|
PR EXC NEUROFIBROMA/NEUROLEMMOMA MAJOR PRPH NRV
|
Professional
|
Both
|
$2,381.00
|
|
|
Service Code
|
HCPCS 64790
|
| Min. Negotiated Rate |
$160.07 |
| Max. Negotiated Rate |
$1,547.65 |
| Rate for Payer: Aetna Commercial |
$1,112.94
|
| Rate for Payer: Aetna Medicare |
$863.77
|
| Rate for Payer: BCBS Complete |
$583.73
|
| Rate for Payer: BCBS MAPPO |
$830.55
|
| Rate for Payer: BCBS Trust/PPO |
$160.07
|
| Rate for Payer: BCN Commercial |
$1,243.68
|
| Rate for Payer: BCN Medicare Advantage |
$830.55
|
| Rate for Payer: Cash Price |
$1,904.80
|
| Rate for Payer: Cash Price |
$1,904.80
|
| Rate for Payer: Cofinity Commercial |
$1,195.99
|
| Rate for Payer: Cofinity Commercial |
$1,112.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$830.55
|
| Rate for Payer: Mclaren Medicaid |
$555.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$872.08
|
| Rate for Payer: Meridian Medicaid |
$583.73
|
| Rate for Payer: Nomi Health Commercial |
$996.66
|
| Rate for Payer: PACE SWMI |
$830.55
|
| Rate for Payer: PHP Medicare Advantage |
$830.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$555.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,547.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,465.02
|
| Rate for Payer: Priority Health Medicare |
$838.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,465.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$830.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$830.55
|
| Rate for Payer: UHC Exchange |
$830.55
|
| Rate for Payer: UHC Medicare Advantage |
$830.55
|
| Rate for Payer: UHCCP Medicaid |
$555.93
|
|
|
PR EXC NEUROMA CUTAN NRV SURGLY IDENTIFIABLE
|
Professional
|
Both
|
$1,218.00
|
|
|
Service Code
|
HCPCS 64774
|
| Min. Negotiated Rate |
$266.26 |
| Max. Negotiated Rate |
$791.70 |
| Rate for Payer: Aetna Commercial |
$554.29
|
| Rate for Payer: Aetna Medicare |
$430.20
|
| Rate for Payer: BCBS Complete |
$293.87
|
| Rate for Payer: BCBS MAPPO |
$413.65
|
| Rate for Payer: BCBS Trust/PPO |
$266.26
|
| Rate for Payer: BCN Commercial |
$627.46
|
| Rate for Payer: BCN Medicare Advantage |
$413.65
|
| Rate for Payer: Cash Price |
$974.40
|
| Rate for Payer: Cash Price |
$974.40
|
| Rate for Payer: Cofinity Commercial |
$595.66
|
| Rate for Payer: Cofinity Commercial |
$554.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.65
|
| Rate for Payer: Mclaren Medicaid |
$279.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$434.33
|
| Rate for Payer: Meridian Medicaid |
$293.87
|
| Rate for Payer: Nomi Health Commercial |
$496.38
|
| Rate for Payer: PACE SWMI |
$413.65
|
| Rate for Payer: PHP Medicare Advantage |
$413.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$279.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$791.70
|
| Rate for Payer: Priority Health HMO/PPO |
$739.90
|
| Rate for Payer: Priority Health Medicare |
$417.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$739.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$413.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$413.65
|
| Rate for Payer: UHC Exchange |
$413.65
|
| Rate for Payer: UHC Medicare Advantage |
$413.65
|
| Rate for Payer: UHCCP Medicaid |
$279.88
|
|
|
PR EXC NEUROMA DIGITAL NERVE 1 OR BOTH SAME DIGIT
|
Professional
|
Both
|
$1,259.00
|
|
|
Service Code
|
HCPCS 64776
|
| Min. Negotiated Rate |
$262.42 |
| Max. Negotiated Rate |
$818.35 |
| Rate for Payer: Aetna Commercial |
$518.42
|
| Rate for Payer: Aetna Medicare |
$402.36
|
| Rate for Payer: BCBS Complete |
$275.54
|
| Rate for Payer: BCBS MAPPO |
$386.88
|
| Rate for Payer: BCBS Trust/PPO |
$302.19
|
| Rate for Payer: BCN Commercial |
$584.95
|
| Rate for Payer: BCN Medicare Advantage |
$386.88
|
| Rate for Payer: Cash Price |
$1,007.20
|
| Rate for Payer: Cash Price |
$1,007.20
|
| Rate for Payer: Cofinity Commercial |
$518.42
|
| Rate for Payer: Cofinity Commercial |
$557.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$386.88
|
| Rate for Payer: Mclaren Medicaid |
$262.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.22
|
| Rate for Payer: Meridian Medicaid |
$275.54
|
| Rate for Payer: Nomi Health Commercial |
$464.26
|
| Rate for Payer: PACE SWMI |
$386.88
|
| Rate for Payer: PHP Medicare Advantage |
$386.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$818.35
|
| Rate for Payer: Priority Health HMO/PPO |
$700.09
|
| Rate for Payer: Priority Health Medicare |
$390.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$700.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$386.88
|
| Rate for Payer: UHC Exchange |
$386.88
|
| Rate for Payer: UHC Medicare Advantage |
$386.88
|
| Rate for Payer: UHCCP Medicaid |
$262.42
|
|
|
PR EXC NEUROMA HAND/FOOT EA NRV XCP SM DGT
|
Professional
|
Both
|
$445.00
|
|
|
Service Code
|
HCPCS 64783
|
| Min. Negotiated Rate |
$136.96 |
| Max. Negotiated Rate |
$362.83 |
| Rate for Payer: Aetna Commercial |
$276.84
|
| Rate for Payer: Aetna Medicare |
$214.86
|
| Rate for Payer: BCBS Complete |
$143.81
|
| Rate for Payer: BCBS MAPPO |
$206.60
|
| Rate for Payer: BCN Commercial |
$311.78
|
| Rate for Payer: BCN Medicare Advantage |
$206.60
|
| Rate for Payer: Cash Price |
$356.00
|
| Rate for Payer: Cash Price |
$356.00
|
| Rate for Payer: Cofinity Commercial |
$297.50
|
| Rate for Payer: Cofinity Commercial |
$276.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.60
|
| Rate for Payer: Mclaren Medicaid |
$136.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.93
|
| Rate for Payer: Meridian Medicaid |
$143.81
|
| Rate for Payer: Nomi Health Commercial |
$247.92
|
| Rate for Payer: PACE SWMI |
$206.60
|
| Rate for Payer: PHP Medicare Advantage |
$206.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.25
|
| Rate for Payer: Priority Health HMO/PPO |
$362.83
|
| Rate for Payer: Priority Health Medicare |
$208.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$362.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$206.60
|
| Rate for Payer: UHC Exchange |
$206.60
|
| Rate for Payer: UHC Medicare Advantage |
$206.60
|
| Rate for Payer: UHCCP Medicaid |
$136.96
|
|
|
PR EXC NEUROMA HAND/FOOT XCP DIGITAL NERVE
|
Professional
|
Both
|
$1,694.00
|
|
|
Service Code
|
HCPCS 64782
|
| Min. Negotiated Rate |
$298.84 |
| Max. Negotiated Rate |
$1,101.10 |
| Rate for Payer: Aetna Commercial |
$591.70
|
| Rate for Payer: Aetna Medicare |
$459.23
|
| Rate for Payer: BCBS Complete |
$313.78
|
| Rate for Payer: BCBS MAPPO |
$441.57
|
| Rate for Payer: BCBS Trust/PPO |
$306.94
|
| Rate for Payer: BCN Commercial |
$666.56
|
| Rate for Payer: BCN Medicare Advantage |
$441.57
|
| Rate for Payer: Cash Price |
$1,355.20
|
| Rate for Payer: Cash Price |
$1,355.20
|
| Rate for Payer: Cofinity Commercial |
$635.86
|
| Rate for Payer: Cofinity Commercial |
$591.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.57
|
| Rate for Payer: Mclaren Medicaid |
$298.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$463.65
|
| Rate for Payer: Meridian Medicaid |
$313.78
|
| Rate for Payer: Nomi Health Commercial |
$529.88
|
| Rate for Payer: PACE SWMI |
$441.57
|
| Rate for Payer: PHP Medicare Advantage |
$441.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,101.10
|
| Rate for Payer: Priority Health HMO/PPO |
$784.25
|
| Rate for Payer: Priority Health Medicare |
$445.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$784.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$441.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$441.57
|
| Rate for Payer: UHC Exchange |
$441.57
|
| Rate for Payer: UHC Medicare Advantage |
$441.57
|
| Rate for Payer: UHCCP Medicaid |
$298.84
|
|
|
PR EXC NEUROMA MAJOR PERIPHERAL NRV XCP SCIATIC
|
Professional
|
Both
|
$2,489.00
|
|
|
Service Code
|
HCPCS 64784
|
| Min. Negotiated Rate |
$128.38 |
| Max. Negotiated Rate |
$1,617.85 |
| Rate for Payer: Aetna Commercial |
$940.63
|
| Rate for Payer: Aetna Medicare |
$730.04
|
| Rate for Payer: BCBS Complete |
$496.05
|
| Rate for Payer: BCBS MAPPO |
$701.96
|
| Rate for Payer: BCBS Trust/PPO |
$128.38
|
| Rate for Payer: BCN Commercial |
$1,063.36
|
| Rate for Payer: BCN Medicare Advantage |
$701.96
|
| Rate for Payer: Cash Price |
$1,991.20
|
| Rate for Payer: Cash Price |
$1,991.20
|
| Rate for Payer: Cofinity Commercial |
$940.63
|
| Rate for Payer: Cofinity Commercial |
$1,010.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$701.96
|
| Rate for Payer: Mclaren Medicaid |
$472.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$737.06
|
| Rate for Payer: Meridian Medicaid |
$496.05
|
| Rate for Payer: Nomi Health Commercial |
$842.35
|
| Rate for Payer: PACE SWMI |
$701.96
|
| Rate for Payer: PHP Medicare Advantage |
$701.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,617.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,244.91
|
| Rate for Payer: Priority Health Medicare |
$708.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,244.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$701.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$701.96
|
| Rate for Payer: UHC Exchange |
$701.96
|
| Rate for Payer: UHC Medicare Advantage |
$701.96
|
| Rate for Payer: UHCCP Medicaid |
$472.43
|
|
|
PR EXC PRESAC/SACROCOCCYGEAL TUMOR
|
Professional
|
Both
|
$4,000.00
|
|
|
Service Code
|
HCPCS 49215
|
| Min. Negotiated Rate |
$757.05 |
| Max. Negotiated Rate |
$3,963.18 |
| Rate for Payer: Aetna Commercial |
$2,857.43
|
| Rate for Payer: Aetna Medicare |
$2,217.71
|
| Rate for Payer: BCBS Complete |
$1,484.82
|
| Rate for Payer: BCBS MAPPO |
$2,132.41
|
| Rate for Payer: BCBS Trust/PPO |
$757.05
|
| Rate for Payer: BCN Commercial |
$3,195.95
|
| Rate for Payer: BCN Medicare Advantage |
$2,132.41
|
| Rate for Payer: Cash Price |
$3,200.00
|
| Rate for Payer: Cash Price |
$3,200.00
|
| Rate for Payer: Cofinity Commercial |
$3,070.67
|
| Rate for Payer: Cofinity Commercial |
$2,857.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,132.41
|
| Rate for Payer: Mclaren Medicaid |
$1,414.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,239.03
|
| Rate for Payer: Meridian Medicaid |
$1,484.82
|
| Rate for Payer: Nomi Health Commercial |
$2,558.89
|
| Rate for Payer: PACE SWMI |
$2,132.41
|
| Rate for Payer: PHP Medicare Advantage |
$2,132.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,414.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,600.00
|
| Rate for Payer: Priority Health HMO/PPO |
$3,963.18
|
| Rate for Payer: Priority Health Medicare |
$2,153.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,963.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,132.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,132.41
|
| Rate for Payer: UHC Exchange |
$2,132.41
|
| Rate for Payer: UHC Medicare Advantage |
$2,132.41
|
| Rate for Payer: UHCCP Medicaid |
$1,414.11
|
|
|
PR EXC PRTD TUM/PRTD GLND LAT DSJ&PRSRV FACIAL NR
|
Professional
|
Both
|
$1,787.00
|
|
|
Service Code
|
HCPCS 42415
|
| Min. Negotiated Rate |
$284.75 |
| Max. Negotiated Rate |
$1,903.13 |
| Rate for Payer: Aetna Commercial |
$1,358.10
|
| Rate for Payer: Aetna Medicare |
$1,054.05
|
| Rate for Payer: BCBS Complete |
$715.46
|
| Rate for Payer: BCBS MAPPO |
$1,013.51
|
| Rate for Payer: BCBS Trust/PPO |
$284.75
|
| Rate for Payer: BCN Commercial |
$1,551.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,013.51
|
| Rate for Payer: Cash Price |
$1,429.60
|
| Rate for Payer: Cash Price |
$1,429.60
|
| Rate for Payer: Cofinity Commercial |
$1,459.45
|
| Rate for Payer: Cofinity Commercial |
$1,358.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,013.51
|
| Rate for Payer: Mclaren Medicaid |
$681.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,064.19
|
| Rate for Payer: Meridian Medicaid |
$715.46
|
| Rate for Payer: Nomi Health Commercial |
$1,216.21
|
| Rate for Payer: PACE SWMI |
$1,013.51
|
| Rate for Payer: PHP Medicare Advantage |
$1,013.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$681.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,161.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,903.13
|
| Rate for Payer: Priority Health Medicare |
$1,023.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,903.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,013.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,013.51
|
| Rate for Payer: UHC Exchange |
$1,013.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,013.51
|
| Rate for Payer: UHCCP Medicaid |
$681.39
|
|
|
PR EXC PRTD TUM/PRTD GLND LAT LOBE W/O NRV DSJ
|
Professional
|
Both
|
$1,184.00
|
|
|
Service Code
|
HCPCS 42410
|
| Min. Negotiated Rate |
$160.60 |
| Max. Negotiated Rate |
$1,136.52 |
| Rate for Payer: Aetna Commercial |
$806.63
|
| Rate for Payer: Aetna Medicare |
$626.04
|
| Rate for Payer: BCBS Complete |
$426.50
|
| Rate for Payer: BCBS MAPPO |
$601.96
|
| Rate for Payer: BCBS Trust/PPO |
$160.60
|
| Rate for Payer: BCN Commercial |
$926.05
|
| Rate for Payer: BCN Medicare Advantage |
$601.96
|
| Rate for Payer: Cash Price |
$947.20
|
| Rate for Payer: Cash Price |
$947.20
|
| Rate for Payer: Cofinity Commercial |
$866.82
|
| Rate for Payer: Cofinity Commercial |
$806.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$601.96
|
| Rate for Payer: Mclaren Medicaid |
$406.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$632.06
|
| Rate for Payer: Meridian Medicaid |
$426.50
|
| Rate for Payer: Nomi Health Commercial |
$722.35
|
| Rate for Payer: PACE SWMI |
$601.96
|
| Rate for Payer: PHP Medicare Advantage |
$601.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$406.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$769.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,136.52
|
| Rate for Payer: Priority Health Medicare |
$607.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,136.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$601.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$601.96
|
| Rate for Payer: UHC Exchange |
$601.96
|
| Rate for Payer: UHC Medicare Advantage |
$601.96
|
| Rate for Payer: UHCCP Medicaid |
$406.19
|
|
|
PR EXC PRTD TUM/PRTD GLND TOT DSJ&PRSRV FACIAL NR
|
Professional
|
Both
|
$2,032.00
|
|
|
Service Code
|
HCPCS 42420
|
| Min. Negotiated Rate |
$279.47 |
| Max. Negotiated Rate |
$2,128.06 |
| Rate for Payer: Aetna Commercial |
$1,521.56
|
| Rate for Payer: Aetna Medicare |
$1,180.91
|
| Rate for Payer: BCBS Complete |
$800.67
|
| Rate for Payer: BCBS MAPPO |
$1,135.49
|
| Rate for Payer: BCBS Trust/PPO |
$279.47
|
| Rate for Payer: BCN Commercial |
$1,737.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,135.49
|
| Rate for Payer: Cash Price |
$1,625.60
|
| Rate for Payer: Cash Price |
$1,625.60
|
| Rate for Payer: Cofinity Commercial |
$1,635.11
|
| Rate for Payer: Cofinity Commercial |
$1,521.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,135.49
|
| Rate for Payer: Mclaren Medicaid |
$762.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,192.26
|
| Rate for Payer: Meridian Medicaid |
$800.67
|
| Rate for Payer: Nomi Health Commercial |
$1,362.59
|
| Rate for Payer: PACE SWMI |
$1,135.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,135.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$762.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,320.80
|
| Rate for Payer: Priority Health HMO/PPO |
$2,128.06
|
| Rate for Payer: Priority Health Medicare |
$1,146.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,128.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,135.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,135.49
|
| Rate for Payer: UHC Exchange |
$1,135.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,135.49
|
| Rate for Payer: UHCCP Medicaid |
$762.54
|
|
|
PR EXC RCT PROCIDENTIA W/ANAST ABDL & PRNL APPROACH
|
Professional
|
Both
|
$2,703.00
|
|
|
Service Code
|
HCPCS 45135
|
| Min. Negotiated Rate |
$826.87 |
| Max. Negotiated Rate |
$2,305.83 |
| Rate for Payer: Aetna Commercial |
$1,653.20
|
| Rate for Payer: Aetna Medicare |
$1,283.08
|
| Rate for Payer: BCBS Complete |
$868.21
|
| Rate for Payer: BCBS MAPPO |
$1,233.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,920.90
|
| Rate for Payer: BCN Commercial |
$1,878.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,233.73
|
| Rate for Payer: Cash Price |
$2,162.40
|
| Rate for Payer: Cash Price |
$2,162.40
|
| Rate for Payer: Cofinity Commercial |
$1,776.57
|
| Rate for Payer: Cofinity Commercial |
$1,653.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,233.73
|
| Rate for Payer: Mclaren Medicaid |
$826.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,295.42
|
| Rate for Payer: Meridian Medicaid |
$868.21
|
| Rate for Payer: Nomi Health Commercial |
$1,480.48
|
| Rate for Payer: PACE SWMI |
$1,233.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,233.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$826.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,756.95
|
| Rate for Payer: Priority Health HMO/PPO |
$2,305.83
|
| Rate for Payer: Priority Health Medicare |
$1,246.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,305.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,233.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,233.73
|
| Rate for Payer: UHC Exchange |
$1,233.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,233.73
|
| Rate for Payer: UHCCP Medicaid |
$826.87
|
|
|
PR EXC RCT PROCIDENTIA W/ANAST PERINEAL APPROACH
|
Professional
|
Both
|
$2,827.00
|
|
|
Service Code
|
HCPCS 45130
|
| Min. Negotiated Rate |
$692.46 |
| Max. Negotiated Rate |
$2,249.50 |
| Rate for Payer: Aetna Commercial |
$1,390.73
|
| Rate for Payer: Aetna Medicare |
$1,079.37
|
| Rate for Payer: BCBS Complete |
$727.08
|
| Rate for Payer: BCBS MAPPO |
$1,037.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,249.50
|
| Rate for Payer: BCN Commercial |
$1,574.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,037.86
|
| Rate for Payer: Cash Price |
$2,261.60
|
| Rate for Payer: Cash Price |
$2,261.60
|
| Rate for Payer: Cofinity Commercial |
$1,494.52
|
| Rate for Payer: Cofinity Commercial |
$1,390.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,037.86
|
| Rate for Payer: Mclaren Medicaid |
$692.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,089.75
|
| Rate for Payer: Meridian Medicaid |
$727.08
|
| Rate for Payer: Nomi Health Commercial |
$1,245.43
|
| Rate for Payer: PACE SWMI |
$1,037.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,037.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,837.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,930.57
|
| Rate for Payer: Priority Health Medicare |
$1,048.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,930.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,037.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,037.86
|
| Rate for Payer: UHC Exchange |
$1,037.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,037.86
|
| Rate for Payer: UHCCP Medicaid |
$692.46
|
|
|
PR EXC RCT TUM INCL MUSCULARIS PROPRIA
|
Professional
|
Both
|
$1,883.00
|
|
|
Service Code
|
HCPCS 45172
|
| Min. Negotiated Rate |
$478.64 |
| Max. Negotiated Rate |
$1,476.58 |
| Rate for Payer: Aetna Commercial |
$1,053.01
|
| Rate for Payer: Aetna Medicare |
$817.26
|
| Rate for Payer: BCBS Complete |
$556.22
|
| Rate for Payer: BCBS MAPPO |
$785.83
|
| Rate for Payer: BCBS Trust/PPO |
$478.64
|
| Rate for Payer: BCN Commercial |
$1,203.12
|
| Rate for Payer: BCN Medicare Advantage |
$785.83
|
| Rate for Payer: Cash Price |
$1,506.40
|
| Rate for Payer: Cash Price |
$1,506.40
|
| Rate for Payer: Cofinity Commercial |
$1,131.60
|
| Rate for Payer: Cofinity Commercial |
$1,053.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$785.83
|
| Rate for Payer: Mclaren Medicaid |
$529.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$825.12
|
| Rate for Payer: Meridian Medicaid |
$556.22
|
| Rate for Payer: Nomi Health Commercial |
$943.00
|
| Rate for Payer: PACE SWMI |
$785.83
|
| Rate for Payer: PHP Medicare Advantage |
$785.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$529.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,223.95
|
| Rate for Payer: Priority Health HMO/PPO |
$1,476.58
|
| Rate for Payer: Priority Health Medicare |
$793.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,476.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$785.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$785.83
|
| Rate for Payer: UHC Exchange |
$785.83
|
| Rate for Payer: UHC Medicare Advantage |
$785.83
|
| Rate for Payer: UHCCP Medicaid |
$529.73
|
|
|
PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA
|
Professional
|
Both
|
$1,370.00
|
|
|
Service Code
|
HCPCS 45171
|
| Min. Negotiated Rate |
$398.52 |
| Max. Negotiated Rate |
$2,751.91 |
| Rate for Payer: Aetna Commercial |
$787.65
|
| Rate for Payer: Aetna Medicare |
$611.31
|
| Rate for Payer: BCBS Complete |
$418.45
|
| Rate for Payer: BCBS MAPPO |
$587.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,751.91
|
| Rate for Payer: BCN Commercial |
$905.03
|
| Rate for Payer: BCN Medicare Advantage |
$587.80
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cofinity Commercial |
$846.43
|
| Rate for Payer: Cofinity Commercial |
$787.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$587.80
|
| Rate for Payer: Mclaren Medicaid |
$398.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$617.19
|
| Rate for Payer: Meridian Medicaid |
$418.45
|
| Rate for Payer: Nomi Health Commercial |
$705.36
|
| Rate for Payer: PACE SWMI |
$587.80
|
| Rate for Payer: PHP Medicare Advantage |
$587.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$398.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,109.06
|
| Rate for Payer: Priority Health Medicare |
$593.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,109.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$587.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$587.80
|
| Rate for Payer: UHC Exchange |
$587.80
|
| Rate for Payer: UHC Medicare Advantage |
$587.80
|
| Rate for Payer: UHCCP Medicaid |
$398.52
|
|
|
PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA
|
Facility
|
IP
|
$1,370.00
|
|
|
Service Code
|
CPT 45171
|
| Hospital Charge Code |
45171
|
| Min. Negotiated Rate |
$890.50 |
| Max. Negotiated Rate |
$1,233.00 |
| Rate for Payer: Aetna Commercial |
$1,164.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,118.33
|
| Rate for Payer: BCN Commercial |
$1,058.74
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cofinity Commercial |
$1,178.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,096.00
|
| Rate for Payer: Healthscope Commercial |
$1,233.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,027.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,164.50
|
| Rate for Payer: Nomi Health Commercial |
$1,123.40
|
| Rate for Payer: PHP Commercial |
$1,164.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,191.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$917.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,205.60
|
| Rate for Payer: UHC Core |
$1,143.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,027.50
|
|
|
PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA
|
Facility
|
OP
|
$1,370.00
|
|
|
Service Code
|
CPT 45171
|
| Hospital Charge Code |
45171
|
| Min. Negotiated Rate |
$325.38 |
| Max. Negotiated Rate |
$2,039.92 |
| Rate for Payer: Aetna Commercial |
$1,164.50
|
| Rate for Payer: Aetna Medicare |
$356.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$428.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$428.12
|
| Rate for Payer: BCBS Complete |
$2,039.92
|
| Rate for Payer: BCBS MAPPO |
$342.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,126.28
|
| Rate for Payer: BCN Commercial |
$1,065.18
|
| Rate for Payer: BCN Medicare Advantage |
$342.50
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cofinity Commercial |
$1,178.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,096.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.50
|
| Rate for Payer: Healthscope Commercial |
$1,233.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,027.50
|
| Rate for Payer: Mclaren Medicaid |
$1,942.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$359.62
|
| Rate for Payer: Meridian Medicaid |
$2,039.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,164.50
|
| Rate for Payer: Nomi Health Commercial |
$1,123.40
|
| Rate for Payer: PACE Senior Care Partners |
$325.38
|
| Rate for Payer: PACE SWMI |
$342.50
|
| Rate for Payer: PHP Commercial |
$1,164.50
|
| Rate for Payer: PHP Medicare Advantage |
$342.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,942.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,191.90
|
| Rate for Payer: Priority Health Medicare |
$345.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$917.90
|
| Rate for Payer: Railroad Medicare Medicare |
$342.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,205.60
|
| Rate for Payer: UHC Core |
$1,143.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$342.50
|
| Rate for Payer: UHC Exchange |
$342.50
|
| Rate for Payer: UHC Medicare Advantage |
$342.50
|
| Rate for Payer: UHCCP Medicaid |
$1,942.66
|
| Rate for Payer: VA VA |
$342.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,027.50
|
|
|
PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA
|
Professional
|
Both
|
$1,370.00
|
|
|
Service Code
|
HCPCS 45171
|
| Hospital Charge Code |
45171
|
| Min. Negotiated Rate |
$398.52 |
| Max. Negotiated Rate |
$2,751.91 |
| Rate for Payer: Aetna Commercial |
$787.65
|
| Rate for Payer: Aetna Medicare |
$611.31
|
| Rate for Payer: BCBS Complete |
$418.45
|
| Rate for Payer: BCBS MAPPO |
$587.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,751.91
|
| Rate for Payer: BCN Commercial |
$905.03
|
| Rate for Payer: BCN Medicare Advantage |
$587.80
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cash Price |
$1,096.00
|
| Rate for Payer: Cofinity Commercial |
$846.43
|
| Rate for Payer: Cofinity Commercial |
$787.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$587.80
|
| Rate for Payer: Mclaren Medicaid |
$398.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$617.19
|
| Rate for Payer: Meridian Medicaid |
$418.45
|
| Rate for Payer: Nomi Health Commercial |
$705.36
|
| Rate for Payer: PACE SWMI |
$587.80
|
| Rate for Payer: PHP Medicare Advantage |
$587.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$398.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,109.06
|
| Rate for Payer: Priority Health Medicare |
$593.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,109.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$587.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$587.80
|
| Rate for Payer: UHC Exchange |
$587.80
|
| Rate for Payer: UHC Medicare Advantage |
$587.80
|
| Rate for Payer: UHCCP Medicaid |
$398.52
|
|
|
PR EXC RCT TUM PROCTOTOMY TRANSSAC/TRANSCOCCYGEAL
|
Professional
|
Both
|
$2,092.00
|
|
|
Service Code
|
HCPCS 45160
|
| Min. Negotiated Rate |
$662.43 |
| Max. Negotiated Rate |
$1,843.47 |
| Rate for Payer: Aetna Commercial |
$1,338.27
|
| Rate for Payer: Aetna Medicare |
$1,038.66
|
| Rate for Payer: BCBS Complete |
$695.55
|
| Rate for Payer: BCBS MAPPO |
$998.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,753.43
|
| Rate for Payer: BCN Commercial |
$1,500.73
|
| Rate for Payer: BCN Medicare Advantage |
$998.71
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cash Price |
$1,673.60
|
| Rate for Payer: Cofinity Commercial |
$1,438.14
|
| Rate for Payer: Cofinity Commercial |
$1,338.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$998.71
|
| Rate for Payer: Mclaren Medicaid |
$662.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,048.65
|
| Rate for Payer: Meridian Medicaid |
$695.55
|
| Rate for Payer: Nomi Health Commercial |
$1,198.45
|
| Rate for Payer: PACE SWMI |
$998.71
|
| Rate for Payer: PHP Medicare Advantage |
$998.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$662.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.80
|
| Rate for Payer: Priority Health HMO/PPO |
$1,843.47
|
| Rate for Payer: Priority Health Medicare |
$1,008.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,843.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$998.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$998.71
|
| Rate for Payer: UHC Exchange |
$998.71
|
| Rate for Payer: UHC Medicare Advantage |
$998.71
|
| Rate for Payer: UHCCP Medicaid |
$662.43
|
|
|
PR EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF CLSR
|
Professional
|
Both
|
$1,549.00
|
|
|
Service Code
|
HCPCS 15936
|
| Min. Negotiated Rate |
$573.40 |
| Max. Negotiated Rate |
$2,625.00 |
| Rate for Payer: Aetna Commercial |
$1,145.43
|
| Rate for Payer: Aetna Medicare |
$888.99
|
| Rate for Payer: BCBS Complete |
$602.07
|
| Rate for Payer: BCBS MAPPO |
$854.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,625.00
|
| Rate for Payer: BCN Commercial |
$1,319.92
|
| Rate for Payer: BCN Medicare Advantage |
$854.80
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cofinity Commercial |
$1,230.91
|
| Rate for Payer: Cofinity Commercial |
$1,145.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$854.80
|
| Rate for Payer: Mclaren Medicaid |
$573.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$897.54
|
| Rate for Payer: Meridian Medicaid |
$602.07
|
| Rate for Payer: Nomi Health Commercial |
$1,025.76
|
| Rate for Payer: PACE SWMI |
$854.80
|
| Rate for Payer: PHP Medicare Advantage |
$854.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,219.55
|
| Rate for Payer: Priority Health Medicare |
$863.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,219.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$854.80
|
| Rate for Payer: UHC Exchange |
$854.80
|
| Rate for Payer: UHC Medicare Advantage |
$854.80
|
| Rate for Payer: UHCCP Medicaid |
$573.40
|
|
|
PR EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF OSTC
|
Professional
|
Both
|
$2,107.00
|
|
|
Service Code
|
HCPCS 15937
|
| Min. Negotiated Rate |
$632.82 |
| Max. Negotiated Rate |
$1,527.61 |
| Rate for Payer: Aetna Commercial |
$1,260.74
|
| Rate for Payer: Aetna Medicare |
$978.48
|
| Rate for Payer: BCBS Complete |
$664.46
|
| Rate for Payer: BCBS MAPPO |
$940.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,266.07
|
| Rate for Payer: BCN Commercial |
$1,527.61
|
| Rate for Payer: BCN Medicare Advantage |
$940.85
|
| Rate for Payer: Cash Price |
$1,685.60
|
| Rate for Payer: Cash Price |
$1,685.60
|
| Rate for Payer: Cofinity Commercial |
$1,354.82
|
| Rate for Payer: Cofinity Commercial |
$1,260.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$940.85
|
| Rate for Payer: Mclaren Medicaid |
$632.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$987.89
|
| Rate for Payer: Meridian Medicaid |
$664.46
|
| Rate for Payer: Nomi Health Commercial |
$1,129.02
|
| Rate for Payer: PACE SWMI |
$940.85
|
| Rate for Payer: PHP Medicare Advantage |
$940.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$632.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,369.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,406.48
|
| Rate for Payer: Priority Health Medicare |
$950.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,406.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$940.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$940.85
|
| Rate for Payer: UHC Exchange |
$940.85
|
| Rate for Payer: UHC Medicare Advantage |
$940.85
|
| Rate for Payer: UHCCP Medicaid |
$632.82
|
|
|
PR EXC SUBLINGUAL SALIVARY CYST RANULA
|
Professional
|
Both
|
$728.00
|
|
|
Service Code
|
HCPCS 42408
|
| Min. Negotiated Rate |
$226.21 |
| Max. Negotiated Rate |
$801.43 |
| Rate for Payer: Aetna Commercial |
$442.88
|
| Rate for Payer: Aetna Medicare |
$343.73
|
| Rate for Payer: BCBS Complete |
$237.52
|
| Rate for Payer: BCBS MAPPO |
$330.51
|
| Rate for Payer: BCBS Trust/PPO |
$229.28
|
| Rate for Payer: BCN Commercial |
$801.43
|
| Rate for Payer: BCN Medicare Advantage |
$330.51
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cofinity Commercial |
$475.93
|
| Rate for Payer: Cofinity Commercial |
$442.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$330.51
|
| Rate for Payer: Mclaren Medicaid |
$226.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$347.04
|
| Rate for Payer: Meridian Medicaid |
$237.52
|
| Rate for Payer: Nomi Health Commercial |
$396.61
|
| Rate for Payer: PACE SWMI |
$330.51
|
| Rate for Payer: PHP Medicare Advantage |
$330.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.20
|
| Rate for Payer: Priority Health HMO/PPO |
$625.83
|
| Rate for Payer: Priority Health Medicare |
$333.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$625.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$330.51
|
| Rate for Payer: UHC Exchange |
$330.51
|
| Rate for Payer: UHC Medicare Advantage |
$330.51
|
| Rate for Payer: UHCCP Medicaid |
$226.21
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Professional
|
Both
|
$1,802.00
|
|
|
Service Code
|
HCPCS 25109
|
| Hospital Charge Code |
25109
|
| Min. Negotiated Rate |
$353.58 |
| Max. Negotiated Rate |
$1,326.56 |
| Rate for Payer: Aetna Commercial |
$696.79
|
| Rate for Payer: Aetna Medicare |
$540.79
|
| Rate for Payer: BCBS Complete |
$371.26
|
| Rate for Payer: BCBS MAPPO |
$519.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,326.56
|
| Rate for Payer: BCN Commercial |
$794.10
|
| Rate for Payer: BCN Medicare Advantage |
$519.99
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$748.79
|
| Rate for Payer: Cofinity Commercial |
$696.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.99
|
| Rate for Payer: Mclaren Medicaid |
$353.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.99
|
| Rate for Payer: Meridian Medicaid |
$371.26
|
| Rate for Payer: Nomi Health Commercial |
$623.99
|
| Rate for Payer: PACE SWMI |
$519.99
|
| Rate for Payer: PHP Medicare Advantage |
$519.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health HMO/PPO |
$835.04
|
| Rate for Payer: Priority Health Medicare |
$525.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$835.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.99
|
| Rate for Payer: UHC Exchange |
$519.99
|
| Rate for Payer: UHC Medicare Advantage |
$519.99
|
| Rate for Payer: UHCCP Medicaid |
$353.58
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Professional
|
Both
|
$1,802.00
|
|
|
Service Code
|
HCPCS 25109
|
| Min. Negotiated Rate |
$353.58 |
| Max. Negotiated Rate |
$1,326.56 |
| Rate for Payer: Aetna Commercial |
$696.79
|
| Rate for Payer: Aetna Medicare |
$540.79
|
| Rate for Payer: BCBS Complete |
$371.26
|
| Rate for Payer: BCBS MAPPO |
$519.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,326.56
|
| Rate for Payer: BCN Commercial |
$794.10
|
| Rate for Payer: BCN Medicare Advantage |
$519.99
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$748.79
|
| Rate for Payer: Cofinity Commercial |
$696.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.99
|
| Rate for Payer: Mclaren Medicaid |
$353.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.99
|
| Rate for Payer: Meridian Medicaid |
$371.26
|
| Rate for Payer: Nomi Health Commercial |
$623.99
|
| Rate for Payer: PACE SWMI |
$519.99
|
| Rate for Payer: PHP Medicare Advantage |
$519.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health HMO/PPO |
$835.04
|
| Rate for Payer: Priority Health Medicare |
$525.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$835.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.99
|
| Rate for Payer: UHC Exchange |
$519.99
|
| Rate for Payer: UHC Medicare Advantage |
$519.99
|
| Rate for Payer: UHCCP Medicaid |
$353.58
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Facility
|
IP
|
$1,802.00
|
|
|
Service Code
|
CPT 25109
|
| Hospital Charge Code |
25109
|
| Min. Negotiated Rate |
$1,171.30 |
| Max. Negotiated Rate |
$1,621.80 |
| Rate for Payer: Aetna Commercial |
$1,531.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,470.97
|
| Rate for Payer: BCN Commercial |
$1,392.59
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$1,549.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,441.60
|
| Rate for Payer: Healthscope Commercial |
$1,621.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,351.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,531.70
|
| Rate for Payer: Nomi Health Commercial |
$1,477.64
|
| Rate for Payer: PHP Commercial |
$1,531.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,567.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,207.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,585.76
|
| Rate for Payer: UHC Core |
$1,504.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,351.50
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Facility
|
OP
|
$1,802.00
|
|
|
Service Code
|
CPT 25109
|
| Hospital Charge Code |
25109
|
| Min. Negotiated Rate |
$427.98 |
| Max. Negotiated Rate |
$2,413.50 |
| Rate for Payer: Aetna Commercial |
$1,531.70
|
| Rate for Payer: Aetna Medicare |
$468.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$563.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$563.12
|
| Rate for Payer: BCBS Complete |
$2,413.50
|
| Rate for Payer: BCBS MAPPO |
$450.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,481.42
|
| Rate for Payer: BCN Commercial |
$1,401.06
|
| Rate for Payer: BCN Medicare Advantage |
$450.50
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$1,549.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,441.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$450.50
|
| Rate for Payer: Healthscope Commercial |
$1,621.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,351.50
|
| Rate for Payer: Mclaren Medicaid |
$2,298.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$473.02
|
| Rate for Payer: Meridian Medicaid |
$2,413.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$518.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,531.70
|
| Rate for Payer: Nomi Health Commercial |
$1,477.64
|
| Rate for Payer: PACE Senior Care Partners |
$427.98
|
| Rate for Payer: PACE SWMI |
$450.50
|
| Rate for Payer: PHP Commercial |
$1,531.70
|
| Rate for Payer: PHP Medicare Advantage |
$450.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,298.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,567.74
|
| Rate for Payer: Priority Health Medicare |
$455.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,207.34
|
| Rate for Payer: Railroad Medicare Medicare |
$450.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,585.76
|
| Rate for Payer: UHC Core |
$1,504.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$450.50
|
| Rate for Payer: UHC Exchange |
$450.50
|
| Rate for Payer: UHC Medicare Advantage |
$450.50
|
| Rate for Payer: UHCCP Medicaid |
$2,298.42
|
| Rate for Payer: VA VA |
$450.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,351.50
|
|
