|
PR RAD RESECT TUMOR SOFT TISSUE HAND/FINGER <3CM
|
Professional
|
Both
|
$2,315.00
|
|
|
Service Code
|
HCPCS 26117
|
| Min. Negotiated Rate |
$171.92 |
| Max. Negotiated Rate |
$1,620.50 |
| Rate for Payer: Aetna Commercial |
$979.55
|
| Rate for Payer: Aetna Medicare |
$760.25
|
| Rate for Payer: BCBS Complete |
$505.67
|
| Rate for Payer: BCBS MAPPO |
$731.01
|
| Rate for Payer: BCBS Trust/PPO |
$171.92
|
| Rate for Payer: BCN Commercial |
$1,091.70
|
| Rate for Payer: BCN Medicare Advantage |
$731.01
|
| Rate for Payer: Cash Price |
$1,852.00
|
| Rate for Payer: Cash Price |
$1,852.00
|
| Rate for Payer: Cofinity Commercial |
$1,052.65
|
| Rate for Payer: Cofinity Commercial |
$979.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.01
|
| Rate for Payer: Mclaren Medicaid |
$481.59
|
| Rate for Payer: Meridian Medicaid |
$505.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$767.56
|
| Rate for Payer: PACE SWMI |
$731.01
|
| Rate for Payer: PHP Medicare Advantage |
$731.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,620.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,140.79
|
| Rate for Payer: Priority Health Medicare |
$731.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,140.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$731.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$731.01
|
| Rate for Payer: UHC Medicare Advantage |
$752.94
|
|
|
PR RAD RESECT TUMOR SOFT TISSUE PELVIS & HIP <5 CM
|
Professional
|
Both
|
$3,100.00
|
|
|
Service Code
|
HCPCS 27049
|
| Min. Negotiated Rate |
$913.34 |
| Max. Negotiated Rate |
$4,326.25 |
| Rate for Payer: Aetna Commercial |
$1,779.37
|
| Rate for Payer: Aetna Medicare |
$1,381.01
|
| Rate for Payer: BCBS Complete |
$959.01
|
| Rate for Payer: BCBS MAPPO |
$1,327.89
|
| Rate for Payer: BCBS Trust/PPO |
$4,326.25
|
| Rate for Payer: BCN Commercial |
$1,956.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,327.89
|
| Rate for Payer: Cash Price |
$2,480.00
|
| Rate for Payer: Cash Price |
$2,480.00
|
| Rate for Payer: Cofinity Commercial |
$1,779.37
|
| Rate for Payer: Cofinity Commercial |
$1,912.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,327.89
|
| Rate for Payer: Mclaren Medicaid |
$913.34
|
| Rate for Payer: Meridian Medicaid |
$959.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,394.28
|
| Rate for Payer: PACE SWMI |
$1,327.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,327.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$913.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,170.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,044.12
|
| Rate for Payer: Priority Health Medicare |
$1,327.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,044.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,327.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,327.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,367.73
|
|
|
PR RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM
|
Professional
|
Both
|
$3,312.00
|
|
|
Service Code
|
HCPCS 27329
|
| Min. Negotiated Rate |
$668.39 |
| Max. Negotiated Rate |
$2,318.40 |
| Rate for Payer: Aetna Commercial |
$1,378.87
|
| Rate for Payer: Aetna Medicare |
$1,070.17
|
| Rate for Payer: BCBS Complete |
$701.81
|
| Rate for Payer: BCBS MAPPO |
$1,029.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,157.51
|
| Rate for Payer: BCN Commercial |
$1,523.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,029.01
|
| Rate for Payer: Cash Price |
$2,649.60
|
| Rate for Payer: Cash Price |
$2,649.60
|
| Rate for Payer: Cofinity Commercial |
$1,481.77
|
| Rate for Payer: Cofinity Commercial |
$1,378.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,029.01
|
| Rate for Payer: Mclaren Medicaid |
$668.39
|
| Rate for Payer: Meridian Medicaid |
$701.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,080.46
|
| Rate for Payer: PACE SWMI |
$1,029.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,029.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$668.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,318.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,591.69
|
| Rate for Payer: Priority Health Medicare |
$1,029.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,591.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,029.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,029.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,059.88
|
|
|
PR RAPID DESENSITIZATION PROCEDURE EACH HOUR
|
Professional
|
Both
|
$248.00
|
|
|
Service Code
|
HCPCS 95180
|
| Min. Negotiated Rate |
$64.54 |
| Max. Negotiated Rate |
$430.04 |
| Rate for Payer: Aetna Commercial |
$133.24
|
| Rate for Payer: Aetna Medicare |
$103.41
|
| Rate for Payer: BCBS Complete |
$67.77
|
| Rate for Payer: BCBS MAPPO |
$99.43
|
| Rate for Payer: BCBS Trust/PPO |
$430.04
|
| Rate for Payer: BCN Commercial |
$198.89
|
| Rate for Payer: BCN Medicare Advantage |
$99.43
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cash Price |
$198.40
|
| Rate for Payer: Cofinity Commercial |
$133.24
|
| Rate for Payer: Cofinity Commercial |
$143.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.43
|
| Rate for Payer: Mclaren Medicaid |
$64.54
|
| Rate for Payer: Meridian Medicaid |
$67.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$104.40
|
| Rate for Payer: PACE SWMI |
$99.43
|
| Rate for Payer: PHP Medicare Advantage |
$99.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.82
|
| Rate for Payer: Priority Health Medicare |
$99.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.43
|
| Rate for Payer: UHC Medicare Advantage |
$102.41
|
|
|
PR RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY
|
Professional
|
Both
|
$834.00
|
|
|
Service Code
|
HCPCS 28313
|
| Hospital Charge Code |
28313
|
| Min. Negotiated Rate |
$333.60 |
| Max. Negotiated Rate |
$1,777.73 |
| Rate for Payer: Aetna Commercial |
$471.69
|
| Rate for Payer: Aetna Medicare |
$366.09
|
| Rate for Payer: BCBS Complete |
$333.60
|
| Rate for Payer: BCBS MAPPO |
$352.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,777.73
|
| Rate for Payer: BCN Commercial |
$770.16
|
| Rate for Payer: BCN Medicare Advantage |
$352.01
|
| Rate for Payer: Cash Price |
$667.20
|
| Rate for Payer: Cash Price |
$667.20
|
| Rate for Payer: Cofinity Commercial |
$506.89
|
| Rate for Payer: Cofinity Commercial |
$471.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$369.61
|
| Rate for Payer: PACE SWMI |
$352.01
|
| Rate for Payer: PHP Medicare Advantage |
$352.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$583.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$550.47
|
| Rate for Payer: Priority Health Medicare |
$352.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$550.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.01
|
| Rate for Payer: UHC Medicare Advantage |
$362.57
|
|
|
PR RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY
|
Facility
|
OP
|
$834.00
|
|
|
Service Code
|
CPT 28313
|
| Hospital Charge Code |
28313
|
| Min. Negotiated Rate |
$198.08 |
| Max. Negotiated Rate |
$2,229.50 |
| Rate for Payer: Aetna Commercial |
$708.90
|
| Rate for Payer: Aetna Medicare |
$216.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$260.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$260.62
|
| Rate for Payer: BCBS Complete |
$2,229.50
|
| Rate for Payer: BCBS MAPPO |
$208.50
|
| Rate for Payer: BCBS Trust/PPO |
$648.44
|
| Rate for Payer: BCN Commercial |
$648.44
|
| Rate for Payer: BCN Medicare Advantage |
$208.50
|
| Rate for Payer: Cash Price |
$667.20
|
| Rate for Payer: Cash Price |
$667.20
|
| Rate for Payer: Cofinity Commercial |
$717.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$667.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.50
|
| Rate for Payer: Healthscope Commercial |
$750.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$625.50
|
| Rate for Payer: Mclaren Medicaid |
$2,123.34
|
| Rate for Payer: Meridian Medicaid |
$2,229.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$218.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$239.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$708.90
|
| Rate for Payer: PACE Senior Care Partners |
$198.08
|
| Rate for Payer: PACE SWMI |
$208.50
|
| Rate for Payer: PHP Commercial |
$708.90
|
| Rate for Payer: PHP Medicare Advantage |
$208.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,123.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$583.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$725.58
|
| Rate for Payer: Priority Health Medicare |
$208.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$508.66
|
| Rate for Payer: Railroad Medicare Medicare |
$208.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$733.92
|
| Rate for Payer: UHC Core |
$696.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$208.50
|
| Rate for Payer: UHC Medicare Advantage |
$214.76
|
| Rate for Payer: VA VA |
$208.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$625.50
|
|
|
PR RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY
|
Facility
|
IP
|
$834.00
|
|
|
Service Code
|
CPT 28313
|
| Hospital Charge Code |
28313
|
| Min. Negotiated Rate |
$508.66 |
| Max. Negotiated Rate |
$750.60 |
| Rate for Payer: Aetna Commercial |
$708.90
|
| Rate for Payer: BCBS Trust/PPO |
$644.52
|
| Rate for Payer: BCN Commercial |
$644.52
|
| Rate for Payer: Cash Price |
$667.20
|
| Rate for Payer: Cofinity Commercial |
$717.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$667.20
|
| Rate for Payer: Healthscope Commercial |
$750.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$625.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$708.90
|
| Rate for Payer: PHP Commercial |
$708.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$583.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$725.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$508.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$733.92
|
| Rate for Payer: UHC Core |
$696.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$625.50
|
|
|
PR RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY
|
Professional
|
Both
|
$834.00
|
|
|
Service Code
|
HCPCS 28313
|
| Min. Negotiated Rate |
$333.60 |
| Max. Negotiated Rate |
$1,777.73 |
| Rate for Payer: Aetna Commercial |
$471.69
|
| Rate for Payer: Aetna Medicare |
$366.09
|
| Rate for Payer: BCBS Complete |
$333.60
|
| Rate for Payer: BCBS MAPPO |
$352.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,777.73
|
| Rate for Payer: BCN Commercial |
$770.16
|
| Rate for Payer: BCN Medicare Advantage |
$352.01
|
| Rate for Payer: Cash Price |
$667.20
|
| Rate for Payer: Cash Price |
$667.20
|
| Rate for Payer: Cofinity Commercial |
$506.89
|
| Rate for Payer: Cofinity Commercial |
$471.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$369.61
|
| Rate for Payer: PACE SWMI |
$352.01
|
| Rate for Payer: PHP Medicare Advantage |
$352.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$583.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$550.47
|
| Rate for Payer: Priority Health Medicare |
$352.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$550.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.01
|
| Rate for Payer: UHC Medicare Advantage |
$362.57
|
|
|
PR RCNSTJ BIFRONTAL SUPERIOR-LAT ORB RIMS & LWR FHD
|
Professional
|
Both
|
$7,055.00
|
|
|
Service Code
|
HCPCS 21175
|
| Min. Negotiated Rate |
$377.57 |
| Max. Negotiated Rate |
$4,938.50 |
| Rate for Payer: Aetna Commercial |
$2,911.22
|
| Rate for Payer: Aetna Medicare |
$2,259.45
|
| Rate for Payer: BCBS Complete |
$1,476.31
|
| Rate for Payer: BCBS MAPPO |
$2,172.55
|
| Rate for Payer: BCBS Trust/PPO |
$377.57
|
| Rate for Payer: BCN Commercial |
$3,551.28
|
| Rate for Payer: BCN Medicare Advantage |
$2,172.55
|
| Rate for Payer: Cash Price |
$5,644.00
|
| Rate for Payer: Cash Price |
$5,644.00
|
| Rate for Payer: Cofinity Commercial |
$3,128.47
|
| Rate for Payer: Cofinity Commercial |
$2,911.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,172.55
|
| Rate for Payer: Mclaren Medicaid |
$1,406.01
|
| Rate for Payer: Meridian Medicaid |
$1,476.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,281.18
|
| Rate for Payer: PACE SWMI |
$2,172.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,172.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,406.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,938.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,370.30
|
| Rate for Payer: Priority Health Medicare |
$2,172.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,370.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,172.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,172.55
|
| Rate for Payer: UHC Medicare Advantage |
$2,237.73
|
|
|
PR RCNSTJ COLTRL LIGM IPHAL JT 1 W/GRF EA JT
|
Professional
|
Both
|
$1,192.00
|
|
|
Service Code
|
HCPCS 26545
|
| Min. Negotiated Rate |
$149.51 |
| Max. Negotiated Rate |
$1,139.77 |
| Rate for Payer: Aetna Commercial |
$961.87
|
| Rate for Payer: Aetna Medicare |
$746.52
|
| Rate for Payer: BCBS Complete |
$500.08
|
| Rate for Payer: BCBS MAPPO |
$717.81
|
| Rate for Payer: BCBS Trust/PPO |
$149.51
|
| Rate for Payer: BCN Commercial |
$1,090.73
|
| Rate for Payer: BCN Medicare Advantage |
$717.81
|
| Rate for Payer: Cash Price |
$953.60
|
| Rate for Payer: Cash Price |
$953.60
|
| Rate for Payer: Cofinity Commercial |
$961.87
|
| Rate for Payer: Cofinity Commercial |
$1,033.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.81
|
| Rate for Payer: Mclaren Medicaid |
$476.27
|
| Rate for Payer: Meridian Medicaid |
$500.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$753.70
|
| Rate for Payer: PACE SWMI |
$717.81
|
| Rate for Payer: PHP Medicare Advantage |
$717.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$834.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,139.77
|
| Rate for Payer: Priority Health Medicare |
$717.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,139.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$717.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$717.81
|
| Rate for Payer: UHC Medicare Advantage |
$739.34
|
|
|
PR RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/LOCAL TISS
|
Professional
|
Both
|
$3,496.00
|
|
|
Service Code
|
HCPCS 26542
|
| Min. Negotiated Rate |
$467.96 |
| Max. Negotiated Rate |
$2,447.20 |
| Rate for Payer: Aetna Commercial |
$946.38
|
| Rate for Payer: Aetna Medicare |
$734.50
|
| Rate for Payer: BCBS Complete |
$491.36
|
| Rate for Payer: BCBS MAPPO |
$706.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,587.54
|
| Rate for Payer: BCN Commercial |
$1,073.63
|
| Rate for Payer: BCN Medicare Advantage |
$706.25
|
| Rate for Payer: Cash Price |
$2,796.80
|
| Rate for Payer: Cash Price |
$2,796.80
|
| Rate for Payer: Cofinity Commercial |
$946.38
|
| Rate for Payer: Cofinity Commercial |
$1,017.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$706.25
|
| Rate for Payer: Mclaren Medicaid |
$467.96
|
| Rate for Payer: Meridian Medicaid |
$491.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$741.56
|
| Rate for Payer: PACE SWMI |
$706.25
|
| Rate for Payer: PHP Medicare Advantage |
$706.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,447.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,121.90
|
| Rate for Payer: Priority Health Medicare |
$706.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,121.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$706.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$706.25
|
| Rate for Payer: UHC Medicare Advantage |
$727.44
|
|
|
PR RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/TDN/FSCAL GRF
|
Professional
|
Both
|
$2,333.00
|
|
|
Service Code
|
HCPCS 26541
|
| Min. Negotiated Rate |
$540.81 |
| Max. Negotiated Rate |
$1,633.10 |
| Rate for Payer: Aetna Commercial |
$1,095.65
|
| Rate for Payer: Aetna Medicare |
$850.36
|
| Rate for Payer: BCBS Complete |
$567.85
|
| Rate for Payer: BCBS MAPPO |
$817.65
|
| Rate for Payer: BCBS Trust/PPO |
$544.15
|
| Rate for Payer: BCN Commercial |
$1,237.82
|
| Rate for Payer: BCN Medicare Advantage |
$817.65
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cofinity Commercial |
$1,177.42
|
| Rate for Payer: Cofinity Commercial |
$1,095.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$817.65
|
| Rate for Payer: Mclaren Medicaid |
$540.81
|
| Rate for Payer: Meridian Medicaid |
$567.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$858.53
|
| Rate for Payer: PACE SWMI |
$817.65
|
| Rate for Payer: PHP Medicare Advantage |
$817.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$540.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,633.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,293.47
|
| Rate for Payer: Priority Health Medicare |
$817.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,293.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$817.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$817.65
|
| Rate for Payer: UHC Medicare Advantage |
$842.18
|
|
|
PR RCNSTJ DISLC PATELLA W/PATELLECTOMY
|
Professional
|
Both
|
$1,489.00
|
|
|
Service Code
|
HCPCS 27424
|
| Min. Negotiated Rate |
$485.21 |
| Max. Negotiated Rate |
$1,153.56 |
| Rate for Payer: Aetna Commercial |
$991.39
|
| Rate for Payer: Aetna Medicare |
$769.43
|
| Rate for Payer: BCBS Complete |
$509.47
|
| Rate for Payer: BCBS MAPPO |
$739.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,069.81
|
| Rate for Payer: BCN Commercial |
$1,103.92
|
| Rate for Payer: BCN Medicare Advantage |
$739.84
|
| Rate for Payer: Cash Price |
$1,191.20
|
| Rate for Payer: Cash Price |
$1,191.20
|
| Rate for Payer: Cofinity Commercial |
$991.39
|
| Rate for Payer: Cofinity Commercial |
$1,065.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$739.84
|
| Rate for Payer: Mclaren Medicaid |
$485.21
|
| Rate for Payer: Meridian Medicaid |
$509.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$776.83
|
| Rate for Payer: PACE SWMI |
$739.84
|
| Rate for Payer: PHP Medicare Advantage |
$739.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,042.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,153.56
|
| Rate for Payer: Priority Health Medicare |
$739.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,153.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$739.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$739.84
|
| Rate for Payer: UHC Medicare Advantage |
$762.04
|
|
|
PR RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL
|
Facility
|
IP
|
$2,268.00
|
|
|
Service Code
|
CPT 27422
|
| Hospital Charge Code |
27422
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,383.25 |
| Max. Negotiated Rate |
$2,041.20 |
| Rate for Payer: Aetna Commercial |
$1,927.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,752.71
|
| Rate for Payer: BCN Commercial |
$1,752.71
|
| Rate for Payer: Cash Price |
$1,814.40
|
| Rate for Payer: Cofinity Commercial |
$1,950.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,814.40
|
| Rate for Payer: Healthscope Commercial |
$2,041.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,701.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,927.80
|
| Rate for Payer: PHP Commercial |
$1,927.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,587.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,973.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,383.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,995.84
|
| Rate for Payer: UHC Core |
$1,893.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,701.00
|
|
|
PR RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL
|
Professional
|
Both
|
$2,268.00
|
|
|
Service Code
|
HCPCS 27422
|
| Hospital Charge Code |
27422
|
| Min. Negotiated Rate |
$478.11 |
| Max. Negotiated Rate |
$1,587.60 |
| Rate for Payer: Aetna Commercial |
$981.71
|
| Rate for Payer: Aetna Medicare |
$761.92
|
| Rate for Payer: BCBS Complete |
$504.56
|
| Rate for Payer: BCBS MAPPO |
$732.62
|
| Rate for Payer: BCBS Trust/PPO |
$478.11
|
| Rate for Payer: BCN Commercial |
$1,093.17
|
| Rate for Payer: BCN Medicare Advantage |
$732.62
|
| Rate for Payer: Cash Price |
$1,814.40
|
| Rate for Payer: Cash Price |
$1,814.40
|
| Rate for Payer: Cofinity Commercial |
$981.71
|
| Rate for Payer: Cofinity Commercial |
$1,054.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$732.62
|
| Rate for Payer: Mclaren Medicaid |
$480.53
|
| Rate for Payer: Meridian Medicaid |
$504.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$769.25
|
| Rate for Payer: PACE SWMI |
$732.62
|
| Rate for Payer: PHP Medicare Advantage |
$732.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$480.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,587.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,142.33
|
| Rate for Payer: Priority Health Medicare |
$732.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,142.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$732.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$732.62
|
| Rate for Payer: UHC Medicare Advantage |
$754.60
|
|
|
PR RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL
|
Facility
|
OP
|
$2,268.00
|
|
|
Service Code
|
CPT 27422
|
| Hospital Charge Code |
27422
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$538.65 |
| Max. Negotiated Rate |
$4,927.66 |
| Rate for Payer: Aetna Commercial |
$1,927.80
|
| Rate for Payer: Aetna Medicare |
$589.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$708.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$708.75
|
| Rate for Payer: BCBS Complete |
$4,927.66
|
| Rate for Payer: BCBS MAPPO |
$567.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,763.37
|
| Rate for Payer: BCN Commercial |
$1,763.37
|
| Rate for Payer: BCN Medicare Advantage |
$567.00
|
| Rate for Payer: Cash Price |
$1,814.40
|
| Rate for Payer: Cash Price |
$1,814.40
|
| Rate for Payer: Cofinity Commercial |
$1,950.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,814.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$567.00
|
| Rate for Payer: Healthscope Commercial |
$2,041.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,701.00
|
| Rate for Payer: Mclaren Medicaid |
$4,693.01
|
| Rate for Payer: Meridian Medicaid |
$4,927.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$595.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$652.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,927.80
|
| Rate for Payer: PACE Senior Care Partners |
$538.65
|
| Rate for Payer: PACE SWMI |
$567.00
|
| Rate for Payer: PHP Commercial |
$1,927.80
|
| Rate for Payer: PHP Medicare Advantage |
$567.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,693.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,587.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,973.16
|
| Rate for Payer: Priority Health Medicare |
$567.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,383.25
|
| Rate for Payer: Railroad Medicare Medicare |
$567.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,995.84
|
| Rate for Payer: UHC Core |
$1,893.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$567.00
|
| Rate for Payer: UHC Medicare Advantage |
$584.01
|
| Rate for Payer: VA VA |
$567.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,701.00
|
|
|
PR RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL
|
Professional
|
Both
|
$2,268.00
|
|
|
Service Code
|
HCPCS 27422
|
| Min. Negotiated Rate |
$478.11 |
| Max. Negotiated Rate |
$1,587.60 |
| Rate for Payer: Aetna Commercial |
$981.71
|
| Rate for Payer: Aetna Medicare |
$761.92
|
| Rate for Payer: BCBS Complete |
$504.56
|
| Rate for Payer: BCBS MAPPO |
$732.62
|
| Rate for Payer: BCBS Trust/PPO |
$478.11
|
| Rate for Payer: BCN Commercial |
$1,093.17
|
| Rate for Payer: BCN Medicare Advantage |
$732.62
|
| Rate for Payer: Cash Price |
$1,814.40
|
| Rate for Payer: Cash Price |
$1,814.40
|
| Rate for Payer: Cofinity Commercial |
$1,054.97
|
| Rate for Payer: Cofinity Commercial |
$981.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$732.62
|
| Rate for Payer: Mclaren Medicaid |
$480.53
|
| Rate for Payer: Meridian Medicaid |
$504.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$769.25
|
| Rate for Payer: PACE SWMI |
$732.62
|
| Rate for Payer: PHP Medicare Advantage |
$732.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$480.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,587.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,142.33
|
| Rate for Payer: Priority Health Medicare |
$732.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,142.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$732.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$732.62
|
| Rate for Payer: UHC Medicare Advantage |
$754.60
|
|
|
PR RCNSTJ DISLOCATING PATELLA
|
Professional
|
Both
|
$2,289.00
|
|
|
Service Code
|
HCPCS 27420
|
| Min. Negotiated Rate |
$486.07 |
| Max. Negotiated Rate |
$1,602.30 |
| Rate for Payer: Aetna Commercial |
$987.51
|
| Rate for Payer: Aetna Medicare |
$766.43
|
| Rate for Payer: BCBS Complete |
$510.37
|
| Rate for Payer: BCBS MAPPO |
$736.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,012.22
|
| Rate for Payer: BCN Commercial |
$1,099.53
|
| Rate for Payer: BCN Medicare Advantage |
$736.95
|
| Rate for Payer: Cash Price |
$1,831.20
|
| Rate for Payer: Cash Price |
$1,831.20
|
| Rate for Payer: Cofinity Commercial |
$987.51
|
| Rate for Payer: Cofinity Commercial |
$1,061.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.95
|
| Rate for Payer: Mclaren Medicaid |
$486.07
|
| Rate for Payer: Meridian Medicaid |
$510.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$773.80
|
| Rate for Payer: PACE SWMI |
$736.95
|
| Rate for Payer: PHP Medicare Advantage |
$736.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$486.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,602.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,148.96
|
| Rate for Payer: Priority Health Medicare |
$736.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,148.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$736.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$736.95
|
| Rate for Payer: UHC Medicare Advantage |
$759.06
|
|
|
PR RCNSTJ LAT COLTRL LIGM ELBOW W/TENDON GRAFT
|
Professional
|
Both
|
$2,961.00
|
|
|
Service Code
|
HCPCS 24344
|
| Min. Negotiated Rate |
$200.75 |
| Max. Negotiated Rate |
$2,072.70 |
| Rate for Payer: Aetna Commercial |
$1,439.52
|
| Rate for Payer: Aetna Medicare |
$1,117.24
|
| Rate for Payer: BCBS Complete |
$749.01
|
| Rate for Payer: BCBS MAPPO |
$1,074.27
|
| Rate for Payer: BCBS Trust/PPO |
$200.75
|
| Rate for Payer: BCN Commercial |
$1,602.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,074.27
|
| Rate for Payer: Cash Price |
$2,368.80
|
| Rate for Payer: Cash Price |
$2,368.80
|
| Rate for Payer: Cofinity Commercial |
$1,546.95
|
| Rate for Payer: Cofinity Commercial |
$1,439.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,074.27
|
| Rate for Payer: Mclaren Medicaid |
$713.34
|
| Rate for Payer: Meridian Medicaid |
$749.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,127.98
|
| Rate for Payer: PACE SWMI |
$1,074.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,074.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$713.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,072.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,674.93
|
| Rate for Payer: Priority Health Medicare |
$1,074.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,674.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,074.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,074.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,106.50
|
|
|
PR RCNSTJ MEDIAL COLTRL LIGM ELBW W/TDN GRF
|
Professional
|
Both
|
$3,270.00
|
|
|
Service Code
|
HCPCS 24346
|
| Min. Negotiated Rate |
$272.60 |
| Max. Negotiated Rate |
$2,289.00 |
| Rate for Payer: Aetna Commercial |
$1,457.38
|
| Rate for Payer: Aetna Medicare |
$1,131.10
|
| Rate for Payer: BCBS Complete |
$749.01
|
| Rate for Payer: BCBS MAPPO |
$1,087.60
|
| Rate for Payer: BCBS Trust/PPO |
$272.60
|
| Rate for Payer: BCN Commercial |
$1,621.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,087.60
|
| Rate for Payer: Cash Price |
$2,616.00
|
| Rate for Payer: Cash Price |
$2,616.00
|
| Rate for Payer: Cofinity Commercial |
$1,566.14
|
| Rate for Payer: Cofinity Commercial |
$1,457.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,087.60
|
| Rate for Payer: Mclaren Medicaid |
$713.34
|
| Rate for Payer: Meridian Medicaid |
$749.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,141.98
|
| Rate for Payer: PACE SWMI |
$1,087.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,087.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$713.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,289.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,694.85
|
| Rate for Payer: Priority Health Medicare |
$1,087.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,694.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,087.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,087.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,120.23
|
|
|
PR RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/GRAFT
|
Professional
|
Both
|
$6,334.00
|
|
|
Service Code
|
HCPCS 21194
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$4,433.80 |
| Rate for Payer: Aetna Commercial |
$1,862.29
|
| Rate for Payer: Aetna Medicare |
$1,445.36
|
| Rate for Payer: BCBS Complete |
$948.73
|
| Rate for Payer: BCBS MAPPO |
$1,389.77
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$2,076.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,389.77
|
| Rate for Payer: Cash Price |
$5,067.20
|
| Rate for Payer: Cash Price |
$5,067.20
|
| Rate for Payer: Cofinity Commercial |
$2,001.27
|
| Rate for Payer: Cofinity Commercial |
$1,862.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,389.77
|
| Rate for Payer: Mclaren Medicaid |
$903.55
|
| Rate for Payer: Meridian Medicaid |
$948.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,459.26
|
| Rate for Payer: PACE SWMI |
$1,389.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,389.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$903.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,433.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,169.76
|
| Rate for Payer: Priority Health Medicare |
$1,389.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,169.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,389.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,389.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,431.46
|
|
|
PR RCNSTJ MNDBL XTRORAL W/TRANSOSTEAL BONE PLATE
|
Professional
|
Both
|
$3,440.00
|
|
|
Service Code
|
HCPCS 21244
|
| Min. Negotiated Rate |
$110.96 |
| Max. Negotiated Rate |
$2,408.00 |
| Rate for Payer: Aetna Commercial |
$1,316.55
|
| Rate for Payer: Aetna Medicare |
$1,021.80
|
| Rate for Payer: BCBS Complete |
$675.87
|
| Rate for Payer: BCBS MAPPO |
$982.50
|
| Rate for Payer: BCBS Trust/PPO |
$110.96
|
| Rate for Payer: BCN Commercial |
$1,474.83
|
| Rate for Payer: BCN Medicare Advantage |
$982.50
|
| Rate for Payer: Cash Price |
$2,752.00
|
| Rate for Payer: Cash Price |
$2,752.00
|
| Rate for Payer: Cofinity Commercial |
$1,316.55
|
| Rate for Payer: Cofinity Commercial |
$1,414.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$982.50
|
| Rate for Payer: Mclaren Medicaid |
$643.69
|
| Rate for Payer: Meridian Medicaid |
$675.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,031.62
|
| Rate for Payer: PACE SWMI |
$982.50
|
| Rate for Payer: PHP Medicare Advantage |
$982.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$643.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,408.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,541.15
|
| Rate for Payer: Priority Health Medicare |
$982.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,541.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$982.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$982.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,011.98
|
|
|
PR RCNSTJ POLYDACTYLOUS DIGIT SOFT TISSUE & BONE
|
Professional
|
Both
|
$1,705.00
|
|
|
Service Code
|
HCPCS 26587
|
| Min. Negotiated Rate |
$57.06 |
| Max. Negotiated Rate |
$1,602.42 |
| Rate for Payer: Aetna Commercial |
$1,378.51
|
| Rate for Payer: Aetna Medicare |
$1,069.89
|
| Rate for Payer: BCBS Complete |
$707.63
|
| Rate for Payer: BCBS MAPPO |
$1,028.74
|
| Rate for Payer: BCBS Trust/PPO |
$57.06
|
| Rate for Payer: BCN Commercial |
$1,533.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,028.74
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Cofinity Commercial |
$1,481.39
|
| Rate for Payer: Cofinity Commercial |
$1,378.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,028.74
|
| Rate for Payer: Mclaren Medicaid |
$673.93
|
| Rate for Payer: Meridian Medicaid |
$707.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,080.18
|
| Rate for Payer: PACE SWMI |
$1,028.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,028.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$673.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,193.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,602.42
|
| Rate for Payer: Priority Health Medicare |
$1,028.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,602.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,028.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,028.74
|
| Rate for Payer: UHC Medicare Advantage |
$1,059.60
|
|
|
PR RCNSTJ PST TIBL TDN W/EXC ACCESSORY TARSL NAVCLR
|
Professional
|
Both
|
$1,453.00
|
|
|
Service Code
|
HCPCS 28238
|
| Min. Negotiated Rate |
$315.03 |
| Max. Negotiated Rate |
$2,785.20 |
| Rate for Payer: Aetna Commercial |
$645.29
|
| Rate for Payer: Aetna Medicare |
$500.82
|
| Rate for Payer: BCBS Complete |
$330.78
|
| Rate for Payer: BCBS MAPPO |
$481.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,785.20
|
| Rate for Payer: BCN Commercial |
$981.75
|
| Rate for Payer: BCN Medicare Advantage |
$481.56
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cash Price |
$1,162.40
|
| Rate for Payer: Cofinity Commercial |
$645.29
|
| Rate for Payer: Cofinity Commercial |
$693.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$481.56
|
| Rate for Payer: Mclaren Medicaid |
$315.03
|
| Rate for Payer: Meridian Medicaid |
$330.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$505.64
|
| Rate for Payer: PACE SWMI |
$481.56
|
| Rate for Payer: PHP Medicare Advantage |
$481.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$315.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,017.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$748.62
|
| Rate for Payer: Priority Health Medicare |
$481.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$748.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$481.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$481.56
|
| Rate for Payer: UHC Medicare Advantage |
$496.01
|
|
|
PR RCNSTJ STABLJ DSTL U/DSTL JT 2 SOFT TISS STABLJ
|
Professional
|
Both
|
$3,376.00
|
|
|
Service Code
|
HCPCS 25337
|
| Min. Negotiated Rate |
$336.53 |
| Max. Negotiated Rate |
$2,363.20 |
| Rate for Payer: Aetna Commercial |
$1,170.50
|
| Rate for Payer: Aetna Medicare |
$908.45
|
| Rate for Payer: BCBS Complete |
$604.31
|
| Rate for Payer: BCBS MAPPO |
$873.51
|
| Rate for Payer: BCBS Trust/PPO |
$336.53
|
| Rate for Payer: BCN Commercial |
$1,307.70
|
| Rate for Payer: BCN Medicare Advantage |
$873.51
|
| Rate for Payer: Cash Price |
$2,700.80
|
| Rate for Payer: Cash Price |
$2,700.80
|
| Rate for Payer: Cofinity Commercial |
$1,170.50
|
| Rate for Payer: Cofinity Commercial |
$1,257.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$873.51
|
| Rate for Payer: Mclaren Medicaid |
$575.53
|
| Rate for Payer: Meridian Medicaid |
$604.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$917.19
|
| Rate for Payer: PACE SWMI |
$873.51
|
| Rate for Payer: PHP Medicare Advantage |
$873.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$575.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,363.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,366.50
|
| Rate for Payer: Priority Health Medicare |
$873.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,366.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$873.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$873.51
|
| Rate for Payer: UHC Medicare Advantage |
$899.72
|
|
