO |
$752.55
|
| Rate for Payer: Priority Health Medicare |
$218.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$579.55
|
| Rate for Payer: Railroad Medicare Medicare |
$216.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$761.20
|
| Rate for Payer: UHC Core |
$722.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.25
|
| Rate for Payer: UHC Exchange |
$216.25
|
| Rate for Payer: UHC Medicare Advantage |
$216.25
|
| Rate for Payer: VA VA |
$216.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$648.75
|
|
|
PR APPENDEC RPTD APPENDIX ABSC/PRITONITIS
|
Professional
|
Both
|
$2,137.00
|
|
|
Service Code
|
HCPCS 44960
|
| Min. Negotiated Rate |
$564.45 |
| Max. Negotiated Rate |
$1,572.03 |
| Rate for Payer: Aetna Commercial |
$1,143.22
|
| Rate for Payer: Aetna Medicare |
$887.28
|
| Rate for Payer: BCBS Complete |
$592.67
|
| Rate for Payer: BCBS MAPPO |
$853.15
|
| Rate for Payer: BCBS Trust/PPO |
$857.96
|
| Rate for Payer: BCN Commercial |
$1,281.31
|
| Rate for Payer: BCN Medicare Advantage |
$853.15
|
| Rate for Payer: Cash Price |
$1,709.60
|
| Rate for Payer: Cash Price |
$1,709.60
|
| Rate for Payer: Cofinity Commercial |
$1,228.54
|
| Rate for Payer: Cofinity Commercial |
$1,143.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$853.15
|
| Rate for Payer: Mclaren Medicaid |
$564.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$895.81
|
| Rate for Payer: Meridian Medicaid |
$592.67
|
| Rate for Payer: Nomi Health Commercial |
$1,023.78
|
| Rate for Payer: PACE SWMI |
$853.15
|
| Rate for Payer: PHP Medicare Advantage |
$853.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$564.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,389.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,572.03
|
| Rate for Payer: Priority Health Medicare |
$861.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,572.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$853.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$853.15
|
| Rate for Payer: UHC Exchange |
$853.15
|
| Rate for Payer: UHC Medicare Advantage |
$853.15
|
| Rate for Payer: UHCCP Medicaid |
$564.45
|
|
|
PR APPENDECTOMY
|
Facility
|
OP
|
$1,738.00
|
|
|
Service Code
|
CPT 44950
|
| Hospital Charge Code |
44950
|
| Min. Negotiated Rate |
$412.78 |
| Max. Negotiated Rate |
$4,641.43 |
| Rate for Payer: Aetna Commercial |
$1,477.30
|
| Rate for Payer: Aetna Medicare |
$451.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$543.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$543.12
|
| Rate for Payer: BCBS Complete |
$4,641.43
|
| Rate for Payer: BCBS MAPPO |
$434.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,428.81
|
| Rate for Payer: BCN Commercial |
$1,351.30
|
| Rate for Payer: BCN Medicare Advantage |
$434.50
|
| Rate for Payer: Cash Price |
$1,390.40
|
| Rate for Payer: Cash Price |
$1,390.40
|
| Rate for Payer: Cofinity Commercial |
$1,494.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,390.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$434.50
|
| Rate for Payer: Healthscope Commercial |
$1,564.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,303.50
|
| Rate for Payer: Mclaren Medicaid |
$4,420.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$456.22
|
| Rate for Payer: Meridian Medicaid |
$4,641.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$499.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,477.30
|
| Rate for Payer: Nomi Health Commercial |
$1,425.16
|
| Rate for Payer: PACE Senior Care Partners |
$412.78
|
| Rate for Payer: PACE SWMI |
$434.50
|
| Rate for Payer: PHP Commercial |
$1,477.30
|
| Rate for Payer: PHP Medicare Advantage |
$434.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,420.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,512.06
|
| Rate for Payer: Priority Health Medicare |
$438.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,164.46
|
| Rate for Payer: Railroad Medicare Medicare |
$434.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,529.44
|
| Rate for Payer: UHC Core |
$1,451.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$434.50
|
| Rate for Payer: UHC Exchange |
$434.50
|
| Rate for Payer: UHC Medicare Advantage |
$434.50
|
| Rate for Payer: UHCCP Medicaid |
$4,420.12
|
| Rate for Payer: VA VA |
$434.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,303.50
|
|
|
PR APPENDECTOMY
|
Facility
|
IP
|
$1,738.00
|
|
|
Service Code
|
CPT 44950
|
| Hospital Charge Code |
44950
|
| Min. Negotiated Rate |
$1,129.70 |
| Max. Negotiated Rate |
$1,564.20 |
| Rate for Payer: Aetna Commercial |
$1,477.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,418.73
|
| Rate for Payer: BCN Commercial |
$1,343.13
|
| Rate for Payer: Cash Price |
$1,390.40
|
| Rate for Payer: Cofinity Commercial |
$1,494.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,390.40
|
| Rate for Payer: Healthscope Commercial |
$1,564.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,303.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,477.30
|
| Rate for Payer: Nomi Health Commercial |
$1,425.16
|
| Rate for Payer: PHP Commercial |
$1,477.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,512.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,164.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,529.44
|
| Rate for Payer: UHC Core |
$1,451.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,303.50
|
|
|
PR APPENDECTOMY
|
Professional
|
Both
|
$1,738.00
|
|
|
Service Code
|
HCPCS 44950
|
| Hospital Charge Code |
44950
|
| Min. Negotiated Rate |
$413.13 |
| Max. Negotiated Rate |
$1,152.61 |
| Rate for Payer: Aetna Commercial |
$836.91
|
| Rate for Payer: Aetna Medicare |
$649.54
|
| Rate for Payer: BCBS Complete |
$434.33
|
| Rate for Payer: BCBS MAPPO |
$624.56
|
| Rate for Payer: BCBS Trust/PPO |
$413.13
|
| Rate for Payer: BCN Commercial |
$938.75
|
| Rate for Payer: BCN Medicare Advantage |
$624.56
|
| Rate for Payer: Cash Price |
$1,390.40
|
| Rate for Payer: Cash Price |
$1,390.40
|
| Rate for Payer: Cofinity Commercial |
$899.37
|
| Rate for Payer: Cofinity Commercial |
$836.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$624.56
|
| Rate for Payer: Mclaren Medicaid |
$413.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$655.79
|
| Rate for Payer: Meridian Medicaid |
$434.33
|
| Rate for Payer: Nomi Health Commercial |
$749.47
|
| Rate for Payer: PACE SWMI |
$624.56
|
| Rate for Payer: PHP Medicare Advantage |
$624.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,152.61
|
| Rate for Payer: Priority Health Medicare |
$630.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,152.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$624.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$624.56
|
| Rate for Payer: UHC Exchange |
$624.56
|
| Rate for Payer: UHC Medicare Advantage |
$624.56
|
| Rate for Payer: UHCCP Medicaid |
$413.65
|
|
|
PR APPENDECTOMY
|
Professional
|
Both
|
$1,738.00
|
|
|
Service Code
|
HCPCS 44950
|
| Min. Negotiated Rate |
$413.13 |
| Max. Negotiated Rate |
$1,152.61 |
| Rate for Payer: Aetna Commercial |
$836.91
|
| Rate for Payer: Aetna Medicare |
$649.54
|
| Rate for Payer: BCBS Complete |
$434.33
|
| Rate for Payer: BCBS MAPPO |
$624.56
|
| Rate for Payer: BCBS Trust/PPO |
$413.13
|
| Rate for Payer: BCN Commercial |
$938.75
|
| Rate for Payer: BCN Medicare Advantage |
$624.56
|
| Rate for Payer: Cash Price |
$1,390.40
|
| Rate for Payer: Cash Price |
$1,390.40
|
| Rate for Payer: Cofinity Commercial |
$899.37
|
| Rate for Payer: Cofinity Commercial |
$836.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$624.56
|
| Rate for Payer: Mclaren Medicaid |
$413.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$655.79
|
| Rate for Payer: Meridian Medicaid |
$434.33
|
| Rate for Payer: Nomi Health Commercial |
$749.47
|
| Rate for Payer: PACE SWMI |
$624.56
|
| Rate for Payer: PHP Medicare Advantage |
$624.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,152.61
|
| Rate for Payer: Priority Health Medicare |
$630.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,152.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$624.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$624.56
|
| Rate for Payer: UHC Exchange |
$624.56
|
| Rate for Payer: UHC Medicare Advantage |
$624.56
|
| Rate for Payer: UHCCP Medicaid |
$413.65
|
|
|
PR APPL CRANIAL TONG/STRTCTC FRAME W/REMOVAL SPX
|
Professional
|
Both
|
$864.00
|
|
|
Service Code
|
HCPCS 20660
|
| Min. Negotiated Rate |
$154.85 |
| Max. Negotiated Rate |
$6,925.56 |
| Rate for Payer: Aetna Commercial |
$317.26
|
| Rate for Payer: Aetna Medicare |
$246.23
|
| Rate for Payer: BCBS Complete |
$162.59
|
| Rate for Payer: BCBS MAPPO |
$236.76
|
| Rate for Payer: BCBS Trust/PPO |
$6,925.56
|
| Rate for Payer: BCN Commercial |
$352.82
|
| Rate for Payer: BCN Medicare Advantage |
$236.76
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cofinity Commercial |
$340.93
|
| Rate for Payer: Cofinity Commercial |
$317.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.76
|
| Rate for Payer: Mclaren Medicaid |
$154.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.60
|
| Rate for Payer: Meridian Medicaid |
$162.59
|
| Rate for Payer: Nomi Health Commercial |
$284.11
|
| Rate for Payer: PACE SWMI |
$236.76
|
| Rate for Payer: PHP Medicare Advantage |
$236.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.60
|
| Rate for Payer: Priority Health HMO/PPO |
$366.38
|
| Rate for Payer: Priority Health Medicare |
$239.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$366.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.76
|
| Rate for Payer: UHC Exchange |
$236.76
|
| Rate for Payer: UHC Medicare Advantage |
$236.76
|
| Rate for Payer: UHCCP Medicaid |
$154.85
|
|
|
PR APPL HIP SPICA CAST ONE&ONE-HALF SPICA/BOTH LEGS
|
Professional
|
Both
|
$660.00
|
|
|
Service Code
|
HCPCS 29325
|
| Min. Negotiated Rate |
$116.09 |
| Max. Negotiated Rate |
$1,154.34 |
| Rate for Payer: Aetna Commercial |
$229.72
|
| Rate for Payer: Aetna Medicare |
$178.29
|
| Rate for Payer: BCBS Complete |
$121.89
|
| Rate for Payer: BCBS MAPPO |
$171.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,154.34
|
| Rate for Payer: BCN Commercial |
$402.67
|
| Rate for Payer: BCN Medicare Advantage |
$171.43
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cofinity Commercial |
$246.86
|
| Rate for Payer: Cofinity Commercial |
$229.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.43
|
| Rate for Payer: Mclaren Medicaid |
$116.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.00
|
| Rate for Payer: Meridian Medicaid |
$121.89
|
| Rate for Payer: Nomi Health Commercial |
$205.72
|
| Rate for Payer: PACE SWMI |
$171.43
|
| Rate for Payer: PHP Medicare Advantage |
$171.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$429.00
|
| Rate for Payer: Priority Health HMO/PPO |
$272.24
|
| Rate for Payer: Priority Health Medicare |
$173.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$272.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.43
|
| Rate for Payer: UHC Exchange |
$171.43
|
| Rate for Payer: UHC Medicare Advantage |
$171.43
|
| Rate for Payer: UHCCP Medicaid |
$116.09
|
|
|
PR APPLICATION CAST ELBOW FINGER SHORT ARM
|
Professional
|
Both
|
$201.00
|
|
|
Service Code
|
HCPCS 29075
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$1,010.64 |
| Rate for Payer: Aetna Commercial |
$81.00
|
| Rate for Payer: Aetna Medicare |
$62.87
|
| Rate for Payer: BCBS Complete |
$43.17
|
| Rate for Payer: BCBS MAPPO |
$60.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,010.64
|
| Rate for Payer: BCN Commercial |
$104.05
|
| Rate for Payer: BCN Medicare Advantage |
$60.45
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cofinity Commercial |
$87.05
|
| Rate for Payer: Cofinity Commercial |
$81.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.45
|
| Rate for Payer: Mclaren Medicaid |
$41.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.47
|
| Rate for Payer: Meridian Medicaid |
$43.17
|
| Rate for Payer: Nomi Health Commercial |
$72.54
|
| Rate for Payer: PACE SWMI |
$60.45
|
| Rate for Payer: PHP Medicare Advantage |
$60.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health HMO/PPO |
$96.17
|
| Rate for Payer: Priority Health Medicare |
$61.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.45
|
| Rate for Payer: UHC Exchange |
$60.45
|
| Rate for Payer: UHC Medicare Advantage |
$60.45
|
| Rate for Payer: UHCCP Medicaid |
$41.11
|
|
|
PR APPLICATION CAST FIGURE-OF-8
|
Professional
|
Both
|
$239.00
|
|
|
Service Code
|
HCPCS 29049
|
| Min. Negotiated Rate |
$45.58 |
| Max. Negotiated Rate |
$822.03 |
| Rate for Payer: Aetna Commercial |
$89.98
|
| Rate for Payer: Aetna Medicare |
$69.84
|
| Rate for Payer: BCBS Complete |
$47.86
|
| Rate for Payer: BCBS MAPPO |
$67.15
|
| Rate for Payer: BCBS Trust/PPO |
$822.03
|
| Rate for Payer: BCN Commercial |
$146.60
|
| Rate for Payer: BCN Medicare Advantage |
$67.15
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cofinity Commercial |
$96.70
|
| Rate for Payer: Cofinity Commercial |
$89.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.15
|
| Rate for Payer: Mclaren Medicaid |
$45.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.51
|
| Rate for Payer: Meridian Medicaid |
$47.86
|
| Rate for Payer: Nomi Health Commercial |
$80.58
|
| Rate for Payer: PACE SWMI |
$67.15
|
| Rate for Payer: PHP Medicare Advantage |
$67.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.35
|
| Rate for Payer: Priority Health HMO/PPO |
$107.37
|
| Rate for Payer: Priority Health Medicare |
$67.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.15
|
| Rate for Payer: UHC Exchange |
$67.15
|
| Rate for Payer: UHC Medicare Advantage |
$67.15
|
| Rate for Payer: UHCCP Medicaid |
$45.58
|
|
|
PR APPLICATION CAST FINGER
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 29086
|
| Min. Negotiated Rate |
$31.95 |
| Max. Negotiated Rate |
$1,122.64 |
| Rate for Payer: Aetna Commercial |
$62.19
|
| Rate for Payer: Aetna Medicare |
$48.27
|
| Rate for Payer: BCBS Complete |
$33.55
|
| Rate for Payer: BCBS MAPPO |
$46.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,122.64
|
| Rate for Payer: BCN Commercial |
$112.40
|
| Rate for Payer: BCN Medicare Advantage |
$46.41
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$66.83
|
| Rate for Payer: Cofinity Commercial |
$62.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.41
|
| Rate for Payer: Mclaren Medicaid |
$31.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.73
|
| Rate for Payer: Meridian Medicaid |
$33.55
|
| Rate for Payer: Nomi Health Commercial |
$55.69
|
| Rate for Payer: PACE SWMI |
$46.41
|
| Rate for Payer: PHP Medicare Advantage |
$46.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health HMO/PPO |
$75.82
|
| Rate for Payer: Priority Health Medicare |
$46.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.41
|
| Rate for Payer: UHC Exchange |
$46.41
|
| Rate for Payer: UHC Medicare Advantage |
$46.41
|
| Rate for Payer: UHCCP Medicaid |
$31.95
|
|
|
PR APPLICATION CAST HAND & LOWER FOREARM GAUNTLET
|
Professional
|
Both
|
$189.00
|
|
|
Service Code
|
HCPCS 29085
|
| Min. Negotiated Rate |
$44.09 |
| Max. Negotiated Rate |
$1,099.39 |
| Rate for Payer: Aetna Commercial |
$86.91
|
| Rate for Payer: Aetna Medicare |
$67.45
|
| Rate for Payer: BCBS Complete |
$46.29
|
| Rate for Payer: BCBS MAPPO |
$64.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.39
|
| Rate for Payer: BCN Commercial |
$113.88
|
| Rate for Payer: BCN Medicare Advantage |
$64.86
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Cofinity Commercial |
$93.40
|
| Rate for Payer: Cofinity Commercial |
$86.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.86
|
| Rate for Payer: Mclaren Medicaid |
$44.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.10
|
| Rate for Payer: Meridian Medicaid |
$46.29
|
| Rate for Payer: Nomi Health Commercial |
$77.83
|
| Rate for Payer: PACE SWMI |
$64.86
|
| Rate for Payer: PHP Medicare Advantage |
$64.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.85
|
| Rate for Payer: Priority Health HMO/PPO |
$103.81
|
| Rate for Payer: Priority Health Medicare |
$65.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.86
|
| Rate for Payer: UHC Exchange |
$64.86
|
| Rate for Payer: UHC Medicare Advantage |
$64.86
|
| Rate for Payer: UHCCP Medicaid |
$44.09
|
|
|
PR APPLICATION CAST SHOULDER HAND LONG ARM
|
Professional
|
Both
|
$259.00
|
|
|
Service Code
|
HCPCS 29065
|
| Min. Negotiated Rate |
$44.30 |
| Max. Negotiated Rate |
$1,191.32 |
| Rate for Payer: Aetna Commercial |
$87.30
|
| Rate for Payer: Aetna Medicare |
$67.76
|
| Rate for Payer: BCBS Complete |
$46.52
|
| Rate for Payer: BCBS MAPPO |
$65.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,191.32
|
| Rate for Payer: BCN Commercial |
$114.65
|
| Rate for Payer: BCN Medicare Advantage |
$65.15
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$93.82
|
| Rate for Payer: Cofinity Commercial |
$87.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.15
|
| Rate for Payer: Mclaren Medicaid |
$44.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.41
|
| Rate for Payer: Meridian Medicaid |
$46.52
|
| Rate for Payer: Nomi Health Commercial |
$78.18
|
| Rate for Payer: PACE SWMI |
$65.15
|
| Rate for Payer: PHP Medicare Advantage |
$65.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health HMO/PPO |
$104.82
|
| Rate for Payer: Priority Health Medicare |
$65.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.15
|
| Rate for Payer: UHC Exchange |
$65.15
|
| Rate for Payer: UHC Medicare Advantage |
$65.15
|
| Rate for Payer: UHCCP Medicaid |
$44.30
|
|
|
PR APPLICATION CYLINDER CAST THIGH ANKLE
|
Professional
|
Both
|
$252.00
|
|
|
Service Code
|
HCPCS 29365
|
| Min. Negotiated Rate |
$56.66 |
| Max. Negotiated Rate |
$701.58 |
| Rate for Payer: Aetna Commercial |
$112.20
|
| Rate for Payer: Aetna Medicare |
$87.08
|
| Rate for Payer: BCBS Complete |
$59.49
|
| Rate for Payer: BCBS MAPPO |
$83.73
|
| Rate for Payer: BCBS Trust/PPO |
$701.58
|
| Rate for Payer: BCN Commercial |
$182.28
|
| Rate for Payer: BCN Medicare Advantage |
$83.73
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cofinity Commercial |
$120.57
|
| Rate for Payer: Cofinity Commercial |
$112.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.73
|
| Rate for Payer: Mclaren Medicaid |
$56.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.92
|
| Rate for Payer: Meridian Medicaid |
$59.49
|
| Rate for Payer: Nomi Health Commercial |
$100.48
|
| Rate for Payer: PACE SWMI |
$83.73
|
| Rate for Payer: PHP Medicare Advantage |
$83.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.80
|
| Rate for Payer: Priority Health HMO/PPO |
$134.85
|
| Rate for Payer: Priority Health Medicare |
$84.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$134.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.73
|
| Rate for Payer: UHC Exchange |
$83.73
|
| Rate for Payer: UHC Medicare Advantage |
$83.73
|
| Rate for Payer: UHCCP Medicaid |
$56.66
|
|
|
PR APPLICATION FINGER SPLINT DYNAMIC
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS 29131
|
| Min. Negotiated Rate |
$22.37 |
| Max. Negotiated Rate |
$2,121.65 |
| Rate for Payer: Aetna Commercial |
$44.49
|
| Rate for Payer: Aetna Medicare |
$34.53
|
| Rate for Payer: BCBS Complete |
$23.49
|
| Rate for Payer: BCBS MAPPO |
$33.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,121.65
|
| Rate for Payer: BCN Commercial |
$78.68
|
| Rate for Payer: BCN Medicare Advantage |
$33.20
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$47.81
|
| Rate for Payer: Cofinity Commercial |
$44.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.20
|
| Rate for Payer: Mclaren Medicaid |
$22.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.86
|
| Rate for Payer: Meridian Medicaid |
$23.49
|
| Rate for Payer: Nomi Health Commercial |
$39.84
|
| Rate for Payer: PACE SWMI |
$33.20
|
| Rate for Payer: PHP Medicare Advantage |
$33.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.25
|
| Rate for Payer: Priority Health HMO/PPO |
$52.92
|
| Rate for Payer: Priority Health Medicare |
$33.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.20
|
| Rate for Payer: UHC Exchange |
$33.20
|
| Rate for Payer: UHC Medicare Advantage |
$33.20
|
| Rate for Payer: UHCCP Medicaid |
$22.37
|
|
|
PR APPLICATION FINGER SPLINT STATIC
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
HCPCS 29130
|
| Min. Negotiated Rate |
$18.53 |
| Max. Negotiated Rate |
$2,436.52 |
| Rate for Payer: Aetna Commercial |
$37.18
|
| Rate for Payer: Aetna Medicare |
$28.86
|
| Rate for Payer: BCBS Complete |
$19.46
|
| Rate for Payer: BCBS MAPPO |
$27.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,436.52
|
| Rate for Payer: BCN Commercial |
$61.58
|
| Rate for Payer: BCN Medicare Advantage |
$27.75
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cofinity Commercial |
$39.96
|
| Rate for Payer: Cofinity Commercial |
$37.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.75
|
| Rate for Payer: Mclaren Medicaid |
$18.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.14
|
| Rate for Payer: Meridian Medicaid |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$33.30
|
| Rate for Payer: PACE SWMI |
$27.75
|
| Rate for Payer: PHP Medicare Advantage |
$27.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.10
|
| Rate for Payer: Priority Health HMO/PPO |
$44.27
|
| Rate for Payer: Priority Health Medicare |
$28.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.75
|
| Rate for Payer: UHC Exchange |
$27.75
|
| Rate for Payer: UHC Medicare Advantage |
$27.75
|
| Rate for Payer: UHCCP Medicaid |
$18.53
|
|
|
PR APPLICATION HALO CRANIAL INCLUDING REMOVAL
|
Professional
|
Both
|
$1,099.00
|
|
|
Service Code
|
HCPCS 20661
|
| Min. Negotiated Rate |
$339.10 |
| Max. Negotiated Rate |
$32,076.33 |
| Rate for Payer: Aetna Commercial |
$669.36
|
| Rate for Payer: Aetna Medicare |
$519.50
|
| Rate for Payer: BCBS Complete |
$356.06
|
| Rate for Payer: BCBS MAPPO |
$499.52
|
| Rate for Payer: BCBS Trust/PPO |
$32,076.33
|
| Rate for Payer: BCN Commercial |
$841.55
|
| Rate for Payer: BCN Medicare Advantage |
$499.52
|
| Rate for Payer: Cash Price |
$879.20
|
| Rate for Payer: Cash Price |
$879.20
|
| Rate for Payer: Cofinity Commercial |
$719.31
|
| Rate for Payer: Cofinity Commercial |
$669.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$499.52
|
| Rate for Payer: Mclaren Medicaid |
$339.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$524.50
|
| Rate for Payer: Meridian Medicaid |
$356.06
|
| Rate for Payer: Nomi Health Commercial |
$599.42
|
| Rate for Payer: PACE SWMI |
$499.52
|
| Rate for Payer: PHP Medicare Advantage |
$499.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$339.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$714.35
|
| Rate for Payer: Priority Health HMO/PPO |
$817.23
|
| Rate for Payer: Priority Health Medicare |
$504.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$817.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$499.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$499.52
|
| Rate for Payer: UHC Exchange |
$499.52
|
| Rate for Payer: UHC Medicare Advantage |
$499.52
|
| Rate for Payer: UHCCP Medicaid |
$339.10
|
|
|
PR APPLICATION HIP SPICA CAST 1 LEG
|
Professional
|
Both
|
$490.00
|
|
|
Service Code
|
HCPCS 29305
|
| Min. Negotiated Rate |
$103.52 |
| Max. Negotiated Rate |
$1,986.41 |
| Rate for Payer: Aetna Commercial |
$204.51
|
| Rate for Payer: Aetna Medicare |
$158.72
|
| Rate for Payer: BCBS Complete |
$108.70
|
| Rate for Payer: BCBS MAPPO |
$152.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,986.41
|
| Rate for Payer: BCN Commercial |
$365.04
|
| Rate for Payer: BCN Medicare Advantage |
$152.62
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Cofinity Commercial |
$219.77
|
| Rate for Payer: Cofinity Commercial |
$204.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.62
|
| Rate for Payer: Mclaren Medicaid |
$103.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.25
|
| Rate for Payer: Meridian Medicaid |
$108.70
|
| Rate for Payer: Nomi Health Commercial |
$183.14
|
| Rate for Payer: PACE SWMI |
$152.62
|
| Rate for Payer: PHP Medicare Advantage |
$152.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.50
|
| Rate for Payer: Priority Health HMO/PPO |
$243.23
|
| Rate for Payer: Priority Health Medicare |
$154.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$243.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.62
|
| Rate for Payer: UHC Exchange |
$152.62
|
| Rate for Payer: UHC Medicare Advantage |
$152.62
|
| Rate for Payer: UHCCP Medicaid |
$103.52
|
|
|
PR APPLICATION INTERVERTEBRAL BIOMECHANICAL DEVICE
|
Professional
|
Both
|
$2,083.00
|
|
|
Service Code
|
HCPCS 22851
|
| Min. Negotiated Rate |
$833.20 |
| Max. Negotiated Rate |
$1,353.95 |
| Rate for Payer: Aetna Medicare |
$1,041.50
|
| Rate for Payer: BCBS Complete |
$833.20
|
| Rate for Payer: Cash Price |
$1,666.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,353.95
|
|
