|
PR DCMPRN FASCT F/ARM&/WRST FLXR/XTNSR W/DBRDMT
|
Professional
|
Both
|
$1,969.00
|
|
|
Service Code
|
HCPCS 25023
|
| Min. Negotiated Rate |
$841.35 |
| Max. Negotiated Rate |
$2,013.05 |
| Rate for Payer: Aetna Commercial |
$1,644.19
|
| Rate for Payer: Aetna Medicare |
$1,276.09
|
| Rate for Payer: BCBS Complete |
$883.42
|
| Rate for Payer: BCBS MAPPO |
$1,227.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,085.13
|
| Rate for Payer: BCN Commercial |
$1,928.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,227.01
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cofinity Commercial |
$1,766.89
|
| Rate for Payer: Cofinity Commercial |
$1,644.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,227.01
|
| Rate for Payer: Mclaren Medicaid |
$841.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,288.36
|
| Rate for Payer: Meridian Medicaid |
$883.42
|
| Rate for Payer: Nomi Health Commercial |
$1,472.41
|
| Rate for Payer: PACE SWMI |
$1,227.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,227.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$841.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,279.85
|
| Rate for Payer: Priority Health HMO/PPO |
$2,013.05
|
| Rate for Payer: Priority Health Medicare |
$1,239.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,013.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,227.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,227.01
|
| Rate for Payer: UHC Exchange |
$1,227.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,227.01
|
| Rate for Payer: UHCCP Medicaid |
$841.35
|
|
|
PR DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR W/O DB
|
Professional
|
Both
|
$1,823.00
|
|
|
Service Code
|
HCPCS 25024
|
| Min. Negotiated Rate |
$218.72 |
| Max. Negotiated Rate |
$1,205.49 |
| Rate for Payer: Aetna Commercial |
$1,006.33
|
| Rate for Payer: Aetna Medicare |
$781.03
|
| Rate for Payer: BCBS Complete |
$532.51
|
| Rate for Payer: BCBS MAPPO |
$750.99
|
| Rate for Payer: BCBS Trust/PPO |
$218.72
|
| Rate for Payer: BCN Commercial |
$1,139.60
|
| Rate for Payer: BCN Medicare Advantage |
$750.99
|
| Rate for Payer: Cash Price |
$1,458.40
|
| Rate for Payer: Cash Price |
$1,458.40
|
| Rate for Payer: Cofinity Commercial |
$1,081.43
|
| Rate for Payer: Cofinity Commercial |
$1,006.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$750.99
|
| Rate for Payer: Mclaren Medicaid |
$507.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$788.54
|
| Rate for Payer: Meridian Medicaid |
$532.51
|
| Rate for Payer: Nomi Health Commercial |
$901.19
|
| Rate for Payer: PACE SWMI |
$750.99
|
| Rate for Payer: PHP Medicare Advantage |
$750.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$507.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,184.95
|
| Rate for Payer: Priority Health HMO/PPO |
$1,205.49
|
| Rate for Payer: Priority Health Medicare |
$758.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,205.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$750.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$750.99
|
| Rate for Payer: UHC Exchange |
$750.99
|
| Rate for Payer: UHC Medicare Advantage |
$750.99
|
| Rate for Payer: UHCCP Medicaid |
$507.15
|
|
|
PR DCMPRN FASCT F/ARM&WRST FLXR/XTNSR W/O DBRDMT
|
Professional
|
Both
|
$1,418.00
|
|
|
Service Code
|
HCPCS 25020
|
| Min. Negotiated Rate |
$160.07 |
| Max. Negotiated Rate |
$1,140.35 |
| Rate for Payer: Aetna Commercial |
$913.83
|
| Rate for Payer: Aetna Medicare |
$709.24
|
| Rate for Payer: BCBS Complete |
$496.95
|
| Rate for Payer: BCBS MAPPO |
$681.96
|
| Rate for Payer: BCBS Trust/PPO |
$160.07
|
| Rate for Payer: BCN Commercial |
$1,100.99
|
| Rate for Payer: BCN Medicare Advantage |
$681.96
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cofinity Commercial |
$982.02
|
| Rate for Payer: Cofinity Commercial |
$913.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$681.96
|
| Rate for Payer: Mclaren Medicaid |
$473.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$716.06
|
| Rate for Payer: Meridian Medicaid |
$496.95
|
| Rate for Payer: Nomi Health Commercial |
$818.35
|
| Rate for Payer: PACE SWMI |
$681.96
|
| Rate for Payer: PHP Medicare Advantage |
$681.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$473.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$921.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,140.35
|
| Rate for Payer: Priority Health Medicare |
$688.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,140.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$681.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$681.96
|
| Rate for Payer: UHC Exchange |
$681.96
|
| Rate for Payer: UHC Medicare Advantage |
$681.96
|
| Rate for Payer: UHCCP Medicaid |
$473.29
|
|
|
PR DCMPRN FASCT LEG ANT&/LAT COMPARTMENTS ONLY
|
Professional
|
Both
|
$1,241.00
|
|
|
Service Code
|
HCPCS 27600
|
| Min. Negotiated Rate |
$259.65 |
| Max. Negotiated Rate |
$863.24 |
| Rate for Payer: Aetna Commercial |
$518.69
|
| Rate for Payer: Aetna Medicare |
$402.56
|
| Rate for Payer: BCBS Complete |
$272.63
|
| Rate for Payer: BCBS MAPPO |
$387.08
|
| Rate for Payer: BCBS Trust/PPO |
$863.24
|
| Rate for Payer: BCN Commercial |
$588.36
|
| Rate for Payer: BCN Medicare Advantage |
$387.08
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Cofinity Commercial |
$557.40
|
| Rate for Payer: Cofinity Commercial |
$518.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.08
|
| Rate for Payer: Mclaren Medicaid |
$259.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.43
|
| Rate for Payer: Meridian Medicaid |
$272.63
|
| Rate for Payer: Nomi Health Commercial |
$464.50
|
| Rate for Payer: PACE SWMI |
$387.08
|
| Rate for Payer: PHP Medicare Advantage |
$387.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$806.65
|
| Rate for Payer: Priority Health HMO/PPO |
$613.69
|
| Rate for Payer: Priority Health Medicare |
$390.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$613.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$387.08
|
| Rate for Payer: UHC Exchange |
$387.08
|
| Rate for Payer: UHC Medicare Advantage |
$387.08
|
| Rate for Payer: UHCCP Medicaid |
$259.65
|
|
|
PR DCMPRN FASCT LEG ANT&/LAT&PST CMPRT
|
Professional
|
Both
|
$1,769.00
|
|
|
Service Code
|
HCPCS 27602
|
| Min. Negotiated Rate |
$305.23 |
| Max. Negotiated Rate |
$1,903.46 |
| Rate for Payer: Aetna Commercial |
$617.36
|
| Rate for Payer: Aetna Medicare |
$479.15
|
| Rate for Payer: BCBS Complete |
$320.49
|
| Rate for Payer: BCBS MAPPO |
$460.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,903.46
|
| Rate for Payer: BCN Commercial |
$695.39
|
| Rate for Payer: BCN Medicare Advantage |
$460.72
|
| Rate for Payer: Cash Price |
$1,415.20
|
| Rate for Payer: Cash Price |
$1,415.20
|
| Rate for Payer: Cofinity Commercial |
$663.44
|
| Rate for Payer: Cofinity Commercial |
$617.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$460.72
|
| Rate for Payer: Mclaren Medicaid |
$305.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$483.76
|
| Rate for Payer: Meridian Medicaid |
$320.49
|
| Rate for Payer: Nomi Health Commercial |
$552.86
|
| Rate for Payer: PACE SWMI |
$460.72
|
| Rate for Payer: PHP Medicare Advantage |
$460.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,149.85
|
| Rate for Payer: Priority Health HMO/PPO |
$726.66
|
| Rate for Payer: Priority Health Medicare |
$465.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$726.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$460.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$460.72
|
| Rate for Payer: UHC Exchange |
$460.72
|
| Rate for Payer: UHC Medicare Advantage |
$460.72
|
| Rate for Payer: UHCCP Medicaid |
$305.23
|
|
|
PR DCMPRN FASCT LEG ANT&/LAT&PST W/DBRDMT MUS
|
Professional
|
Both
|
$2,241.00
|
|
|
Service Code
|
HCPCS 27894
|
| Min. Negotiated Rate |
$530.16 |
| Max. Negotiated Rate |
$2,785.73 |
| Rate for Payer: Aetna Commercial |
$1,062.82
|
| Rate for Payer: Aetna Medicare |
$824.88
|
| Rate for Payer: BCBS Complete |
$556.67
|
| Rate for Payer: BCBS MAPPO |
$793.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,785.73
|
| Rate for Payer: BCN Commercial |
$1,189.44
|
| Rate for Payer: BCN Medicare Advantage |
$793.15
|
| Rate for Payer: Cash Price |
$1,792.80
|
| Rate for Payer: Cash Price |
$1,792.80
|
| Rate for Payer: Cofinity Commercial |
$1,142.14
|
| Rate for Payer: Cofinity Commercial |
$1,062.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$793.15
|
| Rate for Payer: Mclaren Medicaid |
$530.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$832.81
|
| Rate for Payer: Meridian Medicaid |
$556.67
|
| Rate for Payer: Nomi Health Commercial |
$951.78
|
| Rate for Payer: PACE SWMI |
$793.15
|
| Rate for Payer: PHP Medicare Advantage |
$793.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$530.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,456.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,247.22
|
| Rate for Payer: Priority Health Medicare |
$801.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,247.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$793.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$793.15
|
| Rate for Payer: UHC Exchange |
$793.15
|
| Rate for Payer: UHC Medicare Advantage |
$793.15
|
| Rate for Payer: UHCCP Medicaid |
$530.16
|
|
|
PR DCMPRN FASCT LEG ANT&/LAT W/DBRDMT MUSC&/NERVE
|
Professional
|
Both
|
$1,645.00
|
|
|
Service Code
|
HCPCS 27892
|
| Min. Negotiated Rate |
$351.66 |
| Max. Negotiated Rate |
$2,576.52 |
| Rate for Payer: Aetna Commercial |
$700.61
|
| Rate for Payer: Aetna Medicare |
$543.75
|
| Rate for Payer: BCBS Complete |
$369.24
|
| Rate for Payer: BCBS MAPPO |
$522.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,576.52
|
| Rate for Payer: BCN Commercial |
$784.82
|
| Rate for Payer: BCN Medicare Advantage |
$522.84
|
| Rate for Payer: Cash Price |
$1,316.00
|
| Rate for Payer: Cash Price |
$1,316.00
|
| Rate for Payer: Cofinity Commercial |
$752.89
|
| Rate for Payer: Cofinity Commercial |
$700.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$522.84
|
| Rate for Payer: Mclaren Medicaid |
$351.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$548.98
|
| Rate for Payer: Meridian Medicaid |
$369.24
|
| Rate for Payer: Nomi Health Commercial |
$627.41
|
| Rate for Payer: PACE SWMI |
$522.84
|
| Rate for Payer: PHP Medicare Advantage |
$522.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,069.25
|
| Rate for Payer: Priority Health HMO/PPO |
$824.86
|
| Rate for Payer: Priority Health Medicare |
$528.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$824.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$522.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$522.84
|
| Rate for Payer: UHC Exchange |
$522.84
|
| Rate for Payer: UHC Medicare Advantage |
$522.84
|
| Rate for Payer: UHCCP Medicaid |
$351.66
|
|
|
PR DCMPRN FASCT LEG POST COMPARTMENT ONLY
|
Professional
|
Both
|
$1,388.00
|
|
|
Service Code
|
HCPCS 27601
|
| Min. Negotiated Rate |
$284.99 |
| Max. Negotiated Rate |
$2,076.22 |
| Rate for Payer: Aetna Commercial |
$564.73
|
| Rate for Payer: Aetna Medicare |
$438.30
|
| Rate for Payer: BCBS Complete |
$299.24
|
| Rate for Payer: BCBS MAPPO |
$421.44
|
| Rate for Payer: BCBS Trust/PPO |
$2,076.22
|
| Rate for Payer: BCN Commercial |
$648.47
|
| Rate for Payer: BCN Medicare Advantage |
$421.44
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cofinity Commercial |
$606.87
|
| Rate for Payer: Cofinity Commercial |
$564.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.44
|
| Rate for Payer: Mclaren Medicaid |
$284.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$442.51
|
| Rate for Payer: Meridian Medicaid |
$299.24
|
| Rate for Payer: Nomi Health Commercial |
$505.73
|
| Rate for Payer: PACE SWMI |
$421.44
|
| Rate for Payer: PHP Medicare Advantage |
$421.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$902.20
|
| Rate for Payer: Priority Health HMO/PPO |
$682.39
|
| Rate for Payer: Priority Health Medicare |
$425.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$682.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$421.44
|
| Rate for Payer: UHC Exchange |
$421.44
|
| Rate for Payer: UHC Medicare Advantage |
$421.44
|
| Rate for Payer: UHCCP Medicaid |
$284.99
|
|
|
PR DCMPRN FASCT THIGH&/KNEE MLT DBRDMT NV MUSC&NRVE
|
Professional
|
Both
|
$1,156.00
|
|
|
Service Code
|
HCPCS 27499
|
| Min. Negotiated Rate |
$459.44 |
| Max. Negotiated Rate |
$2,735.54 |
| Rate for Payer: Aetna Commercial |
$909.91
|
| Rate for Payer: Aetna Medicare |
$706.20
|
| Rate for Payer: BCBS Complete |
$482.41
|
| Rate for Payer: BCBS MAPPO |
$679.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,735.54
|
| Rate for Payer: BCN Commercial |
$1,036.00
|
| Rate for Payer: BCN Medicare Advantage |
$679.04
|
| Rate for Payer: Cash Price |
$924.80
|
| Rate for Payer: Cash Price |
$924.80
|
| Rate for Payer: Cofinity Commercial |
$977.82
|
| Rate for Payer: Cofinity Commercial |
$909.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$679.04
|
| Rate for Payer: Mclaren Medicaid |
$459.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$712.99
|
| Rate for Payer: Meridian Medicaid |
$482.41
|
| Rate for Payer: Nomi Health Commercial |
$814.85
|
| Rate for Payer: PACE SWMI |
$679.04
|
| Rate for Payer: PHP Medicare Advantage |
$679.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$459.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$751.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,088.45
|
| Rate for Payer: Priority Health Medicare |
$685.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,088.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$679.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$679.04
|
| Rate for Payer: UHC Exchange |
$679.04
|
| Rate for Payer: UHC Medicare Advantage |
$679.04
|
| Rate for Payer: UHCCP Medicaid |
$459.44
|
|
|
PR DCMPRN PX PERQ NUCLEUS PULPOSUS 1/MLT LVL LUMBAR
|
Professional
|
Both
|
$3,001.00
|
|
|
Service Code
|
HCPCS 62287
|
| Min. Negotiated Rate |
$386.38 |
| Max. Negotiated Rate |
$1,950.65 |
| Rate for Payer: Aetna Commercial |
$761.80
|
| Rate for Payer: Aetna Medicare |
$591.25
|
| Rate for Payer: BCBS Complete |
$405.70
|
| Rate for Payer: BCBS MAPPO |
$568.51
|
| Rate for Payer: BCBS Trust/PPO |
$573.21
|
| Rate for Payer: BCN Commercial |
$820.49
|
| Rate for Payer: BCN Medicare Advantage |
$568.51
|
| Rate for Payer: Cash Price |
$2,400.80
|
| Rate for Payer: Cash Price |
$2,400.80
|
| Rate for Payer: Cofinity Commercial |
$818.65
|
| Rate for Payer: Cofinity Commercial |
$761.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$568.51
|
| Rate for Payer: Mclaren Medicaid |
$386.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$596.94
|
| Rate for Payer: Meridian Medicaid |
$405.70
|
| Rate for Payer: Nomi Health Commercial |
$682.21
|
| Rate for Payer: PACE SWMI |
$568.51
|
| Rate for Payer: PHP Medicare Advantage |
$568.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$386.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,950.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,028.80
|
| Rate for Payer: Priority Health Medicare |
$574.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,028.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$568.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$568.51
|
| Rate for Payer: UHC Exchange |
$568.51
|
| Rate for Payer: UHC Medicare Advantage |
$568.51
|
| Rate for Payer: UHCCP Medicaid |
$386.38
|
|
|
PR DEBRIDEMENT BONE 1ST 20 SQ CM/<
|
Professional
|
Both
|
$842.00
|
|
|
Service Code
|
HCPCS 11044
|
| Hospital Charge Code |
11044
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$547.30 |
| Rate for Payer: Aetna Commercial |
$288.82
|
| Rate for Payer: Aetna Medicare |
$224.16
|
| Rate for Payer: BCBS Complete |
$150.52
|
| Rate for Payer: BCBS MAPPO |
$215.54
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$452.52
|
| Rate for Payer: BCN Medicare Advantage |
$215.54
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cofinity Commercial |
$310.38
|
| Rate for Payer: Cofinity Commercial |
$288.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.54
|
| Rate for Payer: Mclaren Medicaid |
$143.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.32
|
| Rate for Payer: Meridian Medicaid |
$150.52
|
| Rate for Payer: Nomi Health Commercial |
$258.65
|
| Rate for Payer: PACE SWMI |
$215.54
|
| Rate for Payer: PHP Medicare Advantage |
$215.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$547.30
|
| Rate for Payer: Priority Health HMO/PPO |
$303.42
|
| Rate for Payer: Priority Health Medicare |
$217.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$303.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$215.54
|
| Rate for Payer: UHC Exchange |
$215.54
|
| Rate for Payer: UHC Medicare Advantage |
$215.54
|
| Rate for Payer: UHCCP Medicaid |
$143.35
|
|
|
PR DEBRIDEMENT BONE 1ST 20 SQ CM/<
|
Facility
|
IP
|
$842.00
|
|
|
Service Code
|
CPT 11044
|
| Hospital Charge Code |
11044
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$547.30 |
| Max. Negotiated Rate |
$757.80 |
| Rate for Payer: Aetna Commercial |
$715.70
|
| Rate for Payer: BCBS Trust/PPO |
$687.32
|
| Rate for Payer: BCN Commercial |
$650.70
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cofinity Commercial |
$724.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.60
|
| Rate for Payer: Healthscope Commercial |
$757.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$631.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.70
|
| Rate for Payer: Nomi Health Commercial |
$690.44
|
| Rate for Payer: PHP Commercial |
$715.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$547.30
|
| Rate for Payer: Priority Health HMO/PPO |
$732.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$564.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.96
|
| Rate for Payer: UHC Core |
$703.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$631.50
|
|
|
PR DEBRIDEMENT BONE 1ST 20 SQ CM/<
|
Professional
|
Both
|
$842.00
|
|
|
Service Code
|
HCPCS 11044
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$547.30 |
| Rate for Payer: Aetna Commercial |
$288.82
|
| Rate for Payer: Aetna Medicare |
$224.16
|
| Rate for Payer: BCBS Complete |
$150.52
|
| Rate for Payer: BCBS MAPPO |
$215.54
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$452.52
|
| Rate for Payer: BCN Medicare Advantage |
$215.54
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cofinity Commercial |
$310.38
|
| Rate for Payer: Cofinity Commercial |
$288.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.54
|
| Rate for Payer: Mclaren Medicaid |
$143.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.32
|
| Rate for Payer: Meridian Medicaid |
$150.52
|
| Rate for Payer: Nomi Health Commercial |
$258.65
|
| Rate for Payer: PACE SWMI |
$215.54
|
| Rate for Payer: PHP Medicare Advantage |
$215.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$547.30
|
| Rate for Payer: Priority Health HMO/PPO |
$303.42
|
| Rate for Payer: Priority Health Medicare |
$217.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$303.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$215.54
|
| Rate for Payer: UHC Exchange |
$215.54
|
| Rate for Payer: UHC Medicare Advantage |
$215.54
|
| Rate for Payer: UHCCP Medicaid |
$143.35
|
|
|
PR DEBRIDEMENT BONE 1ST 20 SQ CM/<
|
Facility
|
OP
|
$842.00
|
|
|
Service Code
|
CPT 11044
|
| Hospital Charge Code |
11044
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$199.98 |
| Max. Negotiated Rate |
$1,205.21 |
| Rate for Payer: Aetna Commercial |
$715.70
|
| Rate for Payer: Aetna Medicare |
$218.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$263.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$263.12
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$210.50
|
| Rate for Payer: BCBS Trust/PPO |
$692.21
|
| Rate for Payer: BCN Commercial |
$654.66
|
| Rate for Payer: BCN Medicare Advantage |
$210.50
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cofinity Commercial |
$724.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.50
|
| Rate for Payer: Healthscope Commercial |
$757.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$631.50
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$221.02
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$242.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.70
|
| Rate for Payer: Nomi Health Commercial |
$690.44
|
| Rate for Payer: PACE Senior Care Partners |
$199.98
|
| Rate for Payer: PACE SWMI |
$210.50
|
| Rate for Payer: PHP Commercial |
$715.70
|
| Rate for Payer: PHP Medicare Advantage |
$210.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$547.30
|
| Rate for Payer: Priority Health HMO/PPO |
$732.54
|
| Rate for Payer: Priority Health Medicare |
$212.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$564.14
|
| Rate for Payer: Railroad Medicare Medicare |
$210.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.96
|
| Rate for Payer: UHC Core |
$703.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$210.50
|
| Rate for Payer: UHC Exchange |
$210.50
|
| Rate for Payer: UHC Medicare Advantage |
$210.50
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$210.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$631.50
|
|
|
PR DEBRIDEMENT BONE EACH ADDITIONAL 20 SQ CM
|
Professional
|
Both
|
$367.00
|
|
|
Service Code
|
HCPCS 11047
|
| Min. Negotiated Rate |
$61.56 |
| Max. Negotiated Rate |
$242.22 |
| Rate for Payer: Aetna Commercial |
$125.04
|
| Rate for Payer: Aetna Medicare |
$97.04
|
| Rate for Payer: BCBS Complete |
$64.64
|
| Rate for Payer: BCBS MAPPO |
$93.31
|
| Rate for Payer: BCBS Trust/PPO |
$242.22
|
| Rate for Payer: BCN Commercial |
$175.93
|
| Rate for Payer: BCN Medicare Advantage |
$93.31
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cofinity Commercial |
$134.37
|
| Rate for Payer: Cofinity Commercial |
$125.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.31
|
| Rate for Payer: Mclaren Medicaid |
$61.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.98
|
| Rate for Payer: Meridian Medicaid |
$64.64
|
| Rate for Payer: Nomi Health Commercial |
$111.97
|
| Rate for Payer: PACE SWMI |
$93.31
|
| Rate for Payer: PHP Medicare Advantage |
$93.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.55
|
| Rate for Payer: Priority Health HMO/PPO |
$130.04
|
| Rate for Payer: Priority Health Medicare |
$94.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.31
|
| Rate for Payer: UHC Exchange |
$93.31
|
| Rate for Payer: UHC Medicare Advantage |
$93.31
|
| Rate for Payer: UHCCP Medicaid |
$61.56
|
|
|
PR DEBRIDEMENT MASTOIDECTOMY CAVITY CMPLX
|
Professional
|
Both
|
$370.00
|
|
|
Service Code
|
HCPCS 69222
|
| Min. Negotiated Rate |
$87.97 |
| Max. Negotiated Rate |
$1,975.31 |
| Rate for Payer: Aetna Commercial |
$171.06
|
| Rate for Payer: Aetna Medicare |
$132.77
|
| Rate for Payer: BCBS Complete |
$92.37
|
| Rate for Payer: BCBS MAPPO |
$127.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,975.31
|
| Rate for Payer: BCN Commercial |
$319.60
|
| Rate for Payer: BCN Medicare Advantage |
$127.66
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cofinity Commercial |
$183.83
|
| Rate for Payer: Cofinity Commercial |
$171.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.66
|
| Rate for Payer: Mclaren Medicaid |
$87.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.04
|
| Rate for Payer: Meridian Medicaid |
$92.37
|
| Rate for Payer: Nomi Health Commercial |
$153.19
|
| Rate for Payer: PACE SWMI |
$127.66
|
| Rate for Payer: PHP Medicare Advantage |
$127.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.50
|
| Rate for Payer: Priority Health HMO/PPO |
$201.36
|
| Rate for Payer: Priority Health Medicare |
$128.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.66
|
| Rate for Payer: UHC Exchange |
$127.66
|
| Rate for Payer: UHC Medicare Advantage |
$127.66
|
| Rate for Payer: UHCCP Medicaid |
$87.97
|
|
|
PR DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
HCPCS 69220
|
| Min. Negotiated Rate |
$33.23 |
| Max. Negotiated Rate |
$1,803.09 |
| Rate for Payer: Aetna Commercial |
$66.28
|
| Rate for Payer: Aetna Medicare |
$51.44
|
| Rate for Payer: BCBS Complete |
$34.89
|
| Rate for Payer: BCBS MAPPO |
$49.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,803.09
|
| Rate for Payer: BCN Commercial |
$114.84
|
| Rate for Payer: BCN Medicare Advantage |
$49.46
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$71.22
|
| Rate for Payer: Cofinity Commercial |
$66.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.46
|
| Rate for Payer: Mclaren Medicaid |
$33.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.93
|
| Rate for Payer: Meridian Medicaid |
$34.89
|
| Rate for Payer: Nomi Health Commercial |
$59.35
|
| Rate for Payer: PACE SWMI |
$49.46
|
| Rate for Payer: PHP Medicare Advantage |
$49.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.60
|
| Rate for Payer: Priority Health HMO/PPO |
$74.90
|
| Rate for Payer: Priority Health Medicare |
$49.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.46
|
| Rate for Payer: UHC Exchange |
$49.46
|
| Rate for Payer: UHC Medicare Advantage |
$49.46
|
| Rate for Payer: UHCCP Medicaid |
$33.23
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA 1ST 20 SQ CM/<
|
Facility
|
IP
|
$479.00
|
|
|
Service Code
|
CPT 11043
|
| Hospital Charge Code |
11043
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$311.35 |
| Max. Negotiated Rate |
$431.10 |
| Rate for Payer: Aetna Commercial |
$407.15
|
| Rate for Payer: BCBS Trust/PPO |
$391.01
|
| Rate for Payer: BCN Commercial |
$370.17
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Cofinity Commercial |
$411.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.20
|
| Rate for Payer: Healthscope Commercial |
$431.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$359.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$407.15
|
| Rate for Payer: Nomi Health Commercial |
$392.78
|
| Rate for Payer: PHP Commercial |
$407.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.35
|
| Rate for Payer: Priority Health HMO/PPO |
$416.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$320.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.52
|
| Rate for Payer: UHC Core |
$399.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$359.25
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA 1ST 20 SQ CM/<
|
Professional
|
Both
|
$479.00
|
|
|
Service Code
|
HCPCS 11043
|
| Min. Negotiated Rate |
$98.41 |
| Max. Negotiated Rate |
$1,522.50 |
| Rate for Payer: Aetna Commercial |
$197.61
|
| Rate for Payer: Aetna Medicare |
$153.37
|
| Rate for Payer: BCBS Complete |
$103.33
|
| Rate for Payer: BCBS MAPPO |
$147.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,522.50
|
| Rate for Payer: BCN Commercial |
$338.65
|
| Rate for Payer: BCN Medicare Advantage |
$147.47
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Cofinity Commercial |
$212.36
|
| Rate for Payer: Cofinity Commercial |
$197.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.47
|
| Rate for Payer: Mclaren Medicaid |
$98.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.84
|
| Rate for Payer: Meridian Medicaid |
$103.33
|
| Rate for Payer: Nomi Health Commercial |
$176.96
|
| Rate for Payer: PACE SWMI |
$147.47
|
| Rate for Payer: PHP Medicare Advantage |
$147.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.35
|
| Rate for Payer: Priority Health HMO/PPO |
$206.80
|
| Rate for Payer: Priority Health Medicare |
$148.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$206.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.47
|
| Rate for Payer: UHC Exchange |
$147.47
|
| Rate for Payer: UHC Medicare Advantage |
$147.47
|
| Rate for Payer: UHCCP Medicaid |
$98.41
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA 1ST 20 SQ CM/<
|
Professional
|
Both
|
$479.00
|
|
|
Service Code
|
HCPCS 11043
|
| Hospital Charge Code |
11043
|
| Min. Negotiated Rate |
$98.41 |
| Max. Negotiated Rate |
$1,522.50 |
| Rate for Payer: Aetna Commercial |
$197.61
|
| Rate for Payer: Aetna Medicare |
$153.37
|
| Rate for Payer: BCBS Complete |
$103.33
|
| Rate for Payer: BCBS MAPPO |
$147.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,522.50
|
| Rate for Payer: BCN Commercial |
$338.65
|
| Rate for Payer: BCN Medicare Advantage |
$147.47
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Cofinity Commercial |
$212.36
|
| Rate for Payer: Cofinity Commercial |
$197.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.47
|
| Rate for Payer: Mclaren Medicaid |
$98.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.84
|
| Rate for Payer: Meridian Medicaid |
$103.33
|
| Rate for Payer: Nomi Health Commercial |
$176.96
|
| Rate for Payer: PACE SWMI |
$147.47
|
| Rate for Payer: PHP Medicare Advantage |
$147.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.35
|
| Rate for Payer: Priority Health HMO/PPO |
$206.80
|
| Rate for Payer: Priority Health Medicare |
$148.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$206.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.47
|
| Rate for Payer: UHC Exchange |
$147.47
|
| Rate for Payer: UHC Medicare Advantage |
$147.47
|
| Rate for Payer: UHCCP Medicaid |
$98.41
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA 1ST 20 SQ CM/<
|
Facility
|
OP
|
$479.00
|
|
|
Service Code
|
CPT 11043
|
| Hospital Charge Code |
11043
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$113.76 |
| Max. Negotiated Rate |
$455.33 |
| Rate for Payer: Aetna Commercial |
$407.15
|
| Rate for Payer: Aetna Medicare |
$124.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$149.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$149.69
|
| Rate for Payer: BCBS Complete |
$455.33
|
| Rate for Payer: BCBS MAPPO |
$119.75
|
| Rate for Payer: BCBS Trust/PPO |
$393.79
|
| Rate for Payer: BCN Commercial |
$372.42
|
| Rate for Payer: BCN Medicare Advantage |
$119.75
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Cofinity Commercial |
$411.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.75
|
| Rate for Payer: Healthscope Commercial |
$431.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$359.25
|
| Rate for Payer: Mclaren Medicaid |
$433.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.74
|
| Rate for Payer: Meridian Medicaid |
$455.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$137.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$407.15
|
| Rate for Payer: Nomi Health Commercial |
$392.78
|
| Rate for Payer: PACE Senior Care Partners |
$113.76
|
| Rate for Payer: PACE SWMI |
$119.75
|
| Rate for Payer: PHP Commercial |
$407.15
|
| Rate for Payer: PHP Medicare Advantage |
$119.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$433.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.35
|
| Rate for Payer: Priority Health HMO/PPO |
$416.73
|
| Rate for Payer: Priority Health Medicare |
$120.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$320.93
|
| Rate for Payer: Railroad Medicare Medicare |
$119.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.52
|
| Rate for Payer: UHC Core |
$399.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.75
|
| Rate for Payer: UHC Exchange |
$119.75
|
| Rate for Payer: UHC Medicare Advantage |
$119.75
|
| Rate for Payer: UHCCP Medicaid |
$433.62
|
| Rate for Payer: VA VA |
$119.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$359.25
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM
|
Professional
|
Both
|
$101.00
|
|
|
Service Code
|
HCPCS 11046
|
| Min. Negotiated Rate |
$34.51 |
| Max. Negotiated Rate |
$2,430.00 |
| Rate for Payer: Aetna Commercial |
$69.99
|
| Rate for Payer: Aetna Medicare |
$54.32
|
| Rate for Payer: BCBS Complete |
$36.24
|
| Rate for Payer: BCBS MAPPO |
$52.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,430.00
|
| Rate for Payer: BCN Commercial |
$106.04
|
| Rate for Payer: BCN Medicare Advantage |
$52.23
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cofinity Commercial |
$75.21
|
| Rate for Payer: Cofinity Commercial |
$69.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.23
|
| Rate for Payer: Mclaren Medicaid |
$34.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.84
|
| Rate for Payer: Meridian Medicaid |
$36.24
|
| Rate for Payer: Nomi Health Commercial |
$62.68
|
| Rate for Payer: PACE SWMI |
$52.23
|
| Rate for Payer: PHP Medicare Advantage |
$52.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.65
|
| Rate for Payer: Priority Health HMO/PPO |
$73.60
|
| Rate for Payer: Priority Health Medicare |
$52.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.23
|
| Rate for Payer: UHC Exchange |
$52.23
|
| Rate for Payer: UHC Medicare Advantage |
$52.23
|
| Rate for Payer: UHCCP Medicaid |
$34.51
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM
|
Facility
|
IP
|
$101.00
|
|
|
Service Code
|
CPT 11046
|
| Hospital Charge Code |
11046
|
| Min. Negotiated Rate |
$65.65 |
| Max. Negotiated Rate |
$90.90 |
| Rate for Payer: Aetna Commercial |
$85.85
|
| Rate for Payer: BCBS Trust/PPO |
$82.45
|
| Rate for Payer: BCN Commercial |
$78.05
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cofinity Commercial |
$86.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.80
|
| Rate for Payer: Healthscope Commercial |
$90.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.85
|
| Rate for Payer: Nomi Health Commercial |
$82.82
|
| Rate for Payer: PHP Commercial |
$85.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.65
|
| Rate for Payer: Priority Health HMO/PPO |
$87.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.88
|
| Rate for Payer: UHC Core |
$84.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.75
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM
|
Professional
|
Both
|
$101.00
|
|
|
Service Code
|
HCPCS 11046
|
| Hospital Charge Code |
11046
|
| Min. Negotiated Rate |
$34.51 |
| Max. Negotiated Rate |
$2,430.00 |
| Rate for Payer: Aetna Commercial |
$69.99
|
| Rate for Payer: Aetna Medicare |
$54.32
|
| Rate for Payer: BCBS Complete |
$36.24
|
| Rate for Payer: BCBS MAPPO |
$52.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,430.00
|
| Rate for Payer: BCN Commercial |
$106.04
|
| Rate for Payer: BCN Medicare Advantage |
$52.23
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cofinity Commercial |
$75.21
|
| Rate for Payer: Cofinity Commercial |
$69.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.23
|
| Rate for Payer: Mclaren Medicaid |
$34.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.84
|
| Rate for Payer: Meridian Medicaid |
$36.24
|
| Rate for Payer: Nomi Health Commercial |
$62.68
|
| Rate for Payer: PACE SWMI |
$52.23
|
| Rate for Payer: PHP Medicare Advantage |
$52.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.65
|
| Rate for Payer: Priority Health HMO/PPO |
$73.60
|
| Rate for Payer: Priority Health Medicare |
$52.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.23
|
| Rate for Payer: UHC Exchange |
$52.23
|
| Rate for Payer: UHC Medicare Advantage |
$52.23
|
| Rate for Payer: UHCCP Medicaid |
$34.51
|
|
|
PR DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM
|
Facility
|
OP
|
$101.00
|
|
|
Service Code
|
CPT 11046
|
| Hospital Charge Code |
11046
|
| Min. Negotiated Rate |
$23.99 |
| Max. Negotiated Rate |
$90.90 |
| Rate for Payer: Aetna Commercial |
$85.85
|
| Rate for Payer: Aetna Medicare |
$26.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.56
|
| Rate for Payer: BCBS Complete |
$40.40
|
| Rate for Payer: BCBS MAPPO |
$25.25
|
| Rate for Payer: BCBS Trust/PPO |
$83.03
|
| Rate for Payer: BCN Commercial |
$78.53
|
| Rate for Payer: BCN Medicare Advantage |
$25.25
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cofinity Commercial |
$86.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.25
|
| Rate for Payer: Healthscope Commercial |
$90.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.85
|
| Rate for Payer: Nomi Health Commercial |
$82.82
|
| Rate for Payer: PACE Senior Care Partners |
$23.99
|
| Rate for Payer: PACE SWMI |
$25.25
|
| Rate for Payer: PHP Commercial |
$85.85
|
| Rate for Payer: PHP Medicare Advantage |
$25.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.65
|
| Rate for Payer: Priority Health HMO/PPO |
$87.87
|
| Rate for Payer: Priority Health Medicare |
$25.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.67
|
| Rate for Payer: Railroad Medicare Medicare |
$25.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.88
|
| Rate for Payer: UHC Core |
$84.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.25
|
| Rate for Payer: UHC Exchange |
$25.25
|
| Rate for Payer: UHC Medicare Advantage |
$25.25
|
| Rate for Payer: VA VA |
$25.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.75
|
|
