|
PR RCNSTJ SUPERIOR-LATERAL ORBITAL RIM & LOWER FHD
|
Professional
|
Both
|
$4,390.00
|
|
|
Service Code
|
HCPCS 21172
|
| Min. Negotiated Rate |
$580.95 |
| Max. Negotiated Rate |
$3,263.56 |
| Rate for Payer: Aetna Commercial |
$2,843.25
|
| Rate for Payer: Aetna Medicare |
$2,206.70
|
| Rate for Payer: BCBS Complete |
$1,439.19
|
| Rate for Payer: BCBS MAPPO |
$2,121.83
|
| Rate for Payer: BCBS Trust/PPO |
$580.95
|
| Rate for Payer: BCN Commercial |
$3,123.14
|
| Rate for Payer: BCN Medicare Advantage |
$2,121.83
|
| Rate for Payer: Cash Price |
$3,512.00
|
| Rate for Payer: Cash Price |
$3,512.00
|
| Rate for Payer: Cofinity Commercial |
$3,055.44
|
| Rate for Payer: Cofinity Commercial |
$2,843.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,121.83
|
| Rate for Payer: Mclaren Medicaid |
$1,370.66
|
| Rate for Payer: Meridian Medicaid |
$1,439.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,227.92
|
| Rate for Payer: PACE SWMI |
$2,121.83
|
| Rate for Payer: PHP Medicare Advantage |
$2,121.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,370.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,073.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,263.56
|
| Rate for Payer: Priority Health Medicare |
$2,121.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,263.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,121.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,121.83
|
| Rate for Payer: UHC Medicare Advantage |
$2,185.48
|
|
|
PR RCNSTJ TDN PULLEY EA TDN W/TDN/FSCAL GRF SPX
|
Professional
|
Both
|
$1,406.00
|
|
|
Service Code
|
HCPCS 26502
|
| Min. Negotiated Rate |
$489.90 |
| Max. Negotiated Rate |
$2,792.59 |
| Rate for Payer: Aetna Commercial |
$992.50
|
| Rate for Payer: Aetna Medicare |
$770.30
|
| Rate for Payer: BCBS Complete |
$514.40
|
| Rate for Payer: BCBS MAPPO |
$740.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,792.59
|
| Rate for Payer: BCN Commercial |
$1,124.45
|
| Rate for Payer: BCN Medicare Advantage |
$740.67
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cofinity Commercial |
$992.50
|
| Rate for Payer: Cofinity Commercial |
$1,066.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$740.67
|
| Rate for Payer: Mclaren Medicaid |
$489.90
|
| Rate for Payer: Meridian Medicaid |
$514.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$777.70
|
| Rate for Payer: PACE SWMI |
$740.67
|
| Rate for Payer: PHP Medicare Advantage |
$740.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$489.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,175.00
|
| Rate for Payer: Priority Health Medicare |
$740.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,175.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$740.67
|
| Rate for Payer: UHC Medicare Advantage |
$762.89
|
|
|
PR RCNSTJ TENDON PULLEY EACH W/LOCAL TISSUES SPX
|
Professional
|
Both
|
$1,361.00
|
|
|
Service Code
|
HCPCS 26500
|
| Min. Negotiated Rate |
$446.24 |
| Max. Negotiated Rate |
$5,862.74 |
| Rate for Payer: Aetna Commercial |
$868.87
|
| Rate for Payer: Aetna Medicare |
$674.35
|
| Rate for Payer: BCBS Complete |
$468.55
|
| Rate for Payer: BCBS MAPPO |
$648.41
|
| Rate for Payer: BCBS Trust/PPO |
$5,862.74
|
| Rate for Payer: BCN Commercial |
$987.13
|
| Rate for Payer: BCN Medicare Advantage |
$648.41
|
| Rate for Payer: Cash Price |
$1,088.80
|
| Rate for Payer: Cash Price |
$1,088.80
|
| Rate for Payer: Cofinity Commercial |
$933.71
|
| Rate for Payer: Cofinity Commercial |
$868.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$648.41
|
| Rate for Payer: Mclaren Medicaid |
$446.24
|
| Rate for Payer: Meridian Medicaid |
$468.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$680.83
|
| Rate for Payer: PACE SWMI |
$648.41
|
| Rate for Payer: PHP Medicare Advantage |
$648.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$446.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$952.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,031.51
|
| Rate for Payer: Priority Health Medicare |
$648.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,031.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$648.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$648.41
|
| Rate for Payer: UHC Medicare Advantage |
$667.86
|
|
|
PR RDCTJ PROCIDENTIA UNDER ANES SEPARATE PROCEDURE
|
Professional
|
Both
|
$379.00
|
|
|
Service Code
|
HCPCS 45900
|
| Min. Negotiated Rate |
$136.75 |
| Max. Negotiated Rate |
$771.85 |
| Rate for Payer: Aetna Commercial |
$281.63
|
| Rate for Payer: Aetna Medicare |
$218.58
|
| Rate for Payer: BCBS Complete |
$143.59
|
| Rate for Payer: BCBS MAPPO |
$210.17
|
| Rate for Payer: BCBS Trust/PPO |
$771.85
|
| Rate for Payer: BCN Commercial |
$311.78
|
| Rate for Payer: BCN Medicare Advantage |
$210.17
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Cofinity Commercial |
$302.64
|
| Rate for Payer: Cofinity Commercial |
$281.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.17
|
| Rate for Payer: Mclaren Medicaid |
$136.75
|
| Rate for Payer: Meridian Medicaid |
$143.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.68
|
| Rate for Payer: PACE SWMI |
$210.17
|
| Rate for Payer: PHP Medicare Advantage |
$210.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$375.13
|
| Rate for Payer: Priority Health Medicare |
$210.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$375.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$210.17
|
| Rate for Payer: UHC Medicare Advantage |
$216.48
|
|
|
PR RDCTJ TORSION TSTIS W/WO FIXJ CLAT TESTIS
|
Professional
|
Both
|
$801.00
|
|
|
Service Code
|
HCPCS 54600
|
| Min. Negotiated Rate |
$290.11 |
| Max. Negotiated Rate |
$2,890.86 |
| Rate for Payer: Aetna Commercial |
$592.43
|
| Rate for Payer: Aetna Medicare |
$459.79
|
| Rate for Payer: BCBS Complete |
$304.62
|
| Rate for Payer: BCBS MAPPO |
$442.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,890.86
|
| Rate for Payer: BCN Commercial |
$655.32
|
| Rate for Payer: BCN Medicare Advantage |
$442.11
|
| Rate for Payer: Cash Price |
$640.80
|
| Rate for Payer: Cash Price |
$640.80
|
| Rate for Payer: Cofinity Commercial |
$592.43
|
| Rate for Payer: Cofinity Commercial |
$636.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$442.11
|
| Rate for Payer: Mclaren Medicaid |
$290.11
|
| Rate for Payer: Meridian Medicaid |
$304.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$464.22
|
| Rate for Payer: PACE SWMI |
$442.11
|
| Rate for Payer: PHP Medicare Advantage |
$442.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$290.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$724.62
|
| Rate for Payer: Priority Health Medicare |
$442.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$724.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$442.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$442.11
|
| Rate for Payer: UHC Medicare Advantage |
$455.37
|
|
|
PR RDCTJ VOLVULUS INTUSSUSCEPTION INT HRNA LAPT
|
Professional
|
Both
|
$2,329.00
|
|
|
Service Code
|
HCPCS 44050
|
| Min. Negotiated Rate |
$598.96 |
| Max. Negotiated Rate |
$2,793.65 |
| Rate for Payer: Aetna Commercial |
$1,247.30
|
| Rate for Payer: Aetna Medicare |
$968.05
|
| Rate for Payer: BCBS Complete |
$628.91
|
| Rate for Payer: BCBS MAPPO |
$930.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,793.65
|
| Rate for Payer: BCN Commercial |
$1,366.35
|
| Rate for Payer: BCN Medicare Advantage |
$930.82
|
| Rate for Payer: Cash Price |
$1,863.20
|
| Rate for Payer: Cash Price |
$1,863.20
|
| Rate for Payer: Cofinity Commercial |
$1,247.30
|
| Rate for Payer: Cofinity Commercial |
$1,340.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$930.82
|
| Rate for Payer: Mclaren Medicaid |
$598.96
|
| Rate for Payer: Meridian Medicaid |
$628.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$977.36
|
| Rate for Payer: PACE SWMI |
$930.82
|
| Rate for Payer: PHP Medicare Advantage |
$930.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$598.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,643.98
|
| Rate for Payer: Priority Health Medicare |
$930.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,643.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$930.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$930.82
|
| Rate for Payer: UHC Medicare Advantage |
$958.74
|
|
|
PR REALIGNMENT EXTENSOR TENDON HAND EACH TENDON
|
Professional
|
Both
|
$1,555.00
|
|
|
Service Code
|
HCPCS 26437
|
| Min. Negotiated Rate |
$147.92 |
| Max. Negotiated Rate |
$1,088.50 |
| Rate for Payer: Aetna Commercial |
$874.02
|
| Rate for Payer: Aetna Medicare |
$678.34
|
| Rate for Payer: BCBS Complete |
$454.01
|
| Rate for Payer: BCBS MAPPO |
$652.25
|
| Rate for Payer: BCBS Trust/PPO |
$147.92
|
| Rate for Payer: BCN Commercial |
$993.97
|
| Rate for Payer: BCN Medicare Advantage |
$652.25
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cofinity Commercial |
$939.24
|
| Rate for Payer: Cofinity Commercial |
$874.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$652.25
|
| Rate for Payer: Mclaren Medicaid |
$432.39
|
| Rate for Payer: Meridian Medicaid |
$454.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$684.86
|
| Rate for Payer: PACE SWMI |
$652.25
|
| Rate for Payer: PHP Medicare Advantage |
$652.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,088.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,038.67
|
| Rate for Payer: Priority Health Medicare |
$652.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,038.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$652.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$652.25
|
| Rate for Payer: UHC Medicare Advantage |
$671.82
|
|
|
PR REAORT VALV W CP BYPASS
|
Professional
|
Both
|
$7,886.00
|
|
|
Service Code
|
HCPCS 33400
|
| Min. Negotiated Rate |
$3,154.40 |
| Max. Negotiated Rate |
$5,520.20 |
| Rate for Payer: BCBS Complete |
$3,154.40
|
| Rate for Payer: Cash Price |
$6,308.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,520.20
|
|
|
PR RECMPL WND LID,NOS,EAR <1 CM
|
Professional
|
Both
|
$591.00
|
|
|
Service Code
|
HCPCS 13150
|
| Min. Negotiated Rate |
$236.40 |
| Max. Negotiated Rate |
$413.70 |
| Rate for Payer: BCBS Complete |
$236.40
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$413.70
|
|
|
PR RECONSTRUCTION EXTERNAL AUDITORY CANAL SPX
|
Professional
|
Both
|
$3,397.00
|
|
|
Service Code
|
HCPCS 69310
|
| Min. Negotiated Rate |
$716.53 |
| Max. Negotiated Rate |
$2,377.90 |
| Rate for Payer: Aetna Commercial |
$1,455.86
|
| Rate for Payer: Aetna Medicare |
$1,129.92
|
| Rate for Payer: BCBS Complete |
$752.36
|
| Rate for Payer: BCBS MAPPO |
$1,086.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,074.63
|
| Rate for Payer: BCN Commercial |
$1,653.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,086.46
|
| Rate for Payer: Cash Price |
$2,717.60
|
| Rate for Payer: Cash Price |
$2,717.60
|
| Rate for Payer: Cofinity Commercial |
$1,455.86
|
| Rate for Payer: Cofinity Commercial |
$1,564.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,086.46
|
| Rate for Payer: Mclaren Medicaid |
$716.53
|
| Rate for Payer: Meridian Medicaid |
$752.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,140.78
|
| Rate for Payer: PACE SWMI |
$1,086.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,086.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$716.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,377.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,594.94
|
| Rate for Payer: Priority Health Medicare |
$1,086.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,594.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,086.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,086.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,119.05
|
|
|
PR RECONSTRUCTION NAIL BED W/GRAFT
|
Professional
|
Both
|
$438.00
|
|
|
Service Code
|
HCPCS 11762
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$421.24 |
| Rate for Payer: Aetna Commercial |
$243.80
|
| Rate for Payer: Aetna Medicare |
$189.22
|
| Rate for Payer: BCBS Complete |
$125.46
|
| Rate for Payer: BCBS MAPPO |
$181.94
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$421.24
|
| Rate for Payer: BCN Medicare Advantage |
$181.94
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cofinity Commercial |
$261.99
|
| Rate for Payer: Cofinity Commercial |
$243.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.94
|
| Rate for Payer: Mclaren Medicaid |
$119.49
|
| Rate for Payer: Meridian Medicaid |
$125.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$191.04
|
| Rate for Payer: PACE SWMI |
$181.94
|
| Rate for Payer: PHP Medicare Advantage |
$181.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$306.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.12
|
| Rate for Payer: Priority Health Medicare |
$181.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$181.94
|
| Rate for Payer: UHC Medicare Advantage |
$187.40
|
|
|
PR RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC
|
Facility
|
IP
|
$3,908.00
|
|
|
Service Code
|
CPT 23420
|
| Hospital Charge Code |
23420
|
| Min. Negotiated Rate |
$2,383.49 |
| Max. Negotiated Rate |
$3,517.20 |
| Rate for Payer: Aetna Commercial |
$3,321.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,020.10
|
| Rate for Payer: BCN Commercial |
$3,020.10
|
| Rate for Payer: Cash Price |
$3,126.40
|
| Rate for Payer: Cofinity Commercial |
$3,360.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,126.40
|
| Rate for Payer: Healthscope Commercial |
$3,517.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,931.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,321.80
|
| Rate for Payer: PHP Commercial |
$3,321.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,735.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,399.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,383.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,439.04
|
| Rate for Payer: UHC Core |
$3,263.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,931.00
|
|
|
PR RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC
|
Professional
|
Both
|
$3,908.00
|
|
|
Service Code
|
HCPCS 23420
|
| Min. Negotiated Rate |
$120.13 |
| Max. Negotiated Rate |
$2,735.60 |
| Rate for Payer: Aetna Commercial |
$1,286.68
|
| Rate for Payer: Aetna Medicare |
$998.62
|
| Rate for Payer: BCBS Complete |
$660.44
|
| Rate for Payer: BCBS MAPPO |
$960.21
|
| Rate for Payer: BCBS Trust/PPO |
$120.13
|
| Rate for Payer: BCN Commercial |
$1,576.02
|
| Rate for Payer: BCN Medicare Advantage |
$960.21
|
| Rate for Payer: Cash Price |
$3,126.40
|
| Rate for Payer: Cash Price |
$3,126.40
|
| Rate for Payer: Cofinity Commercial |
$1,382.70
|
| Rate for Payer: Cofinity Commercial |
$1,286.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$960.21
|
| Rate for Payer: Mclaren Medicaid |
$628.99
|
| Rate for Payer: Meridian Medicaid |
$660.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,008.22
|
| Rate for Payer: PACE SWMI |
$960.21
|
| Rate for Payer: PHP Medicare Advantage |
$960.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$628.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,735.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,495.70
|
| Rate for Payer: Priority Health Medicare |
$960.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,495.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$960.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$960.21
|
| Rate for Payer: UHC Medicare Advantage |
$989.02
|
|
|
PR RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC
|
Facility
|
OP
|
$3,908.00
|
|
|
Service Code
|
CPT 23420
|
| Hospital Charge Code |
23420
|
| Min. Negotiated Rate |
$928.15 |
| Max. Negotiated Rate |
$4,927.66 |
| Rate for Payer: Aetna Commercial |
$3,321.80
|
| Rate for Payer: Aetna Medicare |
$1,016.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,221.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,221.25
|
| Rate for Payer: BCBS Complete |
$4,927.66
|
| Rate for Payer: BCBS MAPPO |
$977.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,038.47
|
| Rate for Payer: BCN Commercial |
$3,038.47
|
| Rate for Payer: BCN Medicare Advantage |
$977.00
|
| Rate for Payer: Cash Price |
$3,126.40
|
| Rate for Payer: Cash Price |
$3,126.40
|
| Rate for Payer: Cofinity Commercial |
$3,360.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,126.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$977.00
|
| Rate for Payer: Healthscope Commercial |
$3,517.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,931.00
|
| Rate for Payer: Mclaren Medicaid |
$4,693.01
|
| Rate for Payer: Meridian Medicaid |
$4,927.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,025.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,123.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,321.80
|
| Rate for Payer: PACE Senior Care Partners |
$928.15
|
| Rate for Payer: PACE SWMI |
$977.00
|
| Rate for Payer: PHP Commercial |
$3,321.80
|
| Rate for Payer: PHP Medicare Advantage |
$977.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,693.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,735.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,399.96
|
| Rate for Payer: Priority Health Medicare |
$977.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,383.49
|
| Rate for Payer: Railroad Medicare Medicare |
$977.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,439.04
|
| Rate for Payer: UHC Core |
$3,263.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$977.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,006.31
|
| Rate for Payer: VA VA |
$977.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,931.00
|
|
|
PR RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC
|
Professional
|
Both
|
$3,908.00
|
|
|
Service Code
|
HCPCS 23420
|
| Hospital Charge Code |
23420
|
| Min. Negotiated Rate |
$120.13 |
| Max. Negotiated Rate |
$2,735.60 |
| Rate for Payer: Aetna Commercial |
$1,286.68
|
| Rate for Payer: Aetna Medicare |
$998.62
|
| Rate for Payer: BCBS Complete |
$660.44
|
| Rate for Payer: BCBS MAPPO |
$960.21
|
| Rate for Payer: BCBS Trust/PPO |
$120.13
|
| Rate for Payer: BCN Commercial |
$1,576.02
|
| Rate for Payer: BCN Medicare Advantage |
$960.21
|
| Rate for Payer: Cash Price |
$3,126.40
|
| Rate for Payer: Cash Price |
$3,126.40
|
| Rate for Payer: Cofinity Commercial |
$1,382.70
|
| Rate for Payer: Cofinity Commercial |
$1,286.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$960.21
|
| Rate for Payer: Mclaren Medicaid |
$628.99
|
| Rate for Payer: Meridian Medicaid |
$660.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,008.22
|
| Rate for Payer: PACE SWMI |
$960.21
|
| Rate for Payer: PHP Medicare Advantage |
$960.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$628.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,735.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,495.70
|
| Rate for Payer: Priority Health Medicare |
$960.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,495.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$960.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$960.21
|
| Rate for Payer: UHC Medicare Advantage |
$989.02
|
|
|
PR RECONSTRUCTION TOE POLYDACTYLY
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 28344
|
| Min. Negotiated Rate |
$180.20 |
| Max. Negotiated Rate |
$2,741.35 |
| Rate for Payer: Aetna Commercial |
$363.76
|
| Rate for Payer: Aetna Medicare |
$282.32
|
| Rate for Payer: BCBS Complete |
$189.21
|
| Rate for Payer: BCBS MAPPO |
$271.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,741.35
|
| Rate for Payer: BCN Commercial |
$607.43
|
| Rate for Payer: BCN Medicare Advantage |
$271.46
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cofinity Commercial |
$390.90
|
| Rate for Payer: Cofinity Commercial |
$363.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.46
|
| Rate for Payer: Mclaren Medicaid |
$180.20
|
| Rate for Payer: Meridian Medicaid |
$189.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$285.03
|
| Rate for Payer: PACE SWMI |
$271.46
|
| Rate for Payer: PHP Medicare Advantage |
$271.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$180.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$423.83
|
| Rate for Payer: Priority Health Medicare |
$271.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$423.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$271.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$271.46
|
| Rate for Payer: UHC Medicare Advantage |
$279.60
|
|
|
PR RECONSTRUCTION VENA CAVA ANY METHOD
|
Professional
|
Both
|
$2,352.00
|
|
|
Service Code
|
HCPCS 34502
|
| Min. Negotiated Rate |
$970.85 |
| Max. Negotiated Rate |
$2,399.01 |
| Rate for Payer: Aetna Commercial |
$2,021.95
|
| Rate for Payer: Aetna Medicare |
$1,569.28
|
| Rate for Payer: BCBS Complete |
$1,019.39
|
| Rate for Payer: BCBS MAPPO |
$1,508.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,399.01
|
| Rate for Payer: BCN Commercial |
$2,200.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,508.92
|
| Rate for Payer: Cash Price |
$1,881.60
|
| Rate for Payer: Cash Price |
$1,881.60
|
| Rate for Payer: Cofinity Commercial |
$2,172.84
|
| Rate for Payer: Cofinity Commercial |
$2,021.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,508.92
|
| Rate for Payer: Mclaren Medicaid |
$970.85
|
| Rate for Payer: Meridian Medicaid |
$1,019.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,584.37
|
| Rate for Payer: PACE SWMI |
$1,508.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,508.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$970.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,394.87
|
| Rate for Payer: Priority Health Medicare |
$1,508.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,394.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,508.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,508.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,554.19
|
|
|
PR RECTAL SESATION TONE & COMPLIANCE TEST
|
Professional
|
Both
|
$696.00
|
|
|
Service Code
|
HCPCS 91120
|
| Min. Negotiated Rate |
$278.40 |
| Max. Negotiated Rate |
$1,003.77 |
| Rate for Payer: Aetna Commercial |
$638.04
|
| Rate for Payer: Aetna Commercial |
$638.04
|
| Rate for Payer: Aetna Medicare |
$495.20
|
| Rate for Payer: Aetna Medicare |
$495.20
|
| Rate for Payer: BCBS Complete |
$36.00
|
| Rate for Payer: BCBS Complete |
$278.40
|
| Rate for Payer: BCBS MAPPO |
$476.15
|
| Rate for Payer: BCBS MAPPO |
$476.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.77
|
| Rate for Payer: BCN Commercial |
$748.66
|
| Rate for Payer: BCN Commercial |
$748.66
|
| Rate for Payer: BCN Medicare Advantage |
$476.15
|
| Rate for Payer: BCN Medicare Advantage |
$476.15
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$556.80
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$556.80
|
| Rate for Payer: Cofinity Commercial |
$685.66
|
| Rate for Payer: Cofinity Commercial |
$685.66
|
| Rate for Payer: Cofinity Commercial |
$638.04
|
| Rate for Payer: Cofinity Commercial |
$638.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$499.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$499.96
|
| Rate for Payer: PACE SWMI |
$476.15
|
| Rate for Payer: PACE SWMI |
$476.15
|
| Rate for Payer: PHP Medicare Advantage |
$476.15
|
| Rate for Payer: PHP Medicare Advantage |
$476.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$688.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$688.08
|
| Rate for Payer: Priority Health Medicare |
$476.15
|
| Rate for Payer: Priority Health Medicare |
$476.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$688.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$688.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$476.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$476.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$476.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$476.15
|
| Rate for Payer: UHC Medicare Advantage |
$490.43
|
| Rate for Payer: UHC Medicare Advantage |
$490.43
|
|
|
PR RECTAL TUMOR EXCISION TRANSANAL ENDOSCOPIC
|
Professional
|
Both
|
$1,758.00
|
|
|
Service Code
|
HCPCS 0184T
|
| Min. Negotiated Rate |
$25.64 |
| Max. Negotiated Rate |
$4,847.67 |
| Rate for Payer: Aetna Commercial |
$771.30
|
| Rate for Payer: BCBS Complete |
$703.20
|
| Rate for Payer: BCBS Trust/PPO |
$25.64
|
| Rate for Payer: BCN Commercial |
$4,847.67
|
| Rate for Payer: Cash Price |
$1,406.40
|
| Rate for Payer: Cash Price |
$1,406.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,230.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,238.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,238.26
|
|
|
PR REGION IV LOCAL ANESTH,UPPER/LOWER EXT
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS 01995
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.50 |
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.50
|
|
|
PR REIMPLANTATION ANOMALOUS PULMONARY ARTERY
|
Professional
|
Both
|
$6,572.00
|
|
|
Service Code
|
HCPCS 33788
|
| Min. Negotiated Rate |
$963.19 |
| Max. Negotiated Rate |
$4,600.40 |
| Rate for Payer: Aetna Commercial |
$2,023.39
|
| Rate for Payer: Aetna Medicare |
$1,570.39
|
| Rate for Payer: BCBS Complete |
$1,011.35
|
| Rate for Payer: BCBS MAPPO |
$1,509.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,462.33
|
| Rate for Payer: BCN Commercial |
$2,201.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,509.99
|
| Rate for Payer: Cash Price |
$5,257.60
|
| Rate for Payer: Cash Price |
$5,257.60
|
| Rate for Payer: Cofinity Commercial |
$2,174.39
|
| Rate for Payer: Cofinity Commercial |
$2,023.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,509.99
|
| Rate for Payer: Mclaren Medicaid |
$963.19
|
| Rate for Payer: Meridian Medicaid |
$1,011.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,585.49
|
| Rate for Payer: PACE SWMI |
$1,509.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,509.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$963.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,600.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,395.94
|
| Rate for Payer: Priority Health Medicare |
$1,509.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,395.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,509.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,509.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,555.29
|
|
|
PR REINSERTION SPINAL FIXATION DEVICE
|
Professional
|
Both
|
$4,902.00
|
|
|
Service Code
|
HCPCS 22849
|
| Min. Negotiated Rate |
$136.69 |
| Max. Negotiated Rate |
$3,431.40 |
| Rate for Payer: Aetna Commercial |
$1,742.35
|
| Rate for Payer: Aetna Medicare |
$1,352.27
|
| Rate for Payer: BCBS Complete |
$884.09
|
| Rate for Payer: BCBS MAPPO |
$1,300.26
|
| Rate for Payer: BCBS Trust/PPO |
$136.69
|
| Rate for Payer: BCN Commercial |
$2,110.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,300.26
|
| Rate for Payer: Cash Price |
$3,921.60
|
| Rate for Payer: Cash Price |
$3,921.60
|
| Rate for Payer: Cofinity Commercial |
$1,742.35
|
| Rate for Payer: Cofinity Commercial |
$1,872.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,300.26
|
| Rate for Payer: Mclaren Medicaid |
$841.99
|
| Rate for Payer: Meridian Medicaid |
$884.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,365.27
|
| Rate for Payer: PACE SWMI |
$1,300.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,300.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$841.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,431.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,003.27
|
| Rate for Payer: Priority Health Medicare |
$1,300.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,003.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,300.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,300.26
|
| Rate for Payer: UHC Medicare Advantage |
$1,339.27
|
|
|
PR RELEASE INTRINSIC MUSCLES HAND EACH MUSCLE
|
Professional
|
Both
|
$1,023.00
|
|
|
Service Code
|
HCPCS 26593
|
| Min. Negotiated Rate |
$390.41 |
| Max. Negotiated Rate |
$1,003.93 |
| Rate for Payer: Aetna Commercial |
$843.07
|
| Rate for Payer: Aetna Medicare |
$654.33
|
| Rate for Payer: BCBS Complete |
$439.03
|
| Rate for Payer: BCBS MAPPO |
$629.16
|
| Rate for Payer: BCBS Trust/PPO |
$390.41
|
| Rate for Payer: BCN Commercial |
$960.74
|
| Rate for Payer: BCN Medicare Advantage |
$629.16
|
| Rate for Payer: Cash Price |
$818.40
|
| Rate for Payer: Cash Price |
$818.40
|
| Rate for Payer: Cofinity Commercial |
$905.99
|
| Rate for Payer: Cofinity Commercial |
$843.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$629.16
|
| Rate for Payer: Mclaren Medicaid |
$418.12
|
| Rate for Payer: Meridian Medicaid |
$439.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$660.62
|
| Rate for Payer: PACE SWMI |
$629.16
|
| Rate for Payer: PHP Medicare Advantage |
$629.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$716.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.93
|
| Rate for Payer: Priority Health Medicare |
$629.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,003.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$629.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$629.16
|
| Rate for Payer: UHC Medicare Advantage |
$648.03
|
|
|
PR RELEASE/RECESSION HAMSTRING PROXIMAL
|
Professional
|
Both
|
$2,280.00
|
|
|
Service Code
|
HCPCS 27097
|
| Min. Negotiated Rate |
$443.04 |
| Max. Negotiated Rate |
$1,596.00 |
| Rate for Payer: Aetna Commercial |
$905.37
|
| Rate for Payer: Aetna Medicare |
$702.68
|
| Rate for Payer: BCBS Complete |
$465.19
|
| Rate for Payer: BCBS MAPPO |
$675.65
|
| Rate for Payer: BCBS Trust/PPO |
$828.90
|
| Rate for Payer: BCN Commercial |
$1,008.63
|
| Rate for Payer: BCN Medicare Advantage |
$675.65
|
| Rate for Payer: Cash Price |
$1,824.00
|
| Rate for Payer: Cash Price |
$1,824.00
|
| Rate for Payer: Cofinity Commercial |
$905.37
|
| Rate for Payer: Cofinity Commercial |
$972.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.65
|
| Rate for Payer: Mclaren Medicaid |
$443.04
|
| Rate for Payer: Meridian Medicaid |
$465.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$709.43
|
| Rate for Payer: PACE SWMI |
$675.65
|
| Rate for Payer: PHP Medicare Advantage |
$675.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,596.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,053.98
|
| Rate for Payer: Priority Health Medicare |
$675.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,053.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$675.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$675.65
|
| Rate for Payer: UHC Medicare Advantage |
$695.92
|
|
|
PR RELEASE TARSAL TUNNEL
|
Professional
|
Both
|
$1,357.00
|
|
|
Service Code
|
HCPCS 28035
|
| Min. Negotiated Rate |
$184.38 |
| Max. Negotiated Rate |
$949.90 |
| Rate for Payer: Aetna Commercial |
$469.88
|
| Rate for Payer: Aetna Medicare |
$364.69
|
| Rate for Payer: BCBS Complete |
$243.11
|
| Rate for Payer: BCBS MAPPO |
$350.66
|
| Rate for Payer: BCBS Trust/PPO |
$184.38
|
| Rate for Payer: BCN Commercial |
$771.63
|
| Rate for Payer: BCN Medicare Advantage |
$350.66
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cofinity Commercial |
$469.88
|
| Rate for Payer: Cofinity Commercial |
$504.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$350.66
|
| Rate for Payer: Mclaren Medicaid |
$231.53
|
| Rate for Payer: Meridian Medicaid |
$243.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$368.19
|
| Rate for Payer: PACE SWMI |
$350.66
|
| Rate for Payer: PHP Medicare Advantage |
$350.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$231.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$949.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$547.93
|
| Rate for Payer: Priority Health Medicare |
$350.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$350.66
|
| Rate for Payer: UHC Medicare Advantage |
$361.18
|
|
