|
PR APPL MODALITY 1+ AREAS ESTIM EA 15 MIN
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 97032
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$831.54 |
| Rate for Payer: Aetna Commercial |
$18.45
|
| Rate for Payer: Aetna Medicare |
$14.32
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$13.77
|
| Rate for Payer: BCBS Trust/PPO |
$831.54
|
| Rate for Payer: BCN Commercial |
$14.03
|
| Rate for Payer: BCN Medicare Advantage |
$13.77
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$18.45
|
| Rate for Payer: Cofinity Commercial |
$19.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.46
|
| Rate for Payer: Nomi Health Commercial |
$16.52
|
| Rate for Payer: PACE SWMI |
$13.77
|
| Rate for Payer: PHP Medicare Advantage |
$13.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health HMO/PPO |
$77.25
|
| Rate for Payer: Priority Health Medicare |
$13.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.77
|
| Rate for Payer: UHC Exchange |
$13.77
|
| Rate for Payer: UHC Medicare Advantage |
$13.77
|
|
|
PR APPL MODALITY 1+ AREAS IONTOPHORESIS EA 15 MIN
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS 97033
|
| Min. Negotiated Rate |
$17.92 |
| Max. Negotiated Rate |
$1,039.69 |
| Rate for Payer: Aetna Commercial |
$24.01
|
| Rate for Payer: Aetna Medicare |
$18.64
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: BCBS MAPPO |
$17.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,039.69
|
| Rate for Payer: BCN Commercial |
$19.25
|
| Rate for Payer: BCN Medicare Advantage |
$17.92
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$24.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.82
|
| Rate for Payer: Nomi Health Commercial |
$21.50
|
| Rate for Payer: PACE SWMI |
$17.92
|
| Rate for Payer: PHP Medicare Advantage |
$17.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.55
|
| Rate for Payer: Priority Health HMO/PPO |
$77.25
|
| Rate for Payer: Priority Health Medicare |
$18.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.92
|
| Rate for Payer: UHC Exchange |
$17.92
|
| Rate for Payer: UHC Medicare Advantage |
$17.92
|
|
|
PR APPL MODALITY 1+ AREAS ULTRASOUND EA 15 MIN
|
Professional
|
Both
|
$22.00
|
|
|
Service Code
|
HCPCS 97035
|
| Min. Negotiated Rate |
$8.80 |
| Max. Negotiated Rate |
$1,260.00 |
| Rate for Payer: Aetna Commercial |
$17.90
|
| Rate for Payer: Aetna Medicare |
$13.89
|
| Rate for Payer: BCBS Complete |
$8.80
|
| Rate for Payer: BCBS MAPPO |
$13.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,260.00
|
| Rate for Payer: BCN Commercial |
$14.03
|
| Rate for Payer: BCN Medicare Advantage |
$13.36
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cofinity Commercial |
$19.24
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.03
|
| Rate for Payer: Nomi Health Commercial |
$16.03
|
| Rate for Payer: PACE SWMI |
$13.36
|
| Rate for Payer: PHP Medicare Advantage |
$13.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.30
|
| Rate for Payer: Priority Health HMO/PPO |
$77.25
|
| Rate for Payer: Priority Health Medicare |
$13.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.36
|
| Rate for Payer: UHC Exchange |
$13.36
|
| Rate for Payer: UHC Medicare Advantage |
$13.36
|
|
|
PR APP MLTPLN UNI XTRNL FIX STRTCTC ADJMT EXCHANGE
|
Professional
|
Both
|
$3,895.00
|
|
|
Service Code
|
HCPCS 20697
|
| Min. Negotiated Rate |
$578.50 |
| Max. Negotiated Rate |
$2,702.06 |
| Rate for Payer: Aetna Commercial |
$2,004.68
|
| Rate for Payer: Aetna Medicare |
$1,555.87
|
| Rate for Payer: BCBS Complete |
$1,558.00
|
| Rate for Payer: BCBS MAPPO |
$1,496.03
|
| Rate for Payer: BCBS Trust/PPO |
$578.50
|
| Rate for Payer: BCN Commercial |
$2,682.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,496.03
|
| Rate for Payer: Cash Price |
$3,116.00
|
| Rate for Payer: Cash Price |
$3,116.00
|
| Rate for Payer: Cofinity Commercial |
$2,154.28
|
| Rate for Payer: Cofinity Commercial |
$2,004.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,496.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,570.83
|
| Rate for Payer: Nomi Health Commercial |
$1,795.24
|
| Rate for Payer: PACE SWMI |
$1,496.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,496.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,531.75
|
| Rate for Payer: Priority Health HMO/PPO |
$2,702.06
|
| Rate for Payer: Priority Health Medicare |
$1,510.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,702.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,496.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,496.03
|
| Rate for Payer: UHC Exchange |
$1,496.03
|
| Rate for Payer: UHC Medicare Advantage |
$1,496.03
|
|
|
PR APP SKN SUB GRFT T/A/L AREA>=100SCM ADL 100SQCM
|
Professional
|
Both
|
$141.00
|
|
|
Service Code
|
HCPCS 15274
|
| Min. Negotiated Rate |
$27.90 |
| Max. Negotiated Rate |
$121.19 |
| Rate for Payer: Aetna Commercial |
$56.63
|
| Rate for Payer: Aetna Medicare |
$43.95
|
| Rate for Payer: BCBS Complete |
$29.30
|
| Rate for Payer: BCBS MAPPO |
$42.26
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$121.19
|
| Rate for Payer: BCN Medicare Advantage |
$42.26
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cofinity Commercial |
$56.63
|
| Rate for Payer: Cofinity Commercial |
$60.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.26
|
| Rate for Payer: Mclaren Medicaid |
$27.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.37
|
| Rate for Payer: Meridian Medicaid |
$29.30
|
| Rate for Payer: Nomi Health Commercial |
$50.71
|
| Rate for Payer: PACE SWMI |
$42.26
|
| Rate for Payer: PHP Medicare Advantage |
$42.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.65
|
| Rate for Payer: Priority Health HMO/PPO |
$59.60
|
| Rate for Payer: Priority Health Medicare |
$42.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.26
|
| Rate for Payer: UHC Exchange |
$42.26
|
| Rate for Payer: UHC Medicare Advantage |
$42.26
|
| Rate for Payer: UHCCP Medicaid |
$27.90
|
|
|
PR APP SKN SUB GRFT T/A/L AREA>=100SCM ADL 100SQCM
|
Professional
|
Both
|
$141.00
|
|
|
Service Code
|
HCPCS 15274
|
| Hospital Charge Code |
15274
|
| Min. Negotiated Rate |
$27.90 |
| Max. Negotiated Rate |
$121.19 |
| Rate for Payer: Aetna Commercial |
$56.63
|
| Rate for Payer: Aetna Medicare |
$43.95
|
| Rate for Payer: BCBS Complete |
$29.30
|
| Rate for Payer: BCBS MAPPO |
$42.26
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$121.19
|
| Rate for Payer: BCN Medicare Advantage |
$42.26
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cofinity Commercial |
$60.85
|
| Rate for Payer: Cofinity Commercial |
$56.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.26
|
| Rate for Payer: Mclaren Medicaid |
$27.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.37
|
| Rate for Payer: Meridian Medicaid |
$29.30
|
| Rate for Payer: Nomi Health Commercial |
$50.71
|
| Rate for Payer: PACE SWMI |
$42.26
|
| Rate for Payer: PHP Medicare Advantage |
$42.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.65
|
| Rate for Payer: Priority Health HMO/PPO |
$59.60
|
| Rate for Payer: Priority Health Medicare |
$42.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.26
|
| Rate for Payer: UHC Exchange |
$42.26
|
| Rate for Payer: UHC Medicare Advantage |
$42.26
|
| Rate for Payer: UHCCP Medicaid |
$27.90
|
|
|
PR APP SKN SUB GRFT T/A/L AREA>=100SCM ADL 100SQCM
|
Facility
|
OP
|
$141.00
|
|
|
Service Code
|
CPT 15274
|
| Hospital Charge Code |
15274
|
| Min. Negotiated Rate |
$33.49 |
| Max. Negotiated Rate |
$126.90 |
| Rate for Payer: Aetna Commercial |
$119.85
|
| Rate for Payer: Aetna Medicare |
$36.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.06
|
| Rate for Payer: BCBS Complete |
$56.40
|
| Rate for Payer: BCBS MAPPO |
$35.25
|
| Rate for Payer: BCBS Trust/PPO |
$115.92
|
| Rate for Payer: BCN Commercial |
$109.63
|
| Rate for Payer: BCN Medicare Advantage |
$35.25
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cofinity Commercial |
$121.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.25
|
| Rate for Payer: Healthscope Commercial |
$126.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.85
|
| Rate for Payer: Nomi Health Commercial |
$115.62
|
| Rate for Payer: PACE Senior Care Partners |
$33.49
|
| Rate for Payer: PACE SWMI |
$35.25
|
| Rate for Payer: PHP Commercial |
$119.85
|
| Rate for Payer: PHP Medicare Advantage |
$35.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.65
|
| Rate for Payer: Priority Health HMO/PPO |
$122.67
|
| Rate for Payer: Priority Health Medicare |
$35.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.47
|
| Rate for Payer: Railroad Medicare Medicare |
$35.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.08
|
| Rate for Payer: UHC Core |
$117.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.25
|
| Rate for Payer: UHC Exchange |
$35.25
|
| Rate for Payer: UHC Medicare Advantage |
$35.25
|
| Rate for Payer: VA VA |
$35.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.75
|
|
|
PR APP SKN SUB GRFT T/A/L AREA>=100SCM ADL 100SQCM
|
Facility
|
IP
|
$141.00
|
|
|
Service Code
|
CPT 15274
|
| Hospital Charge Code |
15274
|
| Min. Negotiated Rate |
$91.65 |
| Max. Negotiated Rate |
$126.90 |
| Rate for Payer: Aetna Commercial |
$119.85
|
| Rate for Payer: BCBS Trust/PPO |
$115.10
|
| Rate for Payer: BCN Commercial |
$108.96
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cofinity Commercial |
$121.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.80
|
| Rate for Payer: Healthscope Commercial |
$126.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.85
|
| Rate for Payer: Nomi Health Commercial |
$115.62
|
| Rate for Payer: PHP Commercial |
$119.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.65
|
| Rate for Payer: Priority Health HMO/PPO |
$122.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.08
|
| Rate for Payer: UHC Core |
$117.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.75
|
|
|
PR APP SKN SUBGRFT T/A/L AREA/100SQ CM 1ST 100SQ CM
|
Professional
|
Both
|
$616.00
|
|
|
Service Code
|
HCPCS 15273
|
| Hospital Charge Code |
15273
|
| Min. Negotiated Rate |
$123.33 |
| Max. Negotiated Rate |
$455.45 |
| Rate for Payer: Aetna Commercial |
$249.28
|
| Rate for Payer: Aetna Medicare |
$193.47
|
| Rate for Payer: BCBS Complete |
$129.50
|
| Rate for Payer: BCBS MAPPO |
$186.03
|
| Rate for Payer: BCBS Trust/PPO |
$383.40
|
| Rate for Payer: BCN Commercial |
$455.45
|
| Rate for Payer: BCN Medicare Advantage |
$186.03
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$267.88
|
| Rate for Payer: Cofinity Commercial |
$249.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.03
|
| Rate for Payer: Mclaren Medicaid |
$123.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.33
|
| Rate for Payer: Meridian Medicaid |
$129.50
|
| Rate for Payer: Nomi Health Commercial |
$223.24
|
| Rate for Payer: PACE SWMI |
$186.03
|
| Rate for Payer: PHP Medicare Advantage |
$186.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.40
|
| Rate for Payer: Priority Health HMO/PPO |
$261.88
|
| Rate for Payer: Priority Health Medicare |
$187.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.03
|
| Rate for Payer: UHC Exchange |
$186.03
|
| Rate for Payer: UHC Medicare Advantage |
$186.03
|
| Rate for Payer: UHCCP Medicaid |
$123.33
|
|
|
PR APP SKN SUBGRFT T/A/L AREA/100SQ CM 1ST 100SQ CM
|
Facility
|
OP
|
$616.00
|
|
|
Service Code
|
CPT 15273
|
| Hospital Charge Code |
15273
|
| Min. Negotiated Rate |
$146.30 |
| Max. Negotiated Rate |
$2,723.21 |
| Rate for Payer: Aetna Commercial |
$523.60
|
| Rate for Payer: Aetna Medicare |
$160.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$192.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$192.50
|
| Rate for Payer: BCBS Complete |
$2,723.21
|
| Rate for Payer: BCBS MAPPO |
$154.00
|
| Rate for Payer: BCBS Trust/PPO |
$506.41
|
| Rate for Payer: BCN Commercial |
$478.94
|
| Rate for Payer: BCN Medicare Advantage |
$154.00
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$529.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$492.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.00
|
| Rate for Payer: Healthscope Commercial |
$554.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$462.00
|
| Rate for Payer: Mclaren Medicaid |
$2,593.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.70
|
| Rate for Payer: Meridian Medicaid |
$2,723.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$523.60
|
| Rate for Payer: Nomi Health Commercial |
$505.12
|
| Rate for Payer: PACE Senior Care Partners |
$146.30
|
| Rate for Payer: PACE SWMI |
$154.00
|
| Rate for Payer: PHP Commercial |
$523.60
|
| Rate for Payer: PHP Medicare Advantage |
$154.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,593.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.40
|
| Rate for Payer: Priority Health HMO/PPO |
$535.92
|
| Rate for Payer: Priority Health Medicare |
$155.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$412.72
|
| Rate for Payer: Railroad Medicare Medicare |
$154.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$542.08
|
| Rate for Payer: UHC Core |
$514.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.00
|
| Rate for Payer: UHC Exchange |
$154.00
|
| Rate for Payer: UHC Medicare Advantage |
$154.00
|
| Rate for Payer: UHCCP Medicaid |
$2,593.36
|
| Rate for Payer: VA VA |
$154.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$462.00
|
|
|
PR APP SKN SUBGRFT T/A/L AREA/100SQ CM 1ST 100SQ CM
|
Professional
|
Both
|
$616.00
|
|
|
Service Code
|
HCPCS 15273
|
| Min. Negotiated Rate |
$123.33 |
| Max. Negotiated Rate |
$455.45 |
| Rate for Payer: Aetna Commercial |
$249.28
|
| Rate for Payer: Aetna Medicare |
$193.47
|
| Rate for Payer: BCBS Complete |
$129.50
|
| Rate for Payer: BCBS MAPPO |
$186.03
|
| Rate for Payer: BCBS Trust/PPO |
$383.40
|
| Rate for Payer: BCN Commercial |
$455.45
|
| Rate for Payer: BCN Medicare Advantage |
$186.03
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$267.88
|
| Rate for Payer: Cofinity Commercial |
$249.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.03
|
| Rate for Payer: Mclaren Medicaid |
$123.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.33
|
| Rate for Payer: Meridian Medicaid |
$129.50
|
| Rate for Payer: Nomi Health Commercial |
$223.24
|
| Rate for Payer: PACE SWMI |
$186.03
|
| Rate for Payer: PHP Medicare Advantage |
$186.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.40
|
| Rate for Payer: Priority Health HMO/PPO |
$261.88
|
| Rate for Payer: Priority Health Medicare |
$187.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.03
|
| Rate for Payer: UHC Exchange |
$186.03
|
| Rate for Payer: UHC Medicare Advantage |
$186.03
|
| Rate for Payer: UHCCP Medicaid |
$123.33
|
|
|
PR APP SKN SUBGRFT T/A/L AREA/100SQ CM 1ST 100SQ CM
|
Facility
|
IP
|
$616.00
|
|
|
Service Code
|
CPT 15273
|
| Hospital Charge Code |
15273
|
| Min. Negotiated Rate |
$400.40 |
| Max. Negotiated Rate |
$554.40 |
| Rate for Payer: Aetna Commercial |
$523.60
|
| Rate for Payer: BCBS Trust/PPO |
$502.84
|
| Rate for Payer: BCN Commercial |
$476.04
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$529.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$492.80
|
| Rate for Payer: Healthscope Commercial |
$554.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$462.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$523.60
|
| Rate for Payer: Nomi Health Commercial |
$505.12
|
| Rate for Payer: PHP Commercial |
$523.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.40
|
| Rate for Payer: Priority Health HMO/PPO |
$535.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$412.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$542.08
|
| Rate for Payer: UHC Core |
$514.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$462.00
|
|
|
PR APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1ST 25
|
Professional
|
Both
|
$278.00
|
|
|
Service Code
|
HCPCS 15271
|
| Hospital Charge Code |
15271
|
| Min. Negotiated Rate |
$53.68 |
| Max. Negotiated Rate |
$1,661.55 |
| Rate for Payer: Aetna Commercial |
$107.68
|
| Rate for Payer: Aetna Medicare |
$83.57
|
| Rate for Payer: BCBS Complete |
$56.36
|
| Rate for Payer: BCBS MAPPO |
$80.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,661.55
|
| Rate for Payer: BCN Commercial |
$224.79
|
| Rate for Payer: BCN Medicare Advantage |
$80.36
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cofinity Commercial |
$115.72
|
| Rate for Payer: Cofinity Commercial |
$107.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.36
|
| Rate for Payer: Mclaren Medicaid |
$53.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.38
|
| Rate for Payer: Meridian Medicaid |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$96.43
|
| Rate for Payer: PACE SWMI |
$80.36
|
| Rate for Payer: PHP Medicare Advantage |
$80.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.70
|
| Rate for Payer: Priority Health HMO/PPO |
$112.88
|
| Rate for Payer: Priority Health Medicare |
$81.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.36
|
| Rate for Payer: UHC Exchange |
$80.36
|
| Rate for Payer: UHC Medicare Advantage |
$80.36
|
| Rate for Payer: UHCCP Medicaid |
$53.68
|
|
|
PR APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1ST 25
|
Professional
|
Both
|
$278.00
|
|
|
Service Code
|
HCPCS 15271
|
| Min. Negotiated Rate |
$53.68 |
| Max. Negotiated Rate |
$1,661.55 |
| Rate for Payer: Aetna Commercial |
$107.68
|
| Rate for Payer: Aetna Medicare |
$83.57
|
| Rate for Payer: BCBS Complete |
$56.36
|
| Rate for Payer: BCBS MAPPO |
$80.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,661.55
|
| Rate for Payer: BCN Commercial |
$224.79
|
| Rate for Payer: BCN Medicare Advantage |
$80.36
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cofinity Commercial |
$115.72
|
| Rate for Payer: Cofinity Commercial |
$107.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.36
|
| Rate for Payer: Mclaren Medicaid |
$53.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.38
|
| Rate for Payer: Meridian Medicaid |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$96.43
|
| Rate for Payer: PACE SWMI |
$80.36
|
| Rate for Payer: PHP Medicare Advantage |
$80.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.70
|
| Rate for Payer: Priority Health HMO/PPO |
$112.88
|
| Rate for Payer: Priority Health Medicare |
$81.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.36
|
| Rate for Payer: UHC Exchange |
$80.36
|
| Rate for Payer: UHC Medicare Advantage |
$80.36
|
| Rate for Payer: UHCCP Medicaid |
$53.68
|
|
|
PR APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1ST 25
|
Facility
|
OP
|
$278.00
|
|
|
Service Code
|
CPT 15271
|
| Hospital Charge Code |
15271
|
| Min. Negotiated Rate |
$66.02 |
| Max. Negotiated Rate |
$1,360.67 |
| Rate for Payer: Aetna Commercial |
$236.30
|
| Rate for Payer: Aetna Medicare |
$72.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.88
|
| Rate for Payer: BCBS Complete |
$1,360.67
|
| Rate for Payer: BCBS MAPPO |
$69.50
|
| Rate for Payer: BCBS Trust/PPO |
$228.54
|
| Rate for Payer: BCN Commercial |
$216.14
|
| Rate for Payer: BCN Medicare Advantage |
$69.50
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cofinity Commercial |
$239.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.50
|
| Rate for Payer: Healthscope Commercial |
$250.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.50
|
| Rate for Payer: Mclaren Medicaid |
$1,295.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.98
|
| Rate for Payer: Meridian Medicaid |
$1,360.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.30
|
| Rate for Payer: Nomi Health Commercial |
$227.96
|
| Rate for Payer: PACE Senior Care Partners |
$66.02
|
| Rate for Payer: PACE SWMI |
$69.50
|
| Rate for Payer: PHP Commercial |
$236.30
|
| Rate for Payer: PHP Medicare Advantage |
$69.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,295.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.70
|
| Rate for Payer: Priority Health HMO/PPO |
$241.86
|
| Rate for Payer: Priority Health Medicare |
$70.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.26
|
| Rate for Payer: Railroad Medicare Medicare |
$69.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.64
|
| Rate for Payer: UHC Core |
$232.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.50
|
| Rate for Payer: UHC Exchange |
$69.50
|
| Rate for Payer: UHC Medicare Advantage |
$69.50
|
| Rate for Payer: UHCCP Medicaid |
$1,295.79
|
| Rate for Payer: VA VA |
$69.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.50
|
|
|
PR APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1ST 25
|
Facility
|
IP
|
$278.00
|
|
|
Service Code
|
CPT 15271
|
| Hospital Charge Code |
15271
|
| Min. Negotiated Rate |
$180.70 |
| Max. Negotiated Rate |
$250.20 |
| Rate for Payer: Aetna Commercial |
$236.30
|
| Rate for Payer: BCBS Trust/PPO |
$226.93
|
| Rate for Payer: BCN Commercial |
$214.84
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cofinity Commercial |
$239.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.40
|
| Rate for Payer: Healthscope Commercial |
$250.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.30
|
| Rate for Payer: Nomi Health Commercial |
$227.96
|
| Rate for Payer: PHP Commercial |
$236.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.70
|
| Rate for Payer: Priority Health HMO/PPO |
$241.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.64
|
| Rate for Payer: UHC Core |
$232.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.50
|
|
|
PR APP SKN SUB GRFT T/A/L AREA/100SQ CM EA ADL 25SC
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 15272
|
| Min. Negotiated Rate |
$10.65 |
| Max. Negotiated Rate |
$116.11 |
| Rate for Payer: Aetna Commercial |
$21.47
|
| Rate for Payer: Aetna Medicare |
$16.66
|
| Rate for Payer: BCBS Complete |
$11.18
|
| Rate for Payer: BCBS MAPPO |
$16.02
|
| Rate for Payer: BCBS Trust/PPO |
$116.11
|
| Rate for Payer: BCN Commercial |
$35.19
|
| Rate for Payer: BCN Medicare Advantage |
$16.02
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$23.07
|
| Rate for Payer: Cofinity Commercial |
$21.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.02
|
| Rate for Payer: Mclaren Medicaid |
$10.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.82
|
| Rate for Payer: Meridian Medicaid |
$11.18
|
| Rate for Payer: Nomi Health Commercial |
$19.22
|
| Rate for Payer: PACE SWMI |
$16.02
|
| Rate for Payer: PHP Medicare Advantage |
$16.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.85
|
| Rate for Payer: Priority Health HMO/PPO |
$22.57
|
| Rate for Payer: Priority Health Medicare |
$16.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.02
|
| Rate for Payer: UHC Exchange |
$16.02
|
| Rate for Payer: UHC Medicare Advantage |
$16.02
|
| Rate for Payer: UHCCP Medicaid |
$10.65
|
|
|
PR ARREST EPIPHYSEAL DISTAL FEMUR
|
Professional
|
Both
|
$1,698.00
|
|
|
Service Code
|
HCPCS 27475
|
| Min. Negotiated Rate |
$434.31 |
| Max. Negotiated Rate |
$1,103.70 |
| Rate for Payer: Aetna Commercial |
$860.13
|
| Rate for Payer: Aetna Medicare |
$667.57
|
| Rate for Payer: BCBS Complete |
$456.03
|
| Rate for Payer: BCBS MAPPO |
$641.89
|
| Rate for Payer: BCBS Trust/PPO |
$925.58
|
| Rate for Payer: BCN Commercial |
$978.82
|
| Rate for Payer: BCN Medicare Advantage |
$641.89
|
| Rate for Payer: Cash Price |
$1,358.40
|
| Rate for Payer: Cash Price |
$1,358.40
|
| Rate for Payer: Cofinity Commercial |
$924.32
|
| Rate for Payer: Cofinity Commercial |
$860.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.89
|
| Rate for Payer: Mclaren Medicaid |
$434.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.98
|
| Rate for Payer: Meridian Medicaid |
$456.03
|
| Rate for Payer: Nomi Health Commercial |
$770.27
|
| Rate for Payer: PACE SWMI |
$641.89
|
| Rate for Payer: PHP Medicare Advantage |
$641.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$434.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,103.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,028.91
|
| Rate for Payer: Priority Health Medicare |
$648.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,028.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$641.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$641.89
|
| Rate for Payer: UHC Exchange |
$641.89
|
| Rate for Payer: UHC Medicare Advantage |
$641.89
|
| Rate for Payer: UHCCP Medicaid |
$434.31
|
|
|
PR ARREST EPIPHYSEAL OPEN DISTAL FIBULA
|
Professional
|
Both
|
$1,522.00
|
|
|
Service Code
|
HCPCS 27732
|
| Min. Negotiated Rate |
$299.69 |
| Max. Negotiated Rate |
$989.30 |
| Rate for Payer: Aetna Commercial |
$589.47
|
| Rate for Payer: Aetna Medicare |
$457.50
|
| Rate for Payer: BCBS Complete |
$314.67
|
| Rate for Payer: BCBS MAPPO |
$439.90
|
| Rate for Payer: BCBS Trust/PPO |
$512.98
|
| Rate for Payer: BCN Commercial |
$673.40
|
| Rate for Payer: BCN Medicare Advantage |
$439.90
|
| Rate for Payer: Cash Price |
$1,217.60
|
| Rate for Payer: Cash Price |
$1,217.60
|
| Rate for Payer: Cofinity Commercial |
$633.46
|
| Rate for Payer: Cofinity Commercial |
$589.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.90
|
| Rate for Payer: Mclaren Medicaid |
$299.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$461.90
|
| Rate for Payer: Meridian Medicaid |
$314.67
|
| Rate for Payer: Nomi Health Commercial |
$527.88
|
| Rate for Payer: PACE SWMI |
$439.90
|
| Rate for Payer: PHP Medicare Advantage |
$439.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$299.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$989.30
|
| Rate for Payer: Priority Health HMO/PPO |
$709.36
|
| Rate for Payer: Priority Health Medicare |
$444.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$709.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$439.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$439.90
|
| Rate for Payer: UHC Exchange |
$439.90
|
| Rate for Payer: UHC Medicare Advantage |
$439.90
|
| Rate for Payer: UHCCP Medicaid |
$299.69
|
|
|
PR ARREST EPIPHYSEAL OPEN DISTAL TIBIA
|
Professional
|
Both
|
$1,430.00
|
|
|
Service Code
|
HCPCS 27730
|
| Min. Negotiated Rate |
$341.28 |
| Max. Negotiated Rate |
$929.50 |
| Rate for Payer: Aetna Commercial |
$763.42
|
| Rate for Payer: Aetna Medicare |
$592.51
|
| Rate for Payer: BCBS Complete |
$405.48
|
| Rate for Payer: BCBS MAPPO |
$569.72
|
| Rate for Payer: BCBS Trust/PPO |
$341.28
|
| Rate for Payer: BCN Commercial |
$869.36
|
| Rate for Payer: BCN Medicare Advantage |
$569.72
|
| Rate for Payer: Cash Price |
$1,144.00
|
| Rate for Payer: Cash Price |
$1,144.00
|
| Rate for Payer: Cofinity Commercial |
$820.40
|
| Rate for Payer: Cofinity Commercial |
$763.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$569.72
|
| Rate for Payer: Mclaren Medicaid |
$386.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$598.21
|
| Rate for Payer: Meridian Medicaid |
$405.48
|
| Rate for Payer: Nomi Health Commercial |
$683.66
|
| Rate for Payer: PACE SWMI |
$569.72
|
| Rate for Payer: PHP Medicare Advantage |
$569.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$386.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$929.50
|
| Rate for Payer: Priority Health HMO/PPO |
$914.93
|
| Rate for Payer: Priority Health Medicare |
$575.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$914.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$569.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$569.72
|
| Rate for Payer: UHC Exchange |
$569.72
|
| Rate for Payer: UHC Medicare Advantage |
$569.72
|
| Rate for Payer: UHCCP Medicaid |
$386.17
|
|
|
PR ARREST EPIPHYSEAL OPEN DISTAL TIBIA&FIBULA
|
Professional
|
Both
|
$2,957.00
|
|
|
Service Code
|
HCPCS 27734
|
| Min. Negotiated Rate |
$237.21 |
| Max. Negotiated Rate |
$1,922.05 |
| Rate for Payer: Aetna Commercial |
$853.71
|
| Rate for Payer: Aetna Medicare |
$662.58
|
| Rate for Payer: BCBS Complete |
$452.67
|
| Rate for Payer: BCBS MAPPO |
$637.10
|
| Rate for Payer: BCBS Trust/PPO |
$237.21
|
| Rate for Payer: BCN Commercial |
$971.00
|
| Rate for Payer: BCN Medicare Advantage |
$637.10
|
| Rate for Payer: Cash Price |
$2,365.60
|
| Rate for Payer: Cash Price |
$2,365.60
|
| Rate for Payer: Cofinity Commercial |
$917.42
|
| Rate for Payer: Cofinity Commercial |
$853.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.10
|
| Rate for Payer: Mclaren Medicaid |
$431.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$668.96
|
| Rate for Payer: Meridian Medicaid |
$452.67
|
| Rate for Payer: Nomi Health Commercial |
$764.52
|
| Rate for Payer: PACE SWMI |
$637.10
|
| Rate for Payer: PHP Medicare Advantage |
$637.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,922.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,020.78
|
| Rate for Payer: Priority Health Medicare |
$643.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,020.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$637.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$637.10
|
| Rate for Payer: UHC Exchange |
$637.10
|
| Rate for Payer: UHC Medicare Advantage |
$637.10
|
| Rate for Payer: UHCCP Medicaid |
$431.11
|
|
|
PR ARRST EPIPHYSL ANY METH TIBFIB&DSTL FEMUR
|
Professional
|
Both
|
$1,353.00
|
|
|
Service Code
|
HCPCS 27742
|
| Min. Negotiated Rate |
$507.79 |
| Max. Negotiated Rate |
$2,852.82 |
| Rate for Payer: Aetna Commercial |
$1,006.90
|
| Rate for Payer: Aetna Medicare |
$781.48
|
| Rate for Payer: BCBS Complete |
$533.18
|
| Rate for Payer: BCBS MAPPO |
$751.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,852.82
|
| Rate for Payer: BCN Commercial |
$1,144.48
|
| Rate for Payer: BCN Medicare Advantage |
$751.42
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cofinity Commercial |
$1,082.04
|
| Rate for Payer: Cofinity Commercial |
$1,006.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$751.42
|
| Rate for Payer: Mclaren Medicaid |
$507.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$788.99
|
| Rate for Payer: Meridian Medicaid |
$533.18
|
| Rate for Payer: Nomi Health Commercial |
$901.70
|
| Rate for Payer: PACE SWMI |
$751.42
|
| Rate for Payer: PHP Medicare Advantage |
$751.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$507.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$879.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,202.95
|
| Rate for Payer: Priority Health Medicare |
$758.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,202.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$751.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$751.42
|
| Rate for Payer: UHC Exchange |
$751.42
|
| Rate for Payer: UHC Medicare Advantage |
$751.42
|
| Rate for Payer: UHCCP Medicaid |
$507.79
|
|
|
PR ARRST EPIPHYSL CMBN DSTL FEMUR PROX TIBFIB
|
Professional
|
Both
|
$3,099.00
|
|
|
Service Code
|
HCPCS 27479
|
| Min. Negotiated Rate |
$597.25 |
| Max. Negotiated Rate |
$2,014.35 |
| Rate for Payer: Aetna Commercial |
$1,188.41
|
| Rate for Payer: Aetna Medicare |
$922.34
|
| Rate for Payer: BCBS Complete |
$627.11
|
| Rate for Payer: BCBS MAPPO |
$886.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,021.73
|
| Rate for Payer: BCN Commercial |
$1,348.75
|
| Rate for Payer: BCN Medicare Advantage |
$886.87
|
| Rate for Payer: Cash Price |
$2,479.20
|
| Rate for Payer: Cash Price |
$2,479.20
|
| Rate for Payer: Cofinity Commercial |
$1,277.09
|
| Rate for Payer: Cofinity Commercial |
$1,188.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$886.87
|
| Rate for Payer: Mclaren Medicaid |
$597.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$931.21
|
| Rate for Payer: Meridian Medicaid |
$627.11
|
| Rate for Payer: Nomi Health Commercial |
$1,064.24
|
| Rate for Payer: PACE SWMI |
$886.87
|
| Rate for Payer: PHP Medicare Advantage |
$886.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,014.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,415.15
|
| Rate for Payer: Priority Health Medicare |
$895.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,415.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$886.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$886.87
|
| Rate for Payer: UHC Exchange |
$886.87
|
| Rate for Payer: UHC Medicare Advantage |
$886.87
|
| Rate for Payer: UHCCP Medicaid |
$597.25
|
|
|
PR ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS 36600
|
| Min. Negotiated Rate |
$9.37 |
| Max. Negotiated Rate |
$789.28 |
| Rate for Payer: Aetna Commercial |
$18.84
|
| Rate for Payer: Aetna Medicare |
$14.62
|
| Rate for Payer: BCBS Complete |
$9.84
|
| Rate for Payer: BCBS MAPPO |
$14.06
|
| Rate for Payer: BCBS Trust/PPO |
$789.28
|
| Rate for Payer: BCN Commercial |
$40.07
|
| Rate for Payer: BCN Medicare Advantage |
$14.06
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cofinity Commercial |
$20.25
|
| Rate for Payer: Cofinity Commercial |
$18.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.06
|
| Rate for Payer: Mclaren Medicaid |
$9.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.76
|
| Rate for Payer: Meridian Medicaid |
$9.84
|
| Rate for Payer: Nomi Health Commercial |
$16.87
|
| Rate for Payer: PACE SWMI |
$14.06
|
| Rate for Payer: PHP Medicare Advantage |
$14.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.00
|
| Rate for Payer: Priority Health HMO/PPO |
$23.41
|
| Rate for Payer: Priority Health Medicare |
$14.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.06
|
| Rate for Payer: UHC Exchange |
$14.06
|
| Rate for Payer: UHC Medicare Advantage |
$14.06
|
| Rate for Payer: UHCCP Medicaid |
$9.37
|
|
|
PR ARTERIOVENOUS ANASTOMOSIS OPEN DIRECT
|
Professional
|
Both
|
$2,238.00
|
|
|
Service Code
|
HCPCS 36821
|
| Min. Negotiated Rate |
$413.43 |
| Max. Negotiated Rate |
$1,454.70 |
| Rate for Payer: Aetna Commercial |
$845.27
|
| Rate for Payer: Aetna Medicare |
$656.03
|
| Rate for Payer: BCBS Complete |
$434.10
|
| Rate for Payer: BCBS MAPPO |
$630.80
|
| Rate for Payer: BCBS Trust/PPO |
$869.05
|
| Rate for Payer: BCN Commercial |
$946.08
|
| Rate for Payer: BCN Medicare Advantage |
$630.80
|
| Rate for Payer: Cash Price |
$1,790.40
|
| Rate for Payer: Cash Price |
$1,790.40
|
| Rate for Payer: Cofinity Commercial |
$908.35
|
| Rate for Payer: Cofinity Commercial |
$845.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$630.80
|
| Rate for Payer: Mclaren Medicaid |
$413.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$662.34
|
| Rate for Payer: Meridian Medicaid |
$434.10
|
| Rate for Payer: Nomi Health Commercial |
$756.96
|
| Rate for Payer: PACE SWMI |
$630.80
|
| Rate for Payer: PHP Medicare Advantage |
$630.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,454.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,031.20
|
| Rate for Payer: Priority Health Medicare |
$637.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,031.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$630.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$630.80
|
| Rate for Payer: UHC Exchange |
$630.80
|
| Rate for Payer: UHC Medicare Advantage |
$630.80
|
| Rate for Payer: UHCCP Medicaid |
$413.43
|
|
