|
PR SUTR&/LIG THORACIC DUCT THORACIC APPROACH
|
Professional
|
Both
|
$5,927.00
|
|
|
Service Code
|
HCPCS 38381
|
| Min. Negotiated Rate |
$780.23 |
| Max. Negotiated Rate |
$3,852.55 |
| Rate for Payer: Aetna Commercial |
$1,045.51
|
| Rate for Payer: Aetna Medicare |
$811.44
|
| Rate for Payer: BCBS Complete |
$2,370.80
|
| Rate for Payer: BCBS MAPPO |
$780.23
|
| Rate for Payer: BCN Medicare Advantage |
$780.23
|
| Rate for Payer: Cash Price |
$4,741.60
|
| Rate for Payer: Cash Price |
$4,741.60
|
| Rate for Payer: Cofinity Commercial |
$1,123.53
|
| Rate for Payer: Cofinity Commercial |
$1,045.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$780.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$819.24
|
| Rate for Payer: Nomi Health Commercial |
$936.28
|
| Rate for Payer: PACE SWMI |
$780.23
|
| Rate for Payer: PHP Medicare Advantage |
$780.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,852.55
|
| Rate for Payer: Priority Health Medicare |
$788.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$780.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$780.23
|
| Rate for Payer: UHC Exchange |
$780.23
|
| Rate for Payer: UHC Medicare Advantage |
$780.23
|
|
|
PR SUTR NRV ITPRL W/WO GRF/DCMPRN LAT GENICULATE
|
Professional
|
Both
|
$2,055.00
|
|
|
Service Code
|
HCPCS 69740
|
| Min. Negotiated Rate |
$822.00 |
| Max. Negotiated Rate |
$1,571.83 |
| Rate for Payer: Aetna Commercial |
$1,462.68
|
| Rate for Payer: Aetna Medicare |
$1,135.21
|
| Rate for Payer: BCBS Complete |
$822.00
|
| Rate for Payer: BCBS MAPPO |
$1,091.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,091.55
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Cofinity Commercial |
$1,571.83
|
| Rate for Payer: Cofinity Commercial |
$1,462.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,091.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,146.13
|
| Rate for Payer: Nomi Health Commercial |
$1,309.86
|
| Rate for Payer: PACE SWMI |
$1,091.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,091.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,335.75
|
| Rate for Payer: Priority Health Medicare |
$1,102.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,091.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,091.55
|
| Rate for Payer: UHC Exchange |
$1,091.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,091.55
|
|
|
PR SUTR PRPH NRV ARM/LEG XCP SCIATIC W/O TRPOS
|
Professional
|
Both
|
$3,175.00
|
|
|
Service Code
|
HCPCS 64857
|
| Min. Negotiated Rate |
$1,008.34 |
| Max. Negotiated Rate |
$2,063.75 |
| Rate for Payer: Aetna Commercial |
$1,351.18
|
| Rate for Payer: Aetna Medicare |
$1,048.67
|
| Rate for Payer: BCBS Complete |
$1,270.00
|
| Rate for Payer: BCBS MAPPO |
$1,008.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,008.34
|
| Rate for Payer: Cash Price |
$2,540.00
|
| Rate for Payer: Cash Price |
$2,540.00
|
| Rate for Payer: Cofinity Commercial |
$1,452.01
|
| Rate for Payer: Cofinity Commercial |
$1,351.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,008.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,058.76
|
| Rate for Payer: Nomi Health Commercial |
$1,210.01
|
| Rate for Payer: PACE SWMI |
$1,008.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,008.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,063.75
|
| Rate for Payer: Priority Health Medicare |
$1,018.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,008.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,008.34
|
| Rate for Payer: UHC Exchange |
$1,008.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,008.34
|
|
|
PR SUTR PRPH NRV ARM/LEG XCP SCIATIC W/TRPOS
|
Professional
|
Both
|
$3,953.00
|
|
|
Service Code
|
HCPCS 64856
|
| Min. Negotiated Rate |
$974.79 |
| Max. Negotiated Rate |
$2,569.45 |
| Rate for Payer: Aetna Commercial |
$1,306.22
|
| Rate for Payer: Aetna Medicare |
$1,013.78
|
| Rate for Payer: BCBS Complete |
$1,581.20
|
| Rate for Payer: BCBS MAPPO |
$974.79
|
| Rate for Payer: BCN Medicare Advantage |
$974.79
|
| Rate for Payer: Cash Price |
$3,162.40
|
| Rate for Payer: Cash Price |
$3,162.40
|
| Rate for Payer: Cofinity Commercial |
$1,403.70
|
| Rate for Payer: Cofinity Commercial |
$1,306.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$974.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,023.53
|
| Rate for Payer: Nomi Health Commercial |
$1,169.75
|
| Rate for Payer: PACE SWMI |
$974.79
|
| Rate for Payer: PHP Medicare Advantage |
$974.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,569.45
|
| Rate for Payer: Priority Health Medicare |
$984.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$974.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$974.79
|
| Rate for Payer: UHC Exchange |
$974.79
|
| Rate for Payer: UHC Medicare Advantage |
$974.79
|
|
|
PR SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ
|
Professional
|
Both
|
$2,342.00
|
|
|
Service Code
|
HCPCS 27386
|
| Min. Negotiated Rate |
$821.35 |
| Max. Negotiated Rate |
$1,522.30 |
| Rate for Payer: Aetna Commercial |
$1,100.61
|
| Rate for Payer: Aetna Medicare |
$854.20
|
| Rate for Payer: BCBS Complete |
$936.80
|
| Rate for Payer: BCBS MAPPO |
$821.35
|
| Rate for Payer: BCN Medicare Advantage |
$821.35
|
| Rate for Payer: Cash Price |
$1,873.60
|
| Rate for Payer: Cash Price |
$1,873.60
|
| Rate for Payer: Cofinity Commercial |
$1,182.74
|
| Rate for Payer: Cofinity Commercial |
$1,100.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$821.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$862.42
|
| Rate for Payer: Nomi Health Commercial |
$985.62
|
| Rate for Payer: PACE SWMI |
$821.35
|
| Rate for Payer: PHP Medicare Advantage |
$821.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.30
|
| Rate for Payer: Priority Health Medicare |
$829.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$821.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$821.35
|
| Rate for Payer: UHC Exchange |
$821.35
|
| Rate for Payer: UHC Medicare Advantage |
$821.35
|
|
|
PR SUTR RPR AORTA/GRT VSL W/O SHUNT/CARD BYP
|
Professional
|
Both
|
$2,203.00
|
|
|
Service Code
|
HCPCS 33320
|
| Min. Negotiated Rate |
$881.20 |
| Max. Negotiated Rate |
$1,479.28 |
| Rate for Payer: Aetna Commercial |
$1,376.56
|
| Rate for Payer: Aetna Medicare |
$1,068.37
|
| Rate for Payer: BCBS Complete |
$881.20
|
| Rate for Payer: BCBS MAPPO |
$1,027.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,027.28
|
| Rate for Payer: Cash Price |
$1,762.40
|
| Rate for Payer: Cash Price |
$1,762.40
|
| Rate for Payer: Cofinity Commercial |
$1,479.28
|
| Rate for Payer: Cofinity Commercial |
$1,376.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,027.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,078.64
|
| Rate for Payer: Nomi Health Commercial |
$1,232.74
|
| Rate for Payer: PACE SWMI |
$1,027.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,027.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,431.95
|
| Rate for Payer: Priority Health Medicare |
$1,037.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,027.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,027.28
|
| Rate for Payer: UHC Exchange |
$1,027.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,027.28
|
|
|
PR SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK
|
Professional
|
Both
|
$1,151.00
|
|
|
Service Code
|
HCPCS 67935
|
| Min. Negotiated Rate |
$406.98 |
| Max. Negotiated Rate |
$748.15 |
| Rate for Payer: Aetna Commercial |
$545.35
|
| Rate for Payer: Aetna Medicare |
$423.26
|
| Rate for Payer: BCBS Complete |
$460.40
|
| Rate for Payer: BCBS MAPPO |
$406.98
|
| Rate for Payer: BCN Medicare Advantage |
$406.98
|
| Rate for Payer: Cash Price |
$920.80
|
| Rate for Payer: Cash Price |
$920.80
|
| Rate for Payer: Cofinity Commercial |
$586.05
|
| Rate for Payer: Cofinity Commercial |
$545.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$406.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$427.33
|
| Rate for Payer: Nomi Health Commercial |
$488.38
|
| Rate for Payer: PACE SWMI |
$406.98
|
| Rate for Payer: PHP Medicare Advantage |
$406.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$748.15
|
| Rate for Payer: Priority Health Medicare |
$411.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$406.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$406.98
|
| Rate for Payer: UHC Exchange |
$406.98
|
| Rate for Payer: UHC Medicare Advantage |
$406.98
|
|
|
PR SUTR WND EYELID/MARGIN/TARSUS/CONJUNC PRTL THICK
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 67930
|
| Min. Negotiated Rate |
$219.58 |
| Max. Negotiated Rate |
$497.25 |
| Rate for Payer: Aetna Commercial |
$294.24
|
| Rate for Payer: Aetna Medicare |
$228.36
|
| Rate for Payer: BCBS Complete |
$306.00
|
| Rate for Payer: BCBS MAPPO |
$219.58
|
| Rate for Payer: BCN Medicare Advantage |
$219.58
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$316.20
|
| Rate for Payer: Cofinity Commercial |
$294.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.56
|
| Rate for Payer: Nomi Health Commercial |
$263.50
|
| Rate for Payer: PACE SWMI |
$219.58
|
| Rate for Payer: PHP Medicare Advantage |
$219.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.25
|
| Rate for Payer: Priority Health Medicare |
$221.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.58
|
| Rate for Payer: UHC Exchange |
$219.58
|
| Rate for Payer: UHC Medicare Advantage |
$219.58
|
|
|
PR SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE
|
Professional
|
Both
|
$2,150.00
|
|
|
Service Code
|
HCPCS 64834
|
| Min. Negotiated Rate |
$717.69 |
| Max. Negotiated Rate |
$1,397.50 |
| Rate for Payer: Aetna Commercial |
$961.70
|
| Rate for Payer: Aetna Medicare |
$746.40
|
| Rate for Payer: BCBS Complete |
$860.00
|
| Rate for Payer: BCBS MAPPO |
$717.69
|
| Rate for Payer: BCN Medicare Advantage |
$717.69
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cash Price |
$1,720.00
|
| Rate for Payer: Cofinity Commercial |
$961.70
|
| Rate for Payer: Cofinity Commercial |
$1,033.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$753.57
|
| Rate for Payer: Nomi Health Commercial |
$861.23
|
| Rate for Payer: PACE SWMI |
$717.69
|
| Rate for Payer: PHP Medicare Advantage |
$717.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,397.50
|
| Rate for Payer: Priority Health Medicare |
$724.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$717.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$717.69
|
| Rate for Payer: UHC Exchange |
$717.69
|
| Rate for Payer: UHC Medicare Advantage |
$717.69
|
|
|
PR SUTURE 1 NERVE MEDIAN MOTOR THENAR
|
Professional
|
Both
|
$2,287.00
|
|
|
Service Code
|
HCPCS 64835
|
| Min. Negotiated Rate |
$787.47 |
| Max. Negotiated Rate |
$1,486.55 |
| Rate for Payer: Aetna Commercial |
$1,055.21
|
| Rate for Payer: Aetna Medicare |
$818.97
|
| Rate for Payer: BCBS Complete |
$914.80
|
| Rate for Payer: BCBS MAPPO |
$787.47
|
| Rate for Payer: BCN Medicare Advantage |
$787.47
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cofinity Commercial |
$1,133.96
|
| Rate for Payer: Cofinity Commercial |
$1,055.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.84
|
| Rate for Payer: Nomi Health Commercial |
$944.96
|
| Rate for Payer: PACE SWMI |
$787.47
|
| Rate for Payer: PHP Medicare Advantage |
$787.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,486.55
|
| Rate for Payer: Priority Health Medicare |
$795.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$787.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$787.47
|
| Rate for Payer: UHC Exchange |
$787.47
|
| Rate for Payer: UHC Medicare Advantage |
$787.47
|
|
|
PR SUTURE 1 NERVE ULNAR MOTOR
|
Professional
|
Both
|
$1,805.00
|
|
|
Service Code
|
HCPCS 64836
|
| Min. Negotiated Rate |
$722.00 |
| Max. Negotiated Rate |
$1,173.25 |
| Rate for Payer: Aetna Commercial |
$1,055.21
|
| Rate for Payer: Aetna Medicare |
$818.97
|
| Rate for Payer: BCBS Complete |
$722.00
|
| Rate for Payer: BCBS MAPPO |
$787.47
|
| Rate for Payer: BCN Medicare Advantage |
$787.47
|
| Rate for Payer: Cash Price |
$1,444.00
|
| Rate for Payer: Cash Price |
$1,444.00
|
| Rate for Payer: Cofinity Commercial |
$1,133.96
|
| Rate for Payer: Cofinity Commercial |
$1,055.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.84
|
| Rate for Payer: Nomi Health Commercial |
$944.96
|
| Rate for Payer: PACE SWMI |
$787.47
|
| Rate for Payer: PHP Medicare Advantage |
$787.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,173.25
|
| Rate for Payer: Priority Health Medicare |
$795.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$787.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$787.47
|
| Rate for Payer: UHC Exchange |
$787.47
|
| Rate for Payer: UHC Medicare Advantage |
$787.47
|
|
|
PR SUTURE BRACHIAL PLEXUS
|
Professional
|
Both
|
$3,705.00
|
|
|
Service Code
|
HCPCS 64861
|
| Min. Negotiated Rate |
$1,482.00 |
| Max. Negotiated Rate |
$2,408.25 |
| Rate for Payer: Aetna Commercial |
$2,023.86
|
| Rate for Payer: Aetna Medicare |
$1,570.75
|
| Rate for Payer: BCBS Complete |
$1,482.00
|
| Rate for Payer: BCBS MAPPO |
$1,510.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,510.34
|
| Rate for Payer: Cash Price |
$2,964.00
|
| Rate for Payer: Cash Price |
$2,964.00
|
| Rate for Payer: Cofinity Commercial |
$2,174.89
|
| Rate for Payer: Cofinity Commercial |
$2,023.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,510.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,585.86
|
| Rate for Payer: Nomi Health Commercial |
$1,812.41
|
| Rate for Payer: PACE SWMI |
$1,510.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,510.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,408.25
|
| Rate for Payer: Priority Health Medicare |
$1,525.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,510.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,510.34
|
| Rate for Payer: UHC Exchange |
$1,510.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,510.34
|
|
|
PR SUTURE DIGITAL NERVE HAND/FOOT 1 NERVE
|
Professional
|
Both
|
$1,985.00
|
|
|
Service Code
|
HCPCS 64831
|
| Min. Negotiated Rate |
$668.23 |
| Max. Negotiated Rate |
$1,290.25 |
| Rate for Payer: Aetna Commercial |
$895.43
|
| Rate for Payer: Aetna Medicare |
$694.96
|
| Rate for Payer: BCBS Complete |
$794.00
|
| Rate for Payer: BCBS MAPPO |
$668.23
|
| Rate for Payer: BCN Medicare Advantage |
$668.23
|
| Rate for Payer: Cash Price |
$1,588.00
|
| Rate for Payer: Cash Price |
$1,588.00
|
| Rate for Payer: Cofinity Commercial |
$962.25
|
| Rate for Payer: Cofinity Commercial |
$895.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$668.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$701.64
|
| Rate for Payer: Nomi Health Commercial |
$801.88
|
| Rate for Payer: PACE SWMI |
$668.23
|
| Rate for Payer: PHP Medicare Advantage |
$668.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,290.25
|
| Rate for Payer: Priority Health Medicare |
$674.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$668.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$668.23
|
| Rate for Payer: UHC Exchange |
$668.23
|
| Rate for Payer: UHC Medicare Advantage |
$668.23
|
|
|
PR SUTURE EACH ADDITIONAL NERVE HAND/FOOT
|
Professional
|
Both
|
$1,311.00
|
|
|
Service Code
|
HCPCS 64837
|
| Min. Negotiated Rate |
$348.27 |
| Max. Negotiated Rate |
$852.15 |
| Rate for Payer: Aetna Commercial |
$466.68
|
| Rate for Payer: Aetna Medicare |
$362.20
|
| Rate for Payer: BCBS Complete |
$524.40
|
| Rate for Payer: BCBS MAPPO |
$348.27
|
| Rate for Payer: BCN Medicare Advantage |
$348.27
|
| Rate for Payer: Cash Price |
$1,048.80
|
| Rate for Payer: Cash Price |
$1,048.80
|
| Rate for Payer: Cofinity Commercial |
$501.51
|
| Rate for Payer: Cofinity Commercial |
$466.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.68
|
| Rate for Payer: Nomi Health Commercial |
$417.92
|
| Rate for Payer: PACE SWMI |
$348.27
|
| Rate for Payer: PHP Medicare Advantage |
$348.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$852.15
|
| Rate for Payer: Priority Health Medicare |
$351.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.27
|
| Rate for Payer: UHC Exchange |
$348.27
|
| Rate for Payer: UHC Medicare Advantage |
$348.27
|
|
|
PR SUTURE EACH ADDITIONAL PERIPHERAL NERVE
|
Professional
|
Both
|
$1,633.00
|
|
|
Service Code
|
HCPCS 64859
|
| Min. Negotiated Rate |
$236.41 |
| Max. Negotiated Rate |
$1,061.45 |
| Rate for Payer: Aetna Commercial |
$316.79
|
| Rate for Payer: Aetna Medicare |
$245.87
|
| Rate for Payer: BCBS Complete |
$653.20
|
| Rate for Payer: BCBS MAPPO |
$236.41
|
| Rate for Payer: BCN Medicare Advantage |
$236.41
|
| Rate for Payer: Cash Price |
$1,306.40
|
| Rate for Payer: Cash Price |
$1,306.40
|
| Rate for Payer: Cofinity Commercial |
$340.43
|
| Rate for Payer: Cofinity Commercial |
$316.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.23
|
| Rate for Payer: Nomi Health Commercial |
$283.69
|
| Rate for Payer: PACE SWMI |
$236.41
|
| Rate for Payer: PHP Medicare Advantage |
$236.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,061.45
|
| Rate for Payer: Priority Health Medicare |
$238.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.41
|
| Rate for Payer: UHC Exchange |
$236.41
|
| Rate for Payer: UHC Medicare Advantage |
$236.41
|
|
|
PR SUTURE EXTRAHEPATIC BILE DUCT PRE-EXIST INJURY
|
Professional
|
Both
|
$3,048.00
|
|
|
Service Code
|
HCPCS 47900
|
| Min. Negotiated Rate |
$1,219.20 |
| Max. Negotiated Rate |
$1,981.20 |
| Rate for Payer: Aetna Commercial |
$1,794.29
|
| Rate for Payer: Aetna Medicare |
$1,392.58
|
| Rate for Payer: BCBS Complete |
$1,219.20
|
| Rate for Payer: BCBS MAPPO |
$1,339.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,339.02
|
| Rate for Payer: Cash Price |
$2,438.40
|
| Rate for Payer: Cash Price |
$2,438.40
|
| Rate for Payer: Cofinity Commercial |
$1,928.19
|
| Rate for Payer: Cofinity Commercial |
$1,794.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,339.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,405.97
|
| Rate for Payer: Nomi Health Commercial |
$1,606.82
|
| Rate for Payer: PACE SWMI |
$1,339.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,339.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,981.20
|
| Rate for Payer: Priority Health Medicare |
$1,352.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,339.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,339.02
|
| Rate for Payer: UHC Exchange |
$1,339.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,339.02
|
|
|
PR SUTURE FACIAL NERVE EXTRACRANIAL
|
Professional
|
Both
|
$2,429.00
|
|
|
Service Code
|
HCPCS 64864
|
| Min. Negotiated Rate |
$823.37 |
| Max. Negotiated Rate |
$1,578.85 |
| Rate for Payer: Aetna Commercial |
$1,103.32
|
| Rate for Payer: Aetna Medicare |
$856.30
|
| Rate for Payer: BCBS Complete |
$971.60
|
| Rate for Payer: BCBS MAPPO |
$823.37
|
| Rate for Payer: BCN Medicare Advantage |
$823.37
|
| Rate for Payer: Cash Price |
$1,943.20
|
| Rate for Payer: Cash Price |
$1,943.20
|
| Rate for Payer: Cofinity Commercial |
$1,185.65
|
| Rate for Payer: Cofinity Commercial |
$1,103.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$823.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$864.54
|
| Rate for Payer: Nomi Health Commercial |
$988.04
|
| Rate for Payer: PACE SWMI |
$823.37
|
| Rate for Payer: PHP Medicare Advantage |
$823.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.85
|
| Rate for Payer: Priority Health Medicare |
$831.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$823.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$823.37
|
| Rate for Payer: UHC Exchange |
$823.37
|
| Rate for Payer: UHC Medicare Advantage |
$823.37
|
|
|
PR SUTURE FACIAL NERVE INFRATEMPORAL W/WO GRAFT
|
Professional
|
Both
|
$3,037.00
|
|
|
Service Code
|
HCPCS 64865
|
| Min. Negotiated Rate |
$1,023.60 |
| Max. Negotiated Rate |
$1,974.05 |
| Rate for Payer: Aetna Commercial |
$1,371.62
|
| Rate for Payer: Aetna Medicare |
$1,064.54
|
| Rate for Payer: BCBS Complete |
$1,214.80
|
| Rate for Payer: BCBS MAPPO |
$1,023.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,023.60
|
| Rate for Payer: Cash Price |
$2,429.60
|
| Rate for Payer: Cash Price |
$2,429.60
|
| Rate for Payer: Cofinity Commercial |
$1,473.98
|
| Rate for Payer: Cofinity Commercial |
$1,371.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,023.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,074.78
|
| Rate for Payer: Nomi Health Commercial |
$1,228.32
|
| Rate for Payer: PACE SWMI |
$1,023.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,023.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,974.05
|
| Rate for Payer: Priority Health Medicare |
$1,033.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,023.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,023.60
|
| Rate for Payer: UHC Exchange |
$1,023.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,023.60
|
|
|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Facility
|
OP
|
$1,551.00
|
|
|
Service Code
|
CPT 27380
|
| Hospital Charge Code |
27380
|
| Min. Negotiated Rate |
$368.36 |
| Max. Negotiated Rate |
$5,423.52 |
| Rate for Payer: Aetna Commercial |
$1,318.35
|
| Rate for Payer: Aetna Medicare |
$403.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$484.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$484.69
|
| Rate for Payer: BCBS Complete |
$5,423.52
|
| Rate for Payer: BCBS MAPPO |
$387.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,275.08
|
| Rate for Payer: BCN Commercial |
$1,205.90
|
| Rate for Payer: BCN Medicare Advantage |
$387.75
|
| Rate for Payer: Cash Price |
$1,240.80
|
| Rate for Payer: Cash Price |
$1,240.80
|
| Rate for Payer: Cofinity Commercial |
$1,333.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,240.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.75
|
| Rate for Payer: Healthscope Commercial |
$1,395.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,163.25
|
| Rate for Payer: Mclaren Medicaid |
$5,164.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$407.14
|
| Rate for Payer: Meridian Medicaid |
$5,423.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$445.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,318.35
|
| Rate for Payer: Nomi Health Commercial |
$1,271.82
|
| Rate for Payer: PACE Senior Care Partners |
$368.36
|
| Rate for Payer: PACE SWMI |
$387.75
|
| Rate for Payer: PHP Commercial |
$1,318.35
|
| Rate for Payer: PHP Medicare Advantage |
$387.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,164.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,349.37
|
| Rate for Payer: Priority Health Medicare |
$391.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,039.17
|
| Rate for Payer: Railroad Medicare Medicare |
$387.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,364.88
|
| Rate for Payer: UHC Core |
$1,295.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$387.75
|
| Rate for Payer: UHC Exchange |
$387.75
|
| Rate for Payer: UHC Medicare Advantage |
$387.75
|
| Rate for Payer: UHCCP Medicaid |
$5,164.92
|
| Rate for Payer: VA VA |
$387.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,163.25
|
|
|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Professional
|
Both
|
$1,551.00
|
|
|
Service Code
|
HCPCS 27380
|
| Hospital Charge Code |
27380
|
| Min. Negotiated Rate |
$595.26 |
| Max. Negotiated Rate |
$1,008.15 |
| Rate for Payer: Aetna Commercial |
$797.65
|
| Rate for Payer: Aetna Medicare |
$619.07
|
| Rate for Payer: BCBS Complete |
$620.40
|
| Rate for Payer: BCBS MAPPO |
$595.26
|
| Rate for Payer: BCN Medicare Advantage |
$595.26
|
| Rate for Payer: Cash Price |
$1,240.80
|
| Rate for Payer: Cash Price |
$1,240.80
|
| Rate for Payer: Cofinity Commercial |
$857.17
|
| Rate for Payer: Cofinity Commercial |
$797.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$595.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$625.02
|
| Rate for Payer: Nomi Health Commercial |
$714.31
|
| Rate for Payer: PACE SWMI |
$595.26
|
| Rate for Payer: PHP Medicare Advantage |
$595.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.15
|
| Rate for Payer: Priority Health Medicare |
$601.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$595.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$595.26
|
| Rate for Payer: UHC Exchange |
$595.26
|
| Rate for Payer: UHC Medicare Advantage |
$595.26
|
|
|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Professional
|
Both
|
$1,551.00
|
|
|
Service Code
|
HCPCS 27380
|
| Min. Negotiated Rate |
$595.26 |
| Max. Negotiated Rate |
$1,008.15 |
| Rate for Payer: Aetna Commercial |
$797.65
|
| Rate for Payer: Aetna Medicare |
$619.07
|
| Rate for Payer: BCBS Complete |
$620.40
|
| Rate for Payer: BCBS MAPPO |
$595.26
|
| Rate for Payer: BCN Medicare Advantage |
$595.26
|
| Rate for Payer: Cash Price |
$1,240.80
|
| Rate for Payer: Cash Price |
$1,240.80
|
| Rate for Payer: Cofinity Commercial |
$857.17
|
| Rate for Payer: Cofinity Commercial |
$797.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$595.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$625.02
|
| Rate for Payer: Nomi Health Commercial |
$714.31
|
| Rate for Payer: PACE SWMI |
$595.26
|
| Rate for Payer: PHP Medicare Advantage |
$595.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.15
|
| Rate for Payer: Priority Health Medicare |
$601.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$595.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$595.26
|
| Rate for Payer: UHC Exchange |
$595.26
|
| Rate for Payer: UHC Medicare Advantage |
$595.26
|
|
|
PR SUTURE INFRAPATELLAR TENDON PRIMARY
|
Facility
|
IP
|
$1,551.00
|
|
|
Service Code
|
CPT 27380
|
| Hospital Charge Code |
27380
|
| Min. Negotiated Rate |
$1,008.15 |
| Max. Negotiated Rate |
$1,395.90 |
| Rate for Payer: Aetna Commercial |
$1,318.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,266.08
|
| Rate for Payer: BCN Commercial |
$1,198.61
|
| Rate for Payer: Cash Price |
$1,240.80
|
| Rate for Payer: Cofinity Commercial |
$1,333.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,240.80
|
| Rate for Payer: Healthscope Commercial |
$1,395.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,163.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,318.35
|
| Rate for Payer: Nomi Health Commercial |
$1,271.82
|
| Rate for Payer: PHP Commercial |
$1,318.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,349.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,039.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,364.88
|
| Rate for Payer: UHC Core |
$1,295.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,163.25
|
|
|
PR SUTURE MESENTERY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,979.00
|
|
|
Service Code
|
HCPCS 44850
|
| Min. Negotiated Rate |
$725.87 |
| Max. Negotiated Rate |
$1,286.35 |
| Rate for Payer: Aetna Commercial |
$972.67
|
| Rate for Payer: Aetna Medicare |
$754.90
|
| Rate for Payer: BCBS Complete |
$791.60
|
| Rate for Payer: BCBS MAPPO |
$725.87
|
| Rate for Payer: BCN Medicare Advantage |
$725.87
|
| Rate for Payer: Cash Price |
$1,583.20
|
| Rate for Payer: Cash Price |
$1,583.20
|
| Rate for Payer: Cofinity Commercial |
$972.67
|
| Rate for Payer: Cofinity Commercial |
$1,045.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$725.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$762.16
|
| Rate for Payer: Nomi Health Commercial |
$871.04
|
| Rate for Payer: PACE SWMI |
$725.87
|
| Rate for Payer: PHP Medicare Advantage |
$725.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,286.35
|
| Rate for Payer: Priority Health Medicare |
$733.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$725.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$725.87
|
| Rate for Payer: UHC Exchange |
$725.87
|
| Rate for Payer: UHC Medicare Advantage |
$725.87
|
|
|
PR SUTURE NERVE REQ SECONDARY/DELAYED SUTURE
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
HCPCS 64872
|
| Min. Negotiated Rate |
$80.80 |
| Max. Negotiated Rate |
$159.52 |
| Rate for Payer: Aetna Commercial |
$148.45
|
| Rate for Payer: Aetna Medicare |
$115.21
|
| Rate for Payer: BCBS Complete |
$80.80
|
| Rate for Payer: BCBS MAPPO |
$110.78
|
| Rate for Payer: BCN Medicare Advantage |
$110.78
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cofinity Commercial |
$159.52
|
| Rate for Payer: Cofinity Commercial |
$148.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$116.32
|
| Rate for Payer: Nomi Health Commercial |
$132.94
|
| Rate for Payer: PACE SWMI |
$110.78
|
| Rate for Payer: PHP Medicare Advantage |
$110.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.30
|
| Rate for Payer: Priority Health Medicare |
$111.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.78
|
| Rate for Payer: UHC Exchange |
$110.78
|
| Rate for Payer: UHC Medicare Advantage |
$110.78
|
|
|
PR SUTURE NERVE REQ XTNSV MOBIL/TRPOS NERVE
|
Professional
|
Both
|
$310.00
|
|
|
Service Code
|
HCPCS 64874
|
| Min. Negotiated Rate |
$124.00 |
| Max. Negotiated Rate |
$238.75 |
| Rate for Payer: Aetna Commercial |
$222.17
|
| Rate for Payer: Aetna Medicare |
$172.43
|
| Rate for Payer: BCBS Complete |
$124.00
|
| Rate for Payer: BCBS MAPPO |
$165.80
|
| Rate for Payer: BCN Medicare Advantage |
$165.80
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cofinity Commercial |
$238.75
|
| Rate for Payer: Cofinity Commercial |
$222.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.09
|
| Rate for Payer: Nomi Health Commercial |
$198.96
|
| Rate for Payer: PACE SWMI |
$165.80
|
| Rate for Payer: PHP Medicare Advantage |
$165.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.50
|
| Rate for Payer: Priority Health Medicare |
$167.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.80
|
| Rate for Payer: UHC Exchange |
$165.80
|
| Rate for Payer: UHC Medicare Advantage |
$165.80
|
|
