|
PR PARTIAL EXCISION BONE METACARPAL
|
Professional
|
Both
|
$1,454.00
|
|
|
Service Code
|
HCPCS 26230
|
| Min. Negotiated Rate |
$485.21 |
| Max. Negotiated Rate |
$945.10 |
| Rate for Payer: Aetna Commercial |
$650.18
|
| Rate for Payer: Aetna Medicare |
$504.62
|
| Rate for Payer: BCBS Complete |
$581.60
|
| Rate for Payer: BCBS MAPPO |
$485.21
|
| Rate for Payer: BCN Medicare Advantage |
$485.21
|
| Rate for Payer: Cash Price |
$1,163.20
|
| Rate for Payer: Cash Price |
$1,163.20
|
| Rate for Payer: Cofinity Commercial |
$698.70
|
| Rate for Payer: Cofinity Commercial |
$650.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$485.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$509.47
|
| Rate for Payer: Nomi Health Commercial |
$582.25
|
| Rate for Payer: PACE SWMI |
$485.21
|
| Rate for Payer: PHP Medicare Advantage |
$485.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$945.10
|
| Rate for Payer: Priority Health Medicare |
$490.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$485.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$485.21
|
| Rate for Payer: UHC Exchange |
$485.21
|
| Rate for Payer: UHC Medicare Advantage |
$485.21
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Professional
|
Both
|
$1,482.00
|
|
|
Service Code
|
HCPCS 24147
|
| Hospital Charge Code |
24147
|
| Min. Negotiated Rate |
$592.80 |
| Max. Negotiated Rate |
$963.30 |
| Rate for Payer: Aetna Commercial |
$813.26
|
| Rate for Payer: Aetna Medicare |
$631.19
|
| Rate for Payer: BCBS Complete |
$592.80
|
| Rate for Payer: BCBS MAPPO |
$606.91
|
| Rate for Payer: BCN Medicare Advantage |
$606.91
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cofinity Commercial |
$873.95
|
| Rate for Payer: Cofinity Commercial |
$813.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$637.26
|
| Rate for Payer: Nomi Health Commercial |
$728.29
|
| Rate for Payer: PACE SWMI |
$606.91
|
| Rate for Payer: PHP Medicare Advantage |
$606.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$963.30
|
| Rate for Payer: Priority Health Medicare |
$612.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$606.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$606.91
|
| Rate for Payer: UHC Exchange |
$606.91
|
| Rate for Payer: UHC Medicare Advantage |
$606.91
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Facility
|
IP
|
$1,482.00
|
|
|
Service Code
|
CPT 24147
|
| Hospital Charge Code |
24147
|
| Min. Negotiated Rate |
$963.30 |
| Max. Negotiated Rate |
$1,333.80 |
| Rate for Payer: Aetna Commercial |
$1,259.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,209.76
|
| Rate for Payer: BCN Commercial |
$1,145.29
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cofinity Commercial |
$1,274.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,185.60
|
| Rate for Payer: Healthscope Commercial |
$1,333.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,111.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,259.70
|
| Rate for Payer: Nomi Health Commercial |
$1,215.24
|
| Rate for Payer: PHP Commercial |
$1,259.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$963.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,289.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$992.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,304.16
|
| Rate for Payer: UHC Core |
$1,237.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,111.50
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Professional
|
Both
|
$1,482.00
|
|
|
Service Code
|
HCPCS 24147
|
| Min. Negotiated Rate |
$592.80 |
| Max. Negotiated Rate |
$963.30 |
| Rate for Payer: Aetna Commercial |
$813.26
|
| Rate for Payer: Aetna Medicare |
$631.19
|
| Rate for Payer: BCBS Complete |
$592.80
|
| Rate for Payer: BCBS MAPPO |
$606.91
|
| Rate for Payer: BCN Medicare Advantage |
$606.91
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cofinity Commercial |
$873.95
|
| Rate for Payer: Cofinity Commercial |
$813.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$637.26
|
| Rate for Payer: Nomi Health Commercial |
$728.29
|
| Rate for Payer: PACE SWMI |
$606.91
|
| Rate for Payer: PHP Medicare Advantage |
$606.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$963.30
|
| Rate for Payer: Priority Health Medicare |
$612.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$606.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$606.91
|
| Rate for Payer: UHC Exchange |
$606.91
|
| Rate for Payer: UHC Medicare Advantage |
$606.91
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Facility
|
OP
|
$1,482.00
|
|
|
Service Code
|
CPT 24147
|
| Hospital Charge Code |
24147
|
| Min. Negotiated Rate |
$351.98 |
| Max. Negotiated Rate |
$2,463.31 |
| Rate for Payer: Aetna Commercial |
$1,259.70
|
| Rate for Payer: Aetna Medicare |
$385.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$463.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$463.12
|
| Rate for Payer: BCBS Complete |
$2,463.31
|
| Rate for Payer: BCBS MAPPO |
$370.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,218.35
|
| Rate for Payer: BCN Commercial |
$1,152.26
|
| Rate for Payer: BCN Medicare Advantage |
$370.50
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cash Price |
$1,185.60
|
| Rate for Payer: Cofinity Commercial |
$1,274.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,185.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$370.50
|
| Rate for Payer: Healthscope Commercial |
$1,333.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,111.50
|
| Rate for Payer: Mclaren Medicaid |
$2,345.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$389.02
|
| Rate for Payer: Meridian Medicaid |
$2,463.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$426.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,259.70
|
| Rate for Payer: Nomi Health Commercial |
$1,215.24
|
| Rate for Payer: PACE Senior Care Partners |
$351.98
|
| Rate for Payer: PACE SWMI |
$370.50
|
| Rate for Payer: PHP Commercial |
$1,259.70
|
| Rate for Payer: PHP Medicare Advantage |
$370.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,345.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$963.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,289.34
|
| Rate for Payer: Priority Health Medicare |
$374.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$992.94
|
| Rate for Payer: Railroad Medicare Medicare |
$370.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,304.16
|
| Rate for Payer: UHC Core |
$1,237.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$370.50
|
| Rate for Payer: UHC Exchange |
$370.50
|
| Rate for Payer: UHC Medicare Advantage |
$370.50
|
| Rate for Payer: UHCCP Medicaid |
$2,345.85
|
| Rate for Payer: VA VA |
$370.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,111.50
|
|
|
PR PARTIAL EXCISION BONE PROXIMAL HUMERUS
|
Professional
|
Both
|
$1,664.00
|
|
|
Service Code
|
HCPCS 23184
|
| Min. Negotiated Rate |
$665.60 |
| Max. Negotiated Rate |
$1,081.60 |
| Rate for Payer: Aetna Commercial |
$957.26
|
| Rate for Payer: Aetna Medicare |
$742.94
|
| Rate for Payer: BCBS Complete |
$665.60
|
| Rate for Payer: BCBS MAPPO |
$714.37
|
| Rate for Payer: BCN Medicare Advantage |
$714.37
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cash Price |
$1,331.20
|
| Rate for Payer: Cofinity Commercial |
$957.26
|
| Rate for Payer: Cofinity Commercial |
$1,028.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$714.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$750.09
|
| Rate for Payer: Nomi Health Commercial |
$857.24
|
| Rate for Payer: PACE SWMI |
$714.37
|
| Rate for Payer: PHP Medicare Advantage |
$714.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,081.60
|
| Rate for Payer: Priority Health Medicare |
$721.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$714.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$714.37
|
| Rate for Payer: UHC Exchange |
$714.37
|
| Rate for Payer: UHC Medicare Advantage |
$714.37
|
|
|
PR PARTIAL EXCISION BONE RADIUS
|
Professional
|
Both
|
$2,289.00
|
|
|
Service Code
|
HCPCS 25151
|
| Min. Negotiated Rate |
$566.75 |
| Max. Negotiated Rate |
$1,487.85 |
| Rate for Payer: Aetna Commercial |
$759.45
|
| Rate for Payer: Aetna Medicare |
$589.42
|
| Rate for Payer: BCBS Complete |
$915.60
|
| Rate for Payer: BCBS MAPPO |
$566.75
|
| Rate for Payer: BCN Medicare Advantage |
$566.75
|
| Rate for Payer: Cash Price |
$1,831.20
|
| Rate for Payer: Cash Price |
$1,831.20
|
| Rate for Payer: Cofinity Commercial |
$816.12
|
| Rate for Payer: Cofinity Commercial |
$759.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$566.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$595.09
|
| Rate for Payer: Nomi Health Commercial |
$680.10
|
| Rate for Payer: PACE SWMI |
$566.75
|
| Rate for Payer: PHP Medicare Advantage |
$566.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,487.85
|
| Rate for Payer: Priority Health Medicare |
$572.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$566.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$566.75
|
| Rate for Payer: UHC Exchange |
$566.75
|
| Rate for Payer: UHC Medicare Advantage |
$566.75
|
|
|
PR PARTIAL EXCISION BONE SCAPULA
|
Professional
|
Both
|
$1,265.00
|
|
|
Service Code
|
HCPCS 23182
|
| Min. Negotiated Rate |
$506.00 |
| Max. Negotiated Rate |
$936.09 |
| Rate for Payer: Aetna Commercial |
$871.08
|
| Rate for Payer: Aetna Medicare |
$676.06
|
| Rate for Payer: BCBS Complete |
$506.00
|
| Rate for Payer: BCBS MAPPO |
$650.06
|
| Rate for Payer: BCN Medicare Advantage |
$650.06
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cofinity Commercial |
$936.09
|
| Rate for Payer: Cofinity Commercial |
$871.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$650.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$682.56
|
| Rate for Payer: Nomi Health Commercial |
$780.07
|
| Rate for Payer: PACE SWMI |
$650.06
|
| Rate for Payer: PHP Medicare Advantage |
$650.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$822.25
|
| Rate for Payer: Priority Health Medicare |
$656.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$650.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$650.06
|
| Rate for Payer: UHC Exchange |
$650.06
|
| Rate for Payer: UHC Medicare Advantage |
$650.06
|
|
|
PR PARTIAL EXCISION BONE TALUS/CALCANEUS
|
Professional
|
Both
|
$1,274.00
|
|
|
Service Code
|
HCPCS 28120
|
| Min. Negotiated Rate |
$473.72 |
| Max. Negotiated Rate |
$828.10 |
| Rate for Payer: Aetna Commercial |
$634.78
|
| Rate for Payer: Aetna Medicare |
$492.67
|
| Rate for Payer: BCBS Complete |
$509.60
|
| Rate for Payer: BCBS MAPPO |
$473.72
|
| Rate for Payer: BCN Medicare Advantage |
$473.72
|
| Rate for Payer: Cash Price |
$1,019.20
|
| Rate for Payer: Cash Price |
$1,019.20
|
| Rate for Payer: Cofinity Commercial |
$682.16
|
| Rate for Payer: Cofinity Commercial |
$634.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$473.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$497.41
|
| Rate for Payer: Nomi Health Commercial |
$568.46
|
| Rate for Payer: PACE SWMI |
$473.72
|
| Rate for Payer: PHP Medicare Advantage |
$473.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$828.10
|
| Rate for Payer: Priority Health Medicare |
$478.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$473.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$473.72
|
| Rate for Payer: UHC Exchange |
$473.72
|
| Rate for Payer: UHC Medicare Advantage |
$473.72
|
|
|
PR PARTIAL EXCISION BONE TIBIA
|
Professional
|
Both
|
$2,763.00
|
|
|
Service Code
|
HCPCS 27640
|
| Min. Negotiated Rate |
$796.25 |
| Max. Negotiated Rate |
$1,795.95 |
| Rate for Payer: Aetna Commercial |
$1,066.97
|
| Rate for Payer: Aetna Medicare |
$828.10
|
| Rate for Payer: BCBS Complete |
$1,105.20
|
| Rate for Payer: BCBS MAPPO |
$796.25
|
| Rate for Payer: BCN Medicare Advantage |
$796.25
|
| Rate for Payer: Cash Price |
$2,210.40
|
| Rate for Payer: Cash Price |
$2,210.40
|
| Rate for Payer: Cofinity Commercial |
$1,146.60
|
| Rate for Payer: Cofinity Commercial |
$1,066.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$796.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$836.06
|
| Rate for Payer: Nomi Health Commercial |
$955.50
|
| Rate for Payer: PACE SWMI |
$796.25
|
| Rate for Payer: PHP Medicare Advantage |
$796.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,795.95
|
| Rate for Payer: Priority Health Medicare |
$804.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$796.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$796.25
|
| Rate for Payer: UHC Exchange |
$796.25
|
| Rate for Payer: UHC Medicare Advantage |
$796.25
|
|
|
PR PARTIAL EXCISION BONE ULNA
|
Professional
|
Both
|
$1,179.00
|
|
|
Service Code
|
HCPCS 25150
|
| Min. Negotiated Rate |
$471.60 |
| Max. Negotiated Rate |
$792.99 |
| Rate for Payer: Aetna Commercial |
$737.92
|
| Rate for Payer: Aetna Medicare |
$572.72
|
| Rate for Payer: BCBS Complete |
$471.60
|
| Rate for Payer: BCBS MAPPO |
$550.69
|
| Rate for Payer: BCN Medicare Advantage |
$550.69
|
| Rate for Payer: Cash Price |
$943.20
|
| Rate for Payer: Cash Price |
$943.20
|
| Rate for Payer: Cofinity Commercial |
$792.99
|
| Rate for Payer: Cofinity Commercial |
$737.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$578.22
|
| Rate for Payer: Nomi Health Commercial |
$660.83
|
| Rate for Payer: PACE SWMI |
$550.69
|
| Rate for Payer: PHP Medicare Advantage |
$550.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$766.35
|
| Rate for Payer: Priority Health Medicare |
$556.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$550.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$550.69
|
| Rate for Payer: UHC Exchange |
$550.69
|
| Rate for Payer: UHC Medicare Advantage |
$550.69
|
|
|
PR PARTIAL EXCISION DEEP PELVIS
|
Professional
|
Both
|
$3,227.00
|
|
|
Service Code
|
HCPCS 27071
|
| Min. Negotiated Rate |
$923.04 |
| Max. Negotiated Rate |
$2,097.55 |
| Rate for Payer: Aetna Commercial |
$1,236.87
|
| Rate for Payer: Aetna Medicare |
$959.96
|
| Rate for Payer: BCBS Complete |
$1,290.80
|
| Rate for Payer: BCBS MAPPO |
$923.04
|
| Rate for Payer: BCN Medicare Advantage |
$923.04
|
| Rate for Payer: Cash Price |
$2,581.60
|
| Rate for Payer: Cash Price |
$2,581.60
|
| Rate for Payer: Cofinity Commercial |
$1,329.18
|
| Rate for Payer: Cofinity Commercial |
$1,236.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$923.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$969.19
|
| Rate for Payer: Nomi Health Commercial |
$1,107.65
|
| Rate for Payer: PACE SWMI |
$923.04
|
| Rate for Payer: PHP Medicare Advantage |
$923.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,097.55
|
| Rate for Payer: Priority Health Medicare |
$932.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$923.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$923.04
|
| Rate for Payer: UHC Exchange |
$923.04
|
| Rate for Payer: UHC Medicare Advantage |
$923.04
|
|
|
PR PARTIAL EXCISION DISTAL PHALANX FINGER
|
Professional
|
Both
|
$1,272.00
|
|
|
Service Code
|
HCPCS 26236
|
| Min. Negotiated Rate |
$428.45 |
| Max. Negotiated Rate |
$826.80 |
| Rate for Payer: Aetna Commercial |
$574.12
|
| Rate for Payer: Aetna Medicare |
$445.59
|
| Rate for Payer: BCBS Complete |
$508.80
|
| Rate for Payer: BCBS MAPPO |
$428.45
|
| Rate for Payer: BCN Medicare Advantage |
$428.45
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cofinity Commercial |
$616.97
|
| Rate for Payer: Cofinity Commercial |
$574.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$428.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.87
|
| Rate for Payer: Nomi Health Commercial |
$514.14
|
| Rate for Payer: PACE SWMI |
$428.45
|
| Rate for Payer: PHP Medicare Advantage |
$428.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.80
|
| Rate for Payer: Priority Health Medicare |
$432.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$428.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$428.45
|
| Rate for Payer: UHC Exchange |
$428.45
|
| Rate for Payer: UHC Medicare Advantage |
$428.45
|
|
|
PR PARTIAL EXCISION PROXIMAL/MIDDLE PHALANX FINGER
|
Professional
|
Both
|
$1,363.00
|
|
|
Service Code
|
HCPCS 26235
|
| Min. Negotiated Rate |
$477.52 |
| Max. Negotiated Rate |
$885.95 |
| Rate for Payer: Aetna Commercial |
$639.88
|
| Rate for Payer: Aetna Medicare |
$496.62
|
| Rate for Payer: BCBS Complete |
$545.20
|
| Rate for Payer: BCBS MAPPO |
$477.52
|
| Rate for Payer: BCN Medicare Advantage |
$477.52
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cash Price |
$1,090.40
|
| Rate for Payer: Cofinity Commercial |
$687.63
|
| Rate for Payer: Cofinity Commercial |
$639.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$477.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$501.40
|
| Rate for Payer: Nomi Health Commercial |
$573.02
|
| Rate for Payer: PACE SWMI |
$477.52
|
| Rate for Payer: PHP Medicare Advantage |
$477.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.95
|
| Rate for Payer: Priority Health Medicare |
$482.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$477.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$477.52
|
| Rate for Payer: UHC Exchange |
$477.52
|
| Rate for Payer: UHC Medicare Advantage |
$477.52
|
|
|
PR PARTIAL EXCISION SUPERFICIAL PELVIS
|
Professional
|
Both
|
$1,528.00
|
|
|
Service Code
|
HCPCS 27070
|
| Min. Negotiated Rate |
$611.20 |
| Max. Negotiated Rate |
$1,205.38 |
| Rate for Payer: Aetna Commercial |
$1,121.67
|
| Rate for Payer: Aetna Medicare |
$870.55
|
| Rate for Payer: BCBS Complete |
$611.20
|
| Rate for Payer: BCBS MAPPO |
$837.07
|
| Rate for Payer: BCN Medicare Advantage |
$837.07
|
| Rate for Payer: Cash Price |
$1,222.40
|
| Rate for Payer: Cash Price |
$1,222.40
|
| Rate for Payer: Cofinity Commercial |
$1,205.38
|
| Rate for Payer: Cofinity Commercial |
$1,121.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$837.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$878.92
|
| Rate for Payer: Nomi Health Commercial |
$1,004.48
|
| Rate for Payer: PACE SWMI |
$837.07
|
| Rate for Payer: PHP Medicare Advantage |
$837.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$993.20
|
| Rate for Payer: Priority Health Medicare |
$845.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$837.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$837.07
|
| Rate for Payer: UHC Exchange |
$837.07
|
| Rate for Payer: UHC Medicare Advantage |
$837.07
|
|
|
PR PARTIAL HYMENECTOMY OR REVISION HYMENAL RING
|
Professional
|
Both
|
$657.00
|
|
|
Service Code
|
HCPCS 56700
|
| Min. Negotiated Rate |
$193.26 |
| Max. Negotiated Rate |
$427.05 |
| Rate for Payer: Aetna Commercial |
$258.97
|
| Rate for Payer: Aetna Medicare |
$200.99
|
| Rate for Payer: BCBS Complete |
$262.80
|
| Rate for Payer: BCBS MAPPO |
$193.26
|
| Rate for Payer: BCN Medicare Advantage |
$193.26
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cofinity Commercial |
$278.29
|
| Rate for Payer: Cofinity Commercial |
$258.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$202.92
|
| Rate for Payer: Nomi Health Commercial |
$231.91
|
| Rate for Payer: PACE SWMI |
$193.26
|
| Rate for Payer: PHP Medicare Advantage |
$193.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.05
|
| Rate for Payer: Priority Health Medicare |
$195.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.26
|
| Rate for Payer: UHC Exchange |
$193.26
|
| Rate for Payer: UHC Medicare Advantage |
$193.26
|
|
|
PR PARTICAL EXCISION BONE PHALANX TOE
|
Professional
|
Both
|
$914.00
|
|
|
Service Code
|
HCPCS 28124
|
| Min. Negotiated Rate |
$320.80 |
| Max. Negotiated Rate |
$594.10 |
| Rate for Payer: Aetna Commercial |
$429.87
|
| Rate for Payer: Aetna Medicare |
$333.63
|
| Rate for Payer: BCBS Complete |
$365.60
|
| Rate for Payer: BCBS MAPPO |
$320.80
|
| Rate for Payer: BCN Medicare Advantage |
$320.80
|
| Rate for Payer: Cash Price |
$731.20
|
| Rate for Payer: Cash Price |
$731.20
|
| Rate for Payer: Cofinity Commercial |
$461.95
|
| Rate for Payer: Cofinity Commercial |
$429.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.84
|
| Rate for Payer: Nomi Health Commercial |
$384.96
|
| Rate for Payer: PACE SWMI |
$320.80
|
| Rate for Payer: PHP Medicare Advantage |
$320.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$594.10
|
| Rate for Payer: Priority Health Medicare |
$324.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.80
|
| Rate for Payer: UHC Exchange |
$320.80
|
| Rate for Payer: UHC Medicare Advantage |
$320.80
|
|
|
PR PATELLECTOMY/HEMIPATELLECTOMY
|
Professional
|
Both
|
$2,101.00
|
|
|
Service Code
|
HCPCS 27350
|
| Min. Negotiated Rate |
$632.86 |
| Max. Negotiated Rate |
$1,365.65 |
| Rate for Payer: Aetna Commercial |
$848.03
|
| Rate for Payer: Aetna Medicare |
$658.17
|
| Rate for Payer: BCBS Complete |
$840.40
|
| Rate for Payer: BCBS MAPPO |
$632.86
|
| Rate for Payer: BCN Medicare Advantage |
$632.86
|
| Rate for Payer: Cash Price |
$1,680.80
|
| Rate for Payer: Cash Price |
$1,680.80
|
| Rate for Payer: Cofinity Commercial |
$911.32
|
| Rate for Payer: Cofinity Commercial |
$848.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$632.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$664.50
|
| Rate for Payer: Nomi Health Commercial |
$759.43
|
| Rate for Payer: PACE SWMI |
$632.86
|
| Rate for Payer: PHP Medicare Advantage |
$632.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,365.65
|
| Rate for Payer: Priority Health Medicare |
$639.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$632.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$632.86
|
| Rate for Payer: UHC Exchange |
$632.86
|
| Rate for Payer: UHC Medicare Advantage |
$632.86
|
|
|
PR PATIENT-INITIATED SPIROMETRIC RECORDING
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 94015
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$40.85 |
| Rate for Payer: Aetna Commercial |
$38.02
|
| Rate for Payer: Aetna Medicare |
$29.50
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS MAPPO |
$28.37
|
| Rate for Payer: BCN Medicare Advantage |
$28.37
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$40.85
|
| Rate for Payer: Cofinity Commercial |
$38.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.79
|
| Rate for Payer: Nomi Health Commercial |
$34.04
|
| Rate for Payer: PACE SWMI |
$28.37
|
| Rate for Payer: PHP Medicare Advantage |
$28.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health Medicare |
$28.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.37
|
| Rate for Payer: UHC Exchange |
$28.37
|
| Rate for Payer: UHC Medicare Advantage |
$28.37
|
|
|
PR PCV13 VACCINE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$290.00
|
|
|
Service Code
|
HCPCS 90670
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$371.51 |
| Rate for Payer: Aetna Commercial |
$345.71
|
| Rate for Payer: Aetna Medicare |
$268.31
|
| Rate for Payer: BCBS Complete |
$116.00
|
| Rate for Payer: BCBS MAPPO |
$257.99
|
| Rate for Payer: BCN Medicare Advantage |
$257.99
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cofinity Commercial |
$371.51
|
| Rate for Payer: Cofinity Commercial |
$345.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.89
|
| Rate for Payer: Nomi Health Commercial |
$309.59
|
| Rate for Payer: PACE SWMI |
$257.99
|
| Rate for Payer: PHP Medicare Advantage |
$257.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.50
|
| Rate for Payer: Priority Health Medicare |
$260.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.99
|
| Rate for Payer: UHC Exchange |
$257.99
|
| Rate for Payer: UHC Medicare Advantage |
$257.99
|
|
|
PR PCV20 VACCINE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$395.00
|
|
|
Service Code
|
HCPCS 90677
|
| Min. Negotiated Rate |
$158.00 |
| Max. Negotiated Rate |
$450.58 |
| Rate for Payer: Aetna Commercial |
$419.29
|
| Rate for Payer: Aetna Medicare |
$325.42
|
| Rate for Payer: BCBS Complete |
$158.00
|
| Rate for Payer: BCBS MAPPO |
$312.90
|
| Rate for Payer: BCN Medicare Advantage |
$312.90
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cofinity Commercial |
$450.58
|
| Rate for Payer: Cofinity Commercial |
$419.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.55
|
| Rate for Payer: Nomi Health Commercial |
$375.48
|
| Rate for Payer: PACE SWMI |
$312.90
|
| Rate for Payer: PHP Medicare Advantage |
$312.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.75
|
| Rate for Payer: Priority Health Medicare |
$316.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$312.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$312.90
|
| Rate for Payer: UHC Exchange |
$312.90
|
| Rate for Payer: UHC Medicare Advantage |
$312.90
|
|
|
PR PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ BY PHYS/QHP
|
Professional
|
Both
|
$365.00
|
|
|
Service Code
|
HCPCS 96573
|
| Min. Negotiated Rate |
$146.00 |
| Max. Negotiated Rate |
$281.45 |
| Rate for Payer: Aetna Commercial |
$261.90
|
| Rate for Payer: Aetna Medicare |
$203.27
|
| Rate for Payer: BCBS Complete |
$146.00
|
| Rate for Payer: BCBS MAPPO |
$195.45
|
| Rate for Payer: BCN Medicare Advantage |
$195.45
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cofinity Commercial |
$281.45
|
| Rate for Payer: Cofinity Commercial |
$261.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$205.22
|
| Rate for Payer: Nomi Health Commercial |
$234.54
|
| Rate for Payer: PACE SWMI |
$195.45
|
| Rate for Payer: PHP Medicare Advantage |
$195.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.25
|
| Rate for Payer: Priority Health Medicare |
$197.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$195.45
|
| Rate for Payer: UHC Exchange |
$195.45
|
| Rate for Payer: UHC Medicare Advantage |
$195.45
|
|
|
PR PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ PER DAY
|
Professional
|
Both
|
$218.00
|
|
|
Service Code
|
HCPCS 96567
|
| Min. Negotiated Rate |
$87.20 |
| Max. Negotiated Rate |
$167.73 |
| Rate for Payer: Aetna Commercial |
$156.08
|
| Rate for Payer: Aetna Medicare |
$121.14
|
| Rate for Payer: BCBS Complete |
$87.20
|
| Rate for Payer: BCBS MAPPO |
$116.48
|
| Rate for Payer: BCN Medicare Advantage |
$116.48
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cofinity Commercial |
$167.73
|
| Rate for Payer: Cofinity Commercial |
$156.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.30
|
| Rate for Payer: Nomi Health Commercial |
$139.78
|
| Rate for Payer: PACE SWMI |
$116.48
|
| Rate for Payer: PHP Medicare Advantage |
$116.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.70
|
| Rate for Payer: Priority Health Medicare |
$117.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.48
|
| Rate for Payer: UHC Exchange |
$116.48
|
| Rate for Payer: UHC Medicare Advantage |
$116.48
|
|
|
PR PEL LMPHADEC W/XTRNL ILIAC HYPOGSTR&OBTURATOR
|
Professional
|
Both
|
$1,298.00
|
|
|
Service Code
|
HCPCS 38770
|
| Min. Negotiated Rate |
$519.20 |
| Max. Negotiated Rate |
$1,112.44 |
| Rate for Payer: Aetna Commercial |
$1,035.19
|
| Rate for Payer: Aetna Medicare |
$803.43
|
| Rate for Payer: BCBS Complete |
$519.20
|
| Rate for Payer: BCBS MAPPO |
$772.53
|
| Rate for Payer: BCN Medicare Advantage |
$772.53
|
| Rate for Payer: Cash Price |
$1,038.40
|
| Rate for Payer: Cash Price |
$1,038.40
|
| Rate for Payer: Cofinity Commercial |
$1,112.44
|
| Rate for Payer: Cofinity Commercial |
$1,035.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$772.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$811.16
|
| Rate for Payer: Nomi Health Commercial |
$927.04
|
| Rate for Payer: PACE SWMI |
$772.53
|
| Rate for Payer: PHP Medicare Advantage |
$772.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.70
|
| Rate for Payer: Priority Health Medicare |
$780.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$772.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$772.53
|
| Rate for Payer: UHC Exchange |
$772.53
|
| Rate for Payer: UHC Medicare Advantage |
$772.53
|
|
|
PR PELVIC EXAMINATION
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 99459
|
| Min. Negotiated Rate |
$18.86 |
| Max. Negotiated Rate |
$31.20 |
| Rate for Payer: Aetna Commercial |
$25.27
|
| Rate for Payer: Aetna Medicare |
$19.61
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: BCBS MAPPO |
$18.86
|
| Rate for Payer: BCN Medicare Advantage |
$18.86
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$27.16
|
| Rate for Payer: Cofinity Commercial |
$25.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.80
|
| Rate for Payer: Nomi Health Commercial |
$22.63
|
| Rate for Payer: PACE SWMI |
$18.86
|
| Rate for Payer: PHP Medicare Advantage |
$18.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: Priority Health Medicare |
$19.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.86
|
| Rate for Payer: UHC Exchange |
$18.86
|
| Rate for Payer: UHC Medicare Advantage |
$18.86
|
|
