|
PR NERVE CONDUCTION STUDIES 3-4 STUDIES
|
Professional
|
Both
|
$218.00
|
|
|
Service Code
|
HCPCS 95908
|
| Min. Negotiated Rate |
$87.20 |
| Max. Negotiated Rate |
$145.83 |
| Rate for Payer: Aetna Commercial |
$135.70
|
| Rate for Payer: Aetna Commercial |
$135.70
|
| Rate for Payer: Aetna Medicare |
$105.32
|
| Rate for Payer: Aetna Medicare |
$105.32
|
| Rate for Payer: BCBS Complete |
$87.20
|
| Rate for Payer: BCBS Complete |
$135.60
|
| Rate for Payer: BCBS MAPPO |
$101.27
|
| Rate for Payer: BCBS MAPPO |
$101.27
|
| Rate for Payer: BCN Medicare Advantage |
$101.27
|
| Rate for Payer: BCN Medicare Advantage |
$101.27
|
| Rate for Payer: Cash Price |
$271.20
|
| Rate for Payer: Cash Price |
$271.20
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cofinity Commercial |
$145.83
|
| Rate for Payer: Cofinity Commercial |
$135.70
|
| Rate for Payer: Cofinity Commercial |
$145.83
|
| Rate for Payer: Cofinity Commercial |
$135.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.33
|
| Rate for Payer: Nomi Health Commercial |
$121.52
|
| Rate for Payer: Nomi Health Commercial |
$121.52
|
| Rate for Payer: PACE SWMI |
$101.27
|
| Rate for Payer: PACE SWMI |
$101.27
|
| Rate for Payer: PHP Medicare Advantage |
$101.27
|
| Rate for Payer: PHP Medicare Advantage |
$101.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.35
|
| Rate for Payer: Priority Health Medicare |
$102.28
|
| Rate for Payer: Priority Health Medicare |
$102.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.27
|
| Rate for Payer: UHC Exchange |
$101.27
|
| Rate for Payer: UHC Exchange |
$101.27
|
| Rate for Payer: UHC Medicare Advantage |
$101.27
|
| Rate for Payer: UHC Medicare Advantage |
$101.27
|
|
|
PR NERVE CONDUCTION STUDIES 5-6 STUDIES
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 95909
|
| Min. Negotiated Rate |
$107.60 |
| Max. Negotiated Rate |
$175.41 |
| Rate for Payer: Aetna Commercial |
$163.23
|
| Rate for Payer: Aetna Commercial |
$163.23
|
| Rate for Payer: Aetna Medicare |
$126.68
|
| Rate for Payer: Aetna Medicare |
$126.68
|
| Rate for Payer: BCBS Complete |
$107.60
|
| Rate for Payer: BCBS Complete |
$162.40
|
| Rate for Payer: BCBS MAPPO |
$121.81
|
| Rate for Payer: BCBS MAPPO |
$121.81
|
| Rate for Payer: BCN Medicare Advantage |
$121.81
|
| Rate for Payer: BCN Medicare Advantage |
$121.81
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$175.41
|
| Rate for Payer: Cofinity Commercial |
$163.23
|
| Rate for Payer: Cofinity Commercial |
$175.41
|
| Rate for Payer: Cofinity Commercial |
$163.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.90
|
| Rate for Payer: Nomi Health Commercial |
$146.17
|
| Rate for Payer: Nomi Health Commercial |
$146.17
|
| Rate for Payer: PACE SWMI |
$121.81
|
| Rate for Payer: PACE SWMI |
$121.81
|
| Rate for Payer: PHP Medicare Advantage |
$121.81
|
| Rate for Payer: PHP Medicare Advantage |
$121.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.90
|
| Rate for Payer: Priority Health Medicare |
$123.03
|
| Rate for Payer: Priority Health Medicare |
$123.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.81
|
| Rate for Payer: UHC Exchange |
$121.81
|
| Rate for Payer: UHC Exchange |
$121.81
|
| Rate for Payer: UHC Medicare Advantage |
$121.81
|
| Rate for Payer: UHC Medicare Advantage |
$121.81
|
|
|
PR NERVE CONDUCTION STUDIES 7-8 STUDIES
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 95910
|
| Min. Negotiated Rate |
$152.40 |
| Max. Negotiated Rate |
$247.65 |
| Rate for Payer: Aetna Commercial |
$213.56
|
| Rate for Payer: Aetna Commercial |
$213.56
|
| Rate for Payer: Aetna Medicare |
$165.74
|
| Rate for Payer: Aetna Medicare |
$165.74
|
| Rate for Payer: BCBS Complete |
$152.40
|
| Rate for Payer: BCBS Complete |
$213.60
|
| Rate for Payer: BCBS MAPPO |
$159.37
|
| Rate for Payer: BCBS MAPPO |
$159.37
|
| Rate for Payer: BCN Medicare Advantage |
$159.37
|
| Rate for Payer: BCN Medicare Advantage |
$159.37
|
| Rate for Payer: Cash Price |
$427.20
|
| Rate for Payer: Cash Price |
$427.20
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cofinity Commercial |
$229.49
|
| Rate for Payer: Cofinity Commercial |
$213.56
|
| Rate for Payer: Cofinity Commercial |
$229.49
|
| Rate for Payer: Cofinity Commercial |
$213.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.34
|
| Rate for Payer: Nomi Health Commercial |
$191.24
|
| Rate for Payer: Nomi Health Commercial |
$191.24
|
| Rate for Payer: PACE SWMI |
$159.37
|
| Rate for Payer: PACE SWMI |
$159.37
|
| Rate for Payer: PHP Medicare Advantage |
$159.37
|
| Rate for Payer: PHP Medicare Advantage |
$159.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.10
|
| Rate for Payer: Priority Health Medicare |
$160.96
|
| Rate for Payer: Priority Health Medicare |
$160.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.37
|
| Rate for Payer: UHC Exchange |
$159.37
|
| Rate for Payer: UHC Exchange |
$159.37
|
| Rate for Payer: UHC Medicare Advantage |
$159.37
|
| Rate for Payer: UHC Medicare Advantage |
$159.37
|
|
|
PR NERVE CONDUCTION STUDIES 9-10 STUDIES
|
Professional
|
Both
|
$453.00
|
|
|
Service Code
|
HCPCS 95911
|
| Min. Negotiated Rate |
$181.20 |
| Max. Negotiated Rate |
$294.45 |
| Rate for Payer: Aetna Commercial |
$256.89
|
| Rate for Payer: Aetna Commercial |
$256.89
|
| Rate for Payer: Aetna Medicare |
$199.38
|
| Rate for Payer: Aetna Medicare |
$199.38
|
| Rate for Payer: BCBS Complete |
$181.20
|
| Rate for Payer: BCBS Complete |
$258.80
|
| Rate for Payer: BCBS MAPPO |
$191.71
|
| Rate for Payer: BCBS MAPPO |
$191.71
|
| Rate for Payer: BCN Medicare Advantage |
$191.71
|
| Rate for Payer: BCN Medicare Advantage |
$191.71
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Cash Price |
$362.40
|
| Rate for Payer: Cash Price |
$362.40
|
| Rate for Payer: Cofinity Commercial |
$276.06
|
| Rate for Payer: Cofinity Commercial |
$256.89
|
| Rate for Payer: Cofinity Commercial |
$276.06
|
| Rate for Payer: Cofinity Commercial |
$256.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.30
|
| Rate for Payer: Nomi Health Commercial |
$230.05
|
| Rate for Payer: Nomi Health Commercial |
$230.05
|
| Rate for Payer: PACE SWMI |
$191.71
|
| Rate for Payer: PACE SWMI |
$191.71
|
| Rate for Payer: PHP Medicare Advantage |
$191.71
|
| Rate for Payer: PHP Medicare Advantage |
$191.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.55
|
| Rate for Payer: Priority Health Medicare |
$193.63
|
| Rate for Payer: Priority Health Medicare |
$193.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.71
|
| Rate for Payer: UHC Exchange |
$191.71
|
| Rate for Payer: UHC Exchange |
$191.71
|
| Rate for Payer: UHC Medicare Advantage |
$191.71
|
| Rate for Payer: UHC Medicare Advantage |
$191.71
|
|
|
PR NERVE GRAFT 1 STRAND ARM/LEG <4 CM
|
Professional
|
Both
|
$2,147.00
|
|
|
Service Code
|
HCPCS 64892
|
| Min. Negotiated Rate |
$858.80 |
| Max. Negotiated Rate |
$1,454.96 |
| Rate for Payer: Aetna Commercial |
$1,353.92
|
| Rate for Payer: Aetna Medicare |
$1,050.81
|
| Rate for Payer: BCBS Complete |
$858.80
|
| Rate for Payer: BCBS MAPPO |
$1,010.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,010.39
|
| Rate for Payer: Cash Price |
$1,717.60
|
| Rate for Payer: Cash Price |
$1,717.60
|
| Rate for Payer: Cofinity Commercial |
$1,454.96
|
| Rate for Payer: Cofinity Commercial |
$1,353.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,010.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,060.91
|
| Rate for Payer: Nomi Health Commercial |
$1,212.47
|
| Rate for Payer: PACE SWMI |
$1,010.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,010.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,395.55
|
| Rate for Payer: Priority Health Medicare |
$1,020.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,010.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,010.39
|
| Rate for Payer: UHC Exchange |
$1,010.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,010.39
|
|
|
PR NERVE GRAFT 1 STRAND ARM/LEG >4 CM
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 64893
|
| Min. Negotiated Rate |
$693.60 |
| Max. Negotiated Rate |
$1,552.10 |
| Rate for Payer: Aetna Commercial |
$1,444.32
|
| Rate for Payer: Aetna Medicare |
$1,120.96
|
| Rate for Payer: BCBS Complete |
$693.60
|
| Rate for Payer: BCBS MAPPO |
$1,077.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,077.85
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$1,552.10
|
| Rate for Payer: Cofinity Commercial |
$1,444.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,077.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,131.74
|
| Rate for Payer: Nomi Health Commercial |
$1,293.42
|
| Rate for Payer: PACE SWMI |
$1,077.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,077.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health Medicare |
$1,088.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,077.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,077.85
|
| Rate for Payer: UHC Exchange |
$1,077.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,077.85
|
|
|
PR NERVE GRAFT 1 STRAND HAND/FOOT <4 CM
|
Professional
|
Both
|
$3,711.00
|
|
|
Service Code
|
HCPCS 64890
|
| Min. Negotiated Rate |
$1,038.69 |
| Max. Negotiated Rate |
$2,412.15 |
| Rate for Payer: Aetna Commercial |
$1,391.84
|
| Rate for Payer: Aetna Medicare |
$1,080.24
|
| Rate for Payer: BCBS Complete |
$1,484.40
|
| Rate for Payer: BCBS MAPPO |
$1,038.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,038.69
|
| Rate for Payer: Cash Price |
$2,968.80
|
| Rate for Payer: Cash Price |
$2,968.80
|
| Rate for Payer: Cofinity Commercial |
$1,495.71
|
| Rate for Payer: Cofinity Commercial |
$1,391.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,038.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,090.62
|
| Rate for Payer: Nomi Health Commercial |
$1,246.43
|
| Rate for Payer: PACE SWMI |
$1,038.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,038.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,412.15
|
| Rate for Payer: Priority Health Medicare |
$1,049.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,038.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,038.69
|
| Rate for Payer: UHC Exchange |
$1,038.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,038.69
|
|
|
PR NERVE GRAFT EACH NERVE MULTIPLE STRANDS
|
Professional
|
Both
|
$2,944.00
|
|
|
Service Code
|
HCPCS 64902
|
| Min. Negotiated Rate |
$657.92 |
| Max. Negotiated Rate |
$1,913.60 |
| Rate for Payer: Aetna Commercial |
$881.61
|
| Rate for Payer: Aetna Medicare |
$684.24
|
| Rate for Payer: BCBS Complete |
$1,177.60
|
| Rate for Payer: BCBS MAPPO |
$657.92
|
| Rate for Payer: BCN Medicare Advantage |
$657.92
|
| Rate for Payer: Cash Price |
$2,355.20
|
| Rate for Payer: Cash Price |
$2,355.20
|
| Rate for Payer: Cofinity Commercial |
$947.40
|
| Rate for Payer: Cofinity Commercial |
$881.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$657.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$690.82
|
| Rate for Payer: Nomi Health Commercial |
$789.50
|
| Rate for Payer: PACE SWMI |
$657.92
|
| Rate for Payer: PHP Medicare Advantage |
$657.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,913.60
|
| Rate for Payer: Priority Health Medicare |
$664.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$657.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$657.92
|
| Rate for Payer: UHC Exchange |
$657.92
|
| Rate for Payer: UHC Medicare Advantage |
$657.92
|
|
|
PR NERVE GRAFT MLT STRANDS ARM/LEG <4 CM
|
Professional
|
Both
|
$2,622.00
|
|
|
Service Code
|
HCPCS 64897
|
| Min. Negotiated Rate |
$1,048.80 |
| Max. Negotiated Rate |
$1,754.41 |
| Rate for Payer: Aetna Commercial |
$1,632.58
|
| Rate for Payer: Aetna Medicare |
$1,267.07
|
| Rate for Payer: BCBS Complete |
$1,048.80
|
| Rate for Payer: BCBS MAPPO |
$1,218.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,218.34
|
| Rate for Payer: Cash Price |
$2,097.60
|
| Rate for Payer: Cash Price |
$2,097.60
|
| Rate for Payer: Cofinity Commercial |
$1,754.41
|
| Rate for Payer: Cofinity Commercial |
$1,632.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,218.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,279.26
|
| Rate for Payer: Nomi Health Commercial |
$1,462.01
|
| Rate for Payer: PACE SWMI |
$1,218.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,218.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,704.30
|
| Rate for Payer: Priority Health Medicare |
$1,230.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,218.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,218.34
|
| Rate for Payer: UHC Exchange |
$1,218.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,218.34
|
|
|
PR NERVE GRAFT MLT STRANDS ARM/LEG >4 CM
|
Professional
|
Both
|
$3,191.00
|
|
|
Service Code
|
HCPCS 64898
|
| Min. Negotiated Rate |
$1,276.40 |
| Max. Negotiated Rate |
$2,074.15 |
| Rate for Payer: Aetna Commercial |
$1,768.02
|
| Rate for Payer: Aetna Medicare |
$1,372.20
|
| Rate for Payer: BCBS Complete |
$1,276.40
|
| Rate for Payer: BCBS MAPPO |
$1,319.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,319.42
|
| Rate for Payer: Cash Price |
$2,552.80
|
| Rate for Payer: Cash Price |
$2,552.80
|
| Rate for Payer: Cofinity Commercial |
$1,899.96
|
| Rate for Payer: Cofinity Commercial |
$1,768.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,319.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,385.39
|
| Rate for Payer: Nomi Health Commercial |
$1,583.30
|
| Rate for Payer: PACE SWMI |
$1,319.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,319.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,074.15
|
| Rate for Payer: Priority Health Medicare |
$1,332.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,319.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,319.42
|
| Rate for Payer: UHC Exchange |
$1,319.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,319.42
|
|
|
PR NERVE GRAFT MLT STRANDS HAND/FOOT <4 CM
|
Professional
|
Both
|
$3,215.00
|
|
|
Service Code
|
HCPCS 64895
|
| Min. Negotiated Rate |
$1,274.13 |
| Max. Negotiated Rate |
$2,089.75 |
| Rate for Payer: Aetna Commercial |
$1,707.33
|
| Rate for Payer: Aetna Medicare |
$1,325.10
|
| Rate for Payer: BCBS Complete |
$1,286.00
|
| Rate for Payer: BCBS MAPPO |
$1,274.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,274.13
|
| Rate for Payer: Cash Price |
$2,572.00
|
| Rate for Payer: Cash Price |
$2,572.00
|
| Rate for Payer: Cofinity Commercial |
$1,834.75
|
| Rate for Payer: Cofinity Commercial |
$1,707.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,274.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,337.84
|
| Rate for Payer: Nomi Health Commercial |
$1,528.96
|
| Rate for Payer: PACE SWMI |
$1,274.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,274.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,089.75
|
| Rate for Payer: Priority Health Medicare |
$1,286.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,274.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,274.13
|
| Rate for Payer: UHC Exchange |
$1,274.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,274.13
|
|
|
PR NERVE PEDICLE TRANSFER FIRST STAGE
|
Professional
|
Both
|
$2,227.00
|
|
|
Service Code
|
HCPCS 64905
|
| Min. Negotiated Rate |
$890.80 |
| Max. Negotiated Rate |
$1,447.55 |
| Rate for Payer: Aetna Commercial |
$1,281.52
|
| Rate for Payer: Aetna Medicare |
$994.61
|
| Rate for Payer: BCBS Complete |
$890.80
|
| Rate for Payer: BCBS MAPPO |
$956.36
|
| Rate for Payer: BCN Medicare Advantage |
$956.36
|
| Rate for Payer: Cash Price |
$1,781.60
|
| Rate for Payer: Cash Price |
$1,781.60
|
| Rate for Payer: Cofinity Commercial |
$1,377.16
|
| Rate for Payer: Cofinity Commercial |
$1,281.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$956.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,004.18
|
| Rate for Payer: Nomi Health Commercial |
$1,147.63
|
| Rate for Payer: PACE SWMI |
$956.36
|
| Rate for Payer: PHP Medicare Advantage |
$956.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,447.55
|
| Rate for Payer: Priority Health Medicare |
$965.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$956.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$956.36
|
| Rate for Payer: UHC Exchange |
$956.36
|
| Rate for Payer: UHC Medicare Advantage |
$956.36
|
|
|
PR NERVE REPAIR W/CONDUIT EACH NERVE
|
Professional
|
Both
|
$2,621.00
|
|
|
Service Code
|
HCPCS 64910
|
| Min. Negotiated Rate |
$727.42 |
| Max. Negotiated Rate |
$1,703.65 |
| Rate for Payer: Aetna Commercial |
$974.74
|
| Rate for Payer: Aetna Medicare |
$756.52
|
| Rate for Payer: BCBS Complete |
$1,048.40
|
| Rate for Payer: BCBS MAPPO |
$727.42
|
| Rate for Payer: BCN Medicare Advantage |
$727.42
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cofinity Commercial |
$974.74
|
| Rate for Payer: Cofinity Commercial |
$1,047.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$727.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$763.79
|
| Rate for Payer: Nomi Health Commercial |
$872.90
|
| Rate for Payer: PACE SWMI |
$727.42
|
| Rate for Payer: PHP Medicare Advantage |
$727.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,703.65
|
| Rate for Payer: Priority Health Medicare |
$734.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$727.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$727.42
|
| Rate for Payer: UHC Exchange |
$727.42
|
| Rate for Payer: UHC Medicare Advantage |
$727.42
|
|
|
PR NERVE REPAIR W/NERVE ALLOGRAFT EA ADDL STRAND
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 64913
|
| Min. Negotiated Rate |
$130.00 |
| Max. Negotiated Rate |
$235.74 |
| Rate for Payer: Aetna Commercial |
$219.37
|
| Rate for Payer: Aetna Medicare |
$170.26
|
| Rate for Payer: BCBS Complete |
$130.00
|
| Rate for Payer: BCBS MAPPO |
$163.71
|
| Rate for Payer: BCN Medicare Advantage |
$163.71
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$235.74
|
| Rate for Payer: Cofinity Commercial |
$219.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$171.90
|
| Rate for Payer: Nomi Health Commercial |
$196.45
|
| Rate for Payer: PACE SWMI |
$163.71
|
| Rate for Payer: PHP Medicare Advantage |
$163.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.25
|
| Rate for Payer: Priority Health Medicare |
$165.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.71
|
| Rate for Payer: UHC Exchange |
$163.71
|
| Rate for Payer: UHC Medicare Advantage |
$163.71
|
|
|
PR NERVE REPAIR W/NERVE ALLOGRAFT FIRST STRAND
|
Professional
|
Both
|
$1,592.00
|
|
|
Service Code
|
HCPCS 64912
|
| Min. Negotiated Rate |
$636.80 |
| Max. Negotiated Rate |
$1,226.55 |
| Rate for Payer: Aetna Commercial |
$1,141.37
|
| Rate for Payer: Aetna Medicare |
$885.84
|
| Rate for Payer: BCBS Complete |
$636.80
|
| Rate for Payer: BCBS MAPPO |
$851.77
|
| Rate for Payer: BCN Medicare Advantage |
$851.77
|
| Rate for Payer: Cash Price |
$1,273.60
|
| Rate for Payer: Cash Price |
$1,273.60
|
| Rate for Payer: Cofinity Commercial |
$1,226.55
|
| Rate for Payer: Cofinity Commercial |
$1,141.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$851.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$894.36
|
| Rate for Payer: Nomi Health Commercial |
$1,022.12
|
| Rate for Payer: PACE SWMI |
$851.77
|
| Rate for Payer: PHP Medicare Advantage |
$851.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,034.80
|
| Rate for Payer: Priority Health Medicare |
$860.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$851.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$851.77
|
| Rate for Payer: UHC Exchange |
$851.77
|
| Rate for Payer: UHC Medicare Advantage |
$851.77
|
|
|
PR NEURAXIAL LABOR ANALG/ANES PLND VAGINAL DELIVERY
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS 01967
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.25 |
| Rate for Payer: Aetna Medicare |
$2.50
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.25
|
|
|
PR NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR
|
Professional
|
Both
|
$216.00
|
|
|
Service Code
|
HCPCS 96116
|
| Min. Negotiated Rate |
$75.49 |
| Max. Negotiated Rate |
$140.40 |
| Rate for Payer: Aetna Commercial |
$101.16
|
| Rate for Payer: Aetna Medicare |
$78.51
|
| Rate for Payer: BCBS Complete |
$86.40
|
| Rate for Payer: BCBS MAPPO |
$75.49
|
| Rate for Payer: BCN Medicare Advantage |
$75.49
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cofinity Commercial |
$108.71
|
| Rate for Payer: Cofinity Commercial |
$101.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.26
|
| Rate for Payer: Nomi Health Commercial |
$90.59
|
| Rate for Payer: PACE SWMI |
$75.49
|
| Rate for Payer: PHP Medicare Advantage |
$75.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.40
|
| Rate for Payer: Priority Health Medicare |
$76.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.49
|
| Rate for Payer: UHC Exchange |
$75.49
|
| Rate for Payer: UHC Medicare Advantage |
$75.49
|
|
|
PR NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR
|
Professional
|
Both
|
$167.00
|
|
|
Service Code
|
HCPCS 96121
|
| Min. Negotiated Rate |
$63.31 |
| Max. Negotiated Rate |
$108.55 |
| Rate for Payer: Aetna Commercial |
$84.84
|
| Rate for Payer: Aetna Medicare |
$65.84
|
| Rate for Payer: BCBS Complete |
$66.80
|
| Rate for Payer: BCBS MAPPO |
$63.31
|
| Rate for Payer: BCN Medicare Advantage |
$63.31
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cofinity Commercial |
$91.17
|
| Rate for Payer: Cofinity Commercial |
$84.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.48
|
| Rate for Payer: Nomi Health Commercial |
$75.97
|
| Rate for Payer: PACE SWMI |
$63.31
|
| Rate for Payer: PHP Medicare Advantage |
$63.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.55
|
| Rate for Payer: Priority Health Medicare |
$63.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.31
|
| Rate for Payer: UHC Exchange |
$63.31
|
| Rate for Payer: UHC Medicare Advantage |
$63.31
|
|
|
PR NEUROENDOSCOPY ICRA W/RETRIEVAL FOREIGN BODY
|
Professional
|
Both
|
$4,388.00
|
|
|
Service Code
|
HCPCS 62164
|
| Min. Negotiated Rate |
$1,755.20 |
| Max. Negotiated Rate |
$2,993.17 |
| Rate for Payer: Aetna Commercial |
$2,785.31
|
| Rate for Payer: Aetna Medicare |
$2,161.73
|
| Rate for Payer: BCBS Complete |
$1,755.20
|
| Rate for Payer: BCBS MAPPO |
$2,078.59
|
| Rate for Payer: BCN Medicare Advantage |
$2,078.59
|
| Rate for Payer: Cash Price |
$3,510.40
|
| Rate for Payer: Cash Price |
$3,510.40
|
| Rate for Payer: Cofinity Commercial |
$2,993.17
|
| Rate for Payer: Cofinity Commercial |
$2,785.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,078.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,182.52
|
| Rate for Payer: Nomi Health Commercial |
$2,494.31
|
| Rate for Payer: PACE SWMI |
$2,078.59
|
| Rate for Payer: PHP Medicare Advantage |
$2,078.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,852.20
|
| Rate for Payer: Priority Health Medicare |
$2,099.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,078.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,078.59
|
| Rate for Payer: UHC Exchange |
$2,078.59
|
| Rate for Payer: UHC Medicare Advantage |
$2,078.59
|
|
|
PR NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH
|
Professional
|
Both
|
$156.00
|
|
|
Service Code
|
HCPCS 95937
|
| Min. Negotiated Rate |
$62.40 |
| Max. Negotiated Rate |
$132.18 |
| Rate for Payer: Aetna Commercial |
$123.00
|
| Rate for Payer: Aetna Medicare |
$95.46
|
| Rate for Payer: BCBS Complete |
$62.40
|
| Rate for Payer: BCBS MAPPO |
$91.79
|
| Rate for Payer: BCN Medicare Advantage |
$91.79
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cofinity Commercial |
$132.18
|
| Rate for Payer: Cofinity Commercial |
$123.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.38
|
| Rate for Payer: Nomi Health Commercial |
$110.15
|
| Rate for Payer: PACE SWMI |
$91.79
|
| Rate for Payer: PHP Medicare Advantage |
$91.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.40
|
| Rate for Payer: Priority Health Medicare |
$92.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.79
|
| Rate for Payer: UHC Exchange |
$91.79
|
| Rate for Payer: UHC Medicare Advantage |
$91.79
|
|
|
PR NEUROPLASTY DIGITAL 1/BOTH SAME DIGIT
|
Professional
|
Both
|
$2,488.00
|
|
|
Service Code
|
HCPCS 64702
|
| Min. Negotiated Rate |
$493.31 |
| Max. Negotiated Rate |
$1,617.20 |
| Rate for Payer: Aetna Commercial |
$661.04
|
| Rate for Payer: Aetna Medicare |
$513.04
|
| Rate for Payer: BCBS Complete |
$995.20
|
| Rate for Payer: BCBS MAPPO |
$493.31
|
| Rate for Payer: BCN Medicare Advantage |
$493.31
|
| Rate for Payer: Cash Price |
$1,990.40
|
| Rate for Payer: Cash Price |
$1,990.40
|
| Rate for Payer: Cofinity Commercial |
$710.37
|
| Rate for Payer: Cofinity Commercial |
$661.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$493.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$517.98
|
| Rate for Payer: Nomi Health Commercial |
$591.97
|
| Rate for Payer: PACE SWMI |
$493.31
|
| Rate for Payer: PHP Medicare Advantage |
$493.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,617.20
|
| Rate for Payer: Priority Health Medicare |
$498.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$493.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$493.31
|
| Rate for Payer: UHC Exchange |
$493.31
|
| Rate for Payer: UHC Medicare Advantage |
$493.31
|
|
|
PR NEUROPLASTY NERVE HAND/FOOT
|
Professional
|
Both
|
$1,888.00
|
|
|
Service Code
|
HCPCS 64704
|
| Min. Negotiated Rate |
$311.16 |
| Max. Negotiated Rate |
$1,227.20 |
| Rate for Payer: Aetna Commercial |
$416.95
|
| Rate for Payer: Aetna Medicare |
$323.61
|
| Rate for Payer: BCBS Complete |
$755.20
|
| Rate for Payer: BCBS MAPPO |
$311.16
|
| Rate for Payer: BCN Medicare Advantage |
$311.16
|
| Rate for Payer: Cash Price |
$1,510.40
|
| Rate for Payer: Cash Price |
$1,510.40
|
| Rate for Payer: Cofinity Commercial |
$448.07
|
| Rate for Payer: Cofinity Commercial |
$416.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$326.72
|
| Rate for Payer: Nomi Health Commercial |
$373.39
|
| Rate for Payer: PACE SWMI |
$311.16
|
| Rate for Payer: PHP Medicare Advantage |
$311.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,227.20
|
| Rate for Payer: Priority Health Medicare |
$314.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$311.16
|
| Rate for Payer: UHC Exchange |
$311.16
|
| Rate for Payer: UHC Medicare Advantage |
$311.16
|
|
|
PR NEUROPLASTY &/TRANSPOSITION CRANIAL NERVE
|
Professional
|
Both
|
$960.00
|
|
|
Service Code
|
HCPCS 64716
|
| Min. Negotiated Rate |
$384.00 |
| Max. Negotiated Rate |
$702.00 |
| Rate for Payer: Aetna Commercial |
$653.25
|
| Rate for Payer: Aetna Medicare |
$507.00
|
| Rate for Payer: BCBS Complete |
$384.00
|
| Rate for Payer: BCBS MAPPO |
$487.50
|
| Rate for Payer: BCN Medicare Advantage |
$487.50
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cofinity Commercial |
$702.00
|
| Rate for Payer: Cofinity Commercial |
$653.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$511.88
|
| Rate for Payer: Nomi Health Commercial |
$585.00
|
| Rate for Payer: PACE SWMI |
$487.50
|
| Rate for Payer: PHP Medicare Advantage |
$487.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$624.00
|
| Rate for Payer: Priority Health Medicare |
$492.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$487.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$487.50
|
| Rate for Payer: UHC Exchange |
$487.50
|
| Rate for Payer: UHC Medicare Advantage |
$487.50
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW
|
Professional
|
Both
|
$3,146.00
|
|
|
Service Code
|
HCPCS 64718
|
| Min. Negotiated Rate |
$581.37 |
| Max. Negotiated Rate |
$2,044.90 |
| Rate for Payer: Aetna Commercial |
$779.04
|
| Rate for Payer: Aetna Medicare |
$604.62
|
| Rate for Payer: BCBS Complete |
$1,258.40
|
| Rate for Payer: BCBS MAPPO |
$581.37
|
| Rate for Payer: BCN Medicare Advantage |
$581.37
|
| Rate for Payer: Cash Price |
$2,516.80
|
| Rate for Payer: Cash Price |
$2,516.80
|
| Rate for Payer: Cofinity Commercial |
$837.17
|
| Rate for Payer: Cofinity Commercial |
$779.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$581.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$610.44
|
| Rate for Payer: Nomi Health Commercial |
$697.64
|
| Rate for Payer: PACE SWMI |
$581.37
|
| Rate for Payer: PHP Medicare Advantage |
$581.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,044.90
|
| Rate for Payer: Priority Health Medicare |
$587.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$581.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$581.37
|
| Rate for Payer: UHC Exchange |
$581.37
|
| Rate for Payer: UHC Medicare Advantage |
$581.37
|
|
|
PR NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW
|
Facility
|
IP
|
$3,146.00
|
|
|
Service Code
|
CPT 64718
|
| Hospital Charge Code |
64718
|
| Min. Negotiated Rate |
$2,044.90 |
| Max. Negotiated Rate |
$2,831.40 |
| Rate for Payer: Aetna Commercial |
$2,674.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,568.08
|
| Rate for Payer: BCN Commercial |
$2,431.23
|
| Rate for Payer: Cash Price |
$2,516.80
|
| Rate for Payer: Cofinity Commercial |
$2,705.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,516.80
|
| Rate for Payer: Healthscope Commercial |
$2,831.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,359.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,674.10
|
| Rate for Payer: Nomi Health Commercial |
$2,579.72
|
| Rate for Payer: PHP Commercial |
$2,674.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,044.90
|
| Rate for Payer: Priority Health HMO/PPO |
$2,737.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,107.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,768.48
|
| Rate for Payer: UHC Core |
$2,626.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,359.50
|
|
