|
PR TEAEC W/WO PATCH GRAFT ABDOMINAL AORTA
|
Professional
|
Both
|
$4,734.00
|
|
|
Service Code
|
HCPCS 35331
|
| Min. Negotiated Rate |
$1,387.99 |
| Max. Negotiated Rate |
$3,077.10 |
| Rate for Payer: Aetna Commercial |
$1,859.91
|
| Rate for Payer: Aetna Medicare |
$1,443.51
|
| Rate for Payer: BCBS Complete |
$1,893.60
|
| Rate for Payer: BCBS MAPPO |
$1,387.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,387.99
|
| Rate for Payer: Cash Price |
$3,787.20
|
| Rate for Payer: Cash Price |
$3,787.20
|
| Rate for Payer: Cofinity Commercial |
$1,998.71
|
| Rate for Payer: Cofinity Commercial |
$1,859.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,387.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,457.39
|
| Rate for Payer: Nomi Health Commercial |
$1,665.59
|
| Rate for Payer: PACE SWMI |
$1,387.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,387.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,077.10
|
| Rate for Payer: Priority Health Medicare |
$1,401.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,387.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,387.99
|
| Rate for Payer: UHC Exchange |
$1,387.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,387.99
|
|
|
PR TEAEC W/WO PATCH GRAFT COMBINED AORTOILIOFEMORAL
|
Professional
|
Both
|
$3,341.00
|
|
|
Service Code
|
HCPCS 35363
|
| Min. Negotiated Rate |
$1,336.40 |
| Max. Negotiated Rate |
$2,254.42 |
| Rate for Payer: Aetna Commercial |
$2,097.86
|
| Rate for Payer: Aetna Medicare |
$1,628.19
|
| Rate for Payer: BCBS Complete |
$1,336.40
|
| Rate for Payer: BCBS MAPPO |
$1,565.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,565.57
|
| Rate for Payer: Cash Price |
$2,672.80
|
| Rate for Payer: Cash Price |
$2,672.80
|
| Rate for Payer: Cofinity Commercial |
$2,254.42
|
| Rate for Payer: Cofinity Commercial |
$2,097.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,565.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,643.85
|
| Rate for Payer: Nomi Health Commercial |
$1,878.68
|
| Rate for Payer: PACE SWMI |
$1,565.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,565.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,171.65
|
| Rate for Payer: Priority Health Medicare |
$1,581.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,565.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,565.57
|
| Rate for Payer: UHC Exchange |
$1,565.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,565.57
|
|
|
PR TEAEC W/WO PATCH GRAFT COMMON FEMORAL
|
Professional
|
Both
|
$1,751.00
|
|
|
Service Code
|
HCPCS 35371
|
| Min. Negotiated Rate |
$700.40 |
| Max. Negotiated Rate |
$1,138.15 |
| Rate for Payer: Aetna Commercial |
$1,045.09
|
| Rate for Payer: Aetna Medicare |
$811.12
|
| Rate for Payer: BCBS Complete |
$700.40
|
| Rate for Payer: BCBS MAPPO |
$779.92
|
| Rate for Payer: BCN Medicare Advantage |
$779.92
|
| Rate for Payer: Cash Price |
$1,400.80
|
| Rate for Payer: Cash Price |
$1,400.80
|
| Rate for Payer: Cofinity Commercial |
$1,123.08
|
| Rate for Payer: Cofinity Commercial |
$1,045.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$779.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$818.92
|
| Rate for Payer: Nomi Health Commercial |
$935.90
|
| Rate for Payer: PACE SWMI |
$779.92
|
| Rate for Payer: PHP Medicare Advantage |
$779.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,138.15
|
| Rate for Payer: Priority Health Medicare |
$787.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$779.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$779.92
|
| Rate for Payer: UHC Exchange |
$779.92
|
| Rate for Payer: UHC Medicare Advantage |
$779.92
|
|
|
PR TEAEC W/WO PATCH GRAFT DEEP PROFUNDA FEMORAL
|
Professional
|
Both
|
$3,773.00
|
|
|
Service Code
|
HCPCS 35372
|
| Min. Negotiated Rate |
$934.36 |
| Max. Negotiated Rate |
$2,452.45 |
| Rate for Payer: Aetna Commercial |
$1,252.04
|
| Rate for Payer: Aetna Medicare |
$971.73
|
| Rate for Payer: BCBS Complete |
$1,509.20
|
| Rate for Payer: BCBS MAPPO |
$934.36
|
| Rate for Payer: BCN Medicare Advantage |
$934.36
|
| Rate for Payer: Cash Price |
$3,018.40
|
| Rate for Payer: Cash Price |
$3,018.40
|
| Rate for Payer: Cofinity Commercial |
$1,345.48
|
| Rate for Payer: Cofinity Commercial |
$1,252.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$934.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$981.08
|
| Rate for Payer: Nomi Health Commercial |
$1,121.23
|
| Rate for Payer: PACE SWMI |
$934.36
|
| Rate for Payer: PHP Medicare Advantage |
$934.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,452.45
|
| Rate for Payer: Priority Health Medicare |
$943.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$934.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$934.36
|
| Rate for Payer: UHC Exchange |
$934.36
|
| Rate for Payer: UHC Medicare Advantage |
$934.36
|
|
|
PR TEAEC W/WO PATCH GRAFT ILIAC
|
Professional
|
Both
|
$2,528.00
|
|
|
Service Code
|
HCPCS 35351
|
| Min. Negotiated Rate |
$1,011.20 |
| Max. Negotiated Rate |
$1,777.84 |
| Rate for Payer: Aetna Commercial |
$1,654.38
|
| Rate for Payer: Aetna Medicare |
$1,283.99
|
| Rate for Payer: BCBS Complete |
$1,011.20
|
| Rate for Payer: BCBS MAPPO |
$1,234.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,234.61
|
| Rate for Payer: Cash Price |
$2,022.40
|
| Rate for Payer: Cash Price |
$2,022.40
|
| Rate for Payer: Cofinity Commercial |
$1,777.84
|
| Rate for Payer: Cofinity Commercial |
$1,654.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,234.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,296.34
|
| Rate for Payer: Nomi Health Commercial |
$1,481.53
|
| Rate for Payer: PACE SWMI |
$1,234.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,234.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,643.20
|
| Rate for Payer: Priority Health Medicare |
$1,246.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,234.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,234.61
|
| Rate for Payer: UHC Exchange |
$1,234.61
|
| Rate for Payer: UHC Medicare Advantage |
$1,234.61
|
|
|
PR TEAEC W/WO PATCH GRAFT ILIOFEMORAL
|
Professional
|
Both
|
$2,053.00
|
|
|
Service Code
|
HCPCS 35355
|
| Min. Negotiated Rate |
$821.20 |
| Max. Negotiated Rate |
$1,421.38 |
| Rate for Payer: Aetna Commercial |
$1,322.67
|
| Rate for Payer: Aetna Medicare |
$1,026.55
|
| Rate for Payer: BCBS Complete |
$821.20
|
| Rate for Payer: BCBS MAPPO |
$987.07
|
| Rate for Payer: BCN Medicare Advantage |
$987.07
|
| Rate for Payer: Cash Price |
$1,642.40
|
| Rate for Payer: Cash Price |
$1,642.40
|
| Rate for Payer: Cofinity Commercial |
$1,421.38
|
| Rate for Payer: Cofinity Commercial |
$1,322.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$987.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,036.42
|
| Rate for Payer: Nomi Health Commercial |
$1,184.48
|
| Rate for Payer: PACE SWMI |
$987.07
|
| Rate for Payer: PHP Medicare Advantage |
$987.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,334.45
|
| Rate for Payer: Priority Health Medicare |
$996.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$987.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$987.07
|
| Rate for Payer: UHC Exchange |
$987.07
|
| Rate for Payer: UHC Medicare Advantage |
$987.07
|
|
|
PR TEAEC W/WO PATCH GRAFT MESENTERIC CELIAC/RENAL
|
Professional
|
Both
|
$4,508.00
|
|
|
Service Code
|
HCPCS 35341
|
| Min. Negotiated Rate |
$1,319.77 |
| Max. Negotiated Rate |
$2,930.20 |
| Rate for Payer: Aetna Commercial |
$1,768.49
|
| Rate for Payer: Aetna Medicare |
$1,372.56
|
| Rate for Payer: BCBS Complete |
$1,803.20
|
| Rate for Payer: BCBS MAPPO |
$1,319.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,319.77
|
| Rate for Payer: Cash Price |
$3,606.40
|
| Rate for Payer: Cash Price |
$3,606.40
|
| Rate for Payer: Cofinity Commercial |
$1,900.47
|
| Rate for Payer: Cofinity Commercial |
$1,768.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,319.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,385.76
|
| Rate for Payer: Nomi Health Commercial |
$1,583.72
|
| Rate for Payer: PACE SWMI |
$1,319.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,319.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,930.20
|
| Rate for Payer: Priority Health Medicare |
$1,332.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,319.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,319.77
|
| Rate for Payer: UHC Exchange |
$1,319.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,319.77
|
|
|
PR TEAEC W/WO PATCH GRF AXILLARY-BRACHIAL
|
Professional
|
Both
|
$3,855.00
|
|
|
Service Code
|
HCPCS 35321
|
| Min. Negotiated Rate |
$869.25 |
| Max. Negotiated Rate |
$2,505.75 |
| Rate for Payer: Aetna Commercial |
$1,164.80
|
| Rate for Payer: Aetna Medicare |
$904.02
|
| Rate for Payer: BCBS Complete |
$1,542.00
|
| Rate for Payer: BCBS MAPPO |
$869.25
|
| Rate for Payer: BCN Medicare Advantage |
$869.25
|
| Rate for Payer: Cash Price |
$3,084.00
|
| Rate for Payer: Cash Price |
$3,084.00
|
| Rate for Payer: Cofinity Commercial |
$1,251.72
|
| Rate for Payer: Cofinity Commercial |
$1,164.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$869.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$912.71
|
| Rate for Payer: Nomi Health Commercial |
$1,043.10
|
| Rate for Payer: PACE SWMI |
$869.25
|
| Rate for Payer: PHP Medicare Advantage |
$869.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,505.75
|
| Rate for Payer: Priority Health Medicare |
$877.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$869.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$869.25
|
| Rate for Payer: UHC Exchange |
$869.25
|
| Rate for Payer: UHC Medicare Advantage |
$869.25
|
|
|
PR TEAEC W/WO PATCH GRF SUBCLAV INNOM THORACIC INC
|
Professional
|
Both
|
$2,846.00
|
|
|
Service Code
|
HCPCS 35311
|
| Min. Negotiated Rate |
$1,138.40 |
| Max. Negotiated Rate |
$2,138.43 |
| Rate for Payer: Aetna Commercial |
$1,989.93
|
| Rate for Payer: Aetna Medicare |
$1,544.42
|
| Rate for Payer: BCBS Complete |
$1,138.40
|
| Rate for Payer: BCBS MAPPO |
$1,485.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,485.02
|
| Rate for Payer: Cash Price |
$2,276.80
|
| Rate for Payer: Cash Price |
$2,276.80
|
| Rate for Payer: Cofinity Commercial |
$2,138.43
|
| Rate for Payer: Cofinity Commercial |
$1,989.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,485.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,559.27
|
| Rate for Payer: Nomi Health Commercial |
$1,782.02
|
| Rate for Payer: PACE SWMI |
$1,485.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,485.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,849.90
|
| Rate for Payer: Priority Health Medicare |
$1,499.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,485.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,485.02
|
| Rate for Payer: UHC Exchange |
$1,485.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,485.02
|
|
|
PR TEAM CONFERENCE NON-FACE-TO-FACE NONPHYSICIAN
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 99368
|
| Min. Negotiated Rate |
$23.60 |
| Max. Negotiated Rate |
$38.35 |
| Rate for Payer: Aetna Medicare |
$29.50
|
| Rate for Payer: BCBS Complete |
$23.60
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.35
|
|
|
PR TEAM CONFERENCE NON-FACE-TO-FACE PHYSICIAN
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 99367
|
| Min. Negotiated Rate |
$61.20 |
| Max. Negotiated Rate |
$99.45 |
| Rate for Payer: Aetna Medicare |
$76.50
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
|
|
PR TELEPHONE ASSMT&MGMT SVC NQHP EST PT 11-20 MIN
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 98967
|
| Min. Negotiated Rate |
$21.65 |
| Max. Negotiated Rate |
$36.40 |
| Rate for Payer: Aetna Commercial |
$29.01
|
| Rate for Payer: Aetna Medicare |
$22.52
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS MAPPO |
$21.65
|
| Rate for Payer: BCN Medicare Advantage |
$21.65
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$29.01
|
| Rate for Payer: Cofinity Commercial |
$31.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.73
|
| Rate for Payer: Nomi Health Commercial |
$25.98
|
| Rate for Payer: PACE SWMI |
$21.65
|
| Rate for Payer: PHP Medicare Advantage |
$21.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health Medicare |
$21.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.65
|
| Rate for Payer: UHC Exchange |
$21.65
|
| Rate for Payer: UHC Medicare Advantage |
$21.65
|
|
|
PR TELEPHONE ASSMT&MGMT SVC NQHP EST PT 21-30 MIN
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 98968
|
| Min. Negotiated Rate |
$30.32 |
| Max. Negotiated Rate |
$53.30 |
| Rate for Payer: Aetna Commercial |
$40.63
|
| Rate for Payer: Aetna Medicare |
$31.53
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: BCBS MAPPO |
$30.32
|
| Rate for Payer: BCN Medicare Advantage |
$30.32
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$43.66
|
| Rate for Payer: Cofinity Commercial |
$40.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.84
|
| Rate for Payer: Nomi Health Commercial |
$36.38
|
| Rate for Payer: PACE SWMI |
$30.32
|
| Rate for Payer: PHP Medicare Advantage |
$30.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
| Rate for Payer: Priority Health Medicare |
$30.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.32
|
| Rate for Payer: UHC Exchange |
$30.32
|
| Rate for Payer: UHC Medicare Advantage |
$30.32
|
|
|
PR TELEPHONE ASSMT&MGMT SVC NQHP EST PT 5-10 MIN
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS 98966
|
| Min. Negotiated Rate |
$11.12 |
| Max. Negotiated Rate |
$18.85 |
| Rate for Payer: Aetna Commercial |
$14.90
|
| Rate for Payer: Aetna Medicare |
$11.56
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: BCBS MAPPO |
$11.12
|
| Rate for Payer: BCN Medicare Advantage |
$11.12
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cofinity Commercial |
$16.01
|
| Rate for Payer: Cofinity Commercial |
$14.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.68
|
| Rate for Payer: Nomi Health Commercial |
$13.34
|
| Rate for Payer: PACE SWMI |
$11.12
|
| Rate for Payer: PHP Medicare Advantage |
$11.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
| Rate for Payer: Priority Health Medicare |
$11.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.12
|
| Rate for Payer: UHC Exchange |
$11.12
|
| Rate for Payer: UHC Medicare Advantage |
$11.12
|
|
|
PR TEMPORARY CLOSURE EYELIDS SUTURE
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 67875
|
| Min. Negotiated Rate |
$89.27 |
| Max. Negotiated Rate |
$247.65 |
| Rate for Payer: Aetna Commercial |
$119.62
|
| Rate for Payer: Aetna Medicare |
$92.84
|
| Rate for Payer: BCBS Complete |
$152.40
|
| Rate for Payer: BCBS MAPPO |
$89.27
|
| Rate for Payer: BCN Medicare Advantage |
$89.27
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cofinity Commercial |
$128.55
|
| Rate for Payer: Cofinity Commercial |
$119.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.73
|
| Rate for Payer: Nomi Health Commercial |
$107.12
|
| Rate for Payer: PACE SWMI |
$89.27
|
| Rate for Payer: PHP Medicare Advantage |
$89.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.65
|
| Rate for Payer: Priority Health Medicare |
$90.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.27
|
| Rate for Payer: UHC Exchange |
$89.27
|
| Rate for Payer: UHC Medicare Advantage |
$89.27
|
|
|
PR TENDON GRAFT FROM A DISTANCE
|
Professional
|
Both
|
$1,113.00
|
|
|
Service Code
|
HCPCS 20924
|
| Min. Negotiated Rate |
$445.20 |
| Max. Negotiated Rate |
$723.45 |
| Rate for Payer: Aetna Commercial |
$650.99
|
| Rate for Payer: Aetna Medicare |
$505.24
|
| Rate for Payer: BCBS Complete |
$445.20
|
| Rate for Payer: BCBS MAPPO |
$485.81
|
| Rate for Payer: BCN Medicare Advantage |
$485.81
|
| Rate for Payer: Cash Price |
$890.40
|
| Rate for Payer: Cash Price |
$890.40
|
| Rate for Payer: Cofinity Commercial |
$699.57
|
| Rate for Payer: Cofinity Commercial |
$650.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$485.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$510.10
|
| Rate for Payer: Nomi Health Commercial |
$582.97
|
| Rate for Payer: PACE SWMI |
$485.81
|
| Rate for Payer: PHP Medicare Advantage |
$485.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$723.45
|
| Rate for Payer: Priority Health Medicare |
$490.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$485.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$485.81
|
| Rate for Payer: UHC Exchange |
$485.81
|
| Rate for Payer: UHC Medicare Advantage |
$485.81
|
|
|
PR TENDON LENGTHENING UPPER ARM/ELBOW EA TENDON
|
Professional
|
Both
|
$1,029.00
|
|
|
Service Code
|
HCPCS 24305
|
| Min. Negotiated Rate |
$411.60 |
| Max. Negotiated Rate |
$808.60 |
| Rate for Payer: Aetna Commercial |
$752.45
|
| Rate for Payer: Aetna Medicare |
$583.99
|
| Rate for Payer: BCBS Complete |
$411.60
|
| Rate for Payer: BCBS MAPPO |
$561.53
|
| Rate for Payer: BCN Medicare Advantage |
$561.53
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cofinity Commercial |
$808.60
|
| Rate for Payer: Cofinity Commercial |
$752.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.61
|
| Rate for Payer: Nomi Health Commercial |
$673.84
|
| Rate for Payer: PACE SWMI |
$561.53
|
| Rate for Payer: PHP Medicare Advantage |
$561.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$668.85
|
| Rate for Payer: Priority Health Medicare |
$567.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$561.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$561.53
|
| Rate for Payer: UHC Exchange |
$561.53
|
| Rate for Payer: UHC Medicare Advantage |
$561.53
|
|
|
PR TENDON SHEATH INCISION
|
Professional
|
Both
|
$1,180.00
|
|
|
Service Code
|
HCPCS 26055
|
| Hospital Charge Code |
26055
|
| Min. Negotiated Rate |
$282.19 |
| Max. Negotiated Rate |
$767.00 |
| Rate for Payer: Aetna Commercial |
$378.13
|
| Rate for Payer: Aetna Medicare |
$293.48
|
| Rate for Payer: BCBS Complete |
$472.00
|
| Rate for Payer: BCBS MAPPO |
$282.19
|
| Rate for Payer: BCN Medicare Advantage |
$282.19
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$406.35
|
| Rate for Payer: Cofinity Commercial |
$378.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.30
|
| Rate for Payer: Nomi Health Commercial |
$338.63
|
| Rate for Payer: PACE SWMI |
$282.19
|
| Rate for Payer: PHP Medicare Advantage |
$282.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.00
|
| Rate for Payer: Priority Health Medicare |
$285.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$282.19
|
| Rate for Payer: UHC Exchange |
$282.19
|
| Rate for Payer: UHC Medicare Advantage |
$282.19
|
|
|
PR TENDON SHEATH INCISION
|
Facility
|
OP
|
$1,180.00
|
|
|
Service Code
|
CPT 26055
|
| Hospital Charge Code |
26055
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$280.25 |
| Max. Negotiated Rate |
$1,215.03 |
| Rate for Payer: Aetna Commercial |
$1,003.00
|
| Rate for Payer: Aetna Medicare |
$306.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$368.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$368.75
|
| Rate for Payer: BCBS Complete |
$1,215.03
|
| Rate for Payer: BCBS MAPPO |
$295.00
|
| Rate for Payer: BCBS Trust/PPO |
$970.08
|
| Rate for Payer: BCN Commercial |
$917.45
|
| Rate for Payer: BCN Medicare Advantage |
$295.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$1,014.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$295.00
|
| Rate for Payer: Healthscope Commercial |
$1,062.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$885.00
|
| Rate for Payer: Mclaren Medicaid |
$1,157.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$309.75
|
| Rate for Payer: Meridian Medicaid |
$1,215.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$339.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,003.00
|
| Rate for Payer: Nomi Health Commercial |
$967.60
|
| Rate for Payer: PACE Senior Care Partners |
$280.25
|
| Rate for Payer: PACE SWMI |
$295.00
|
| Rate for Payer: PHP Commercial |
$1,003.00
|
| Rate for Payer: PHP Medicare Advantage |
$295.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,157.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.00
|
| Rate for Payer: Priority Health HMO/PPO |
$1,026.60
|
| Rate for Payer: Priority Health Medicare |
$297.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$790.60
|
| Rate for Payer: Railroad Medicare Medicare |
$295.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,038.40
|
| Rate for Payer: UHC Core |
$985.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$295.00
|
| Rate for Payer: UHC Exchange |
$295.00
|
| Rate for Payer: UHC Medicare Advantage |
$295.00
|
| Rate for Payer: UHCCP Medicaid |
$1,157.10
|
| Rate for Payer: VA VA |
$295.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$885.00
|
|
|
PR TENDON SHEATH INCISION
|
Professional
|
Both
|
$1,180.00
|
|
|
Service Code
|
HCPCS 26055
|
| Min. Negotiated Rate |
$282.19 |
| Max. Negotiated Rate |
$767.00 |
| Rate for Payer: Aetna Commercial |
$378.13
|
| Rate for Payer: Aetna Medicare |
$293.48
|
| Rate for Payer: BCBS Complete |
$472.00
|
| Rate for Payer: BCBS MAPPO |
$282.19
|
| Rate for Payer: BCN Medicare Advantage |
$282.19
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$406.35
|
| Rate for Payer: Cofinity Commercial |
$378.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.30
|
| Rate for Payer: Nomi Health Commercial |
$338.63
|
| Rate for Payer: PACE SWMI |
$282.19
|
| Rate for Payer: PHP Medicare Advantage |
$282.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.00
|
| Rate for Payer: Priority Health Medicare |
$285.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$282.19
|
| Rate for Payer: UHC Exchange |
$282.19
|
| Rate for Payer: UHC Medicare Advantage |
$282.19
|
|
|
PR TENDON SHEATH INCISION
|
Facility
|
IP
|
$1,180.00
|
|
|
Service Code
|
CPT 26055
|
| Hospital Charge Code |
26055
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$767.00 |
| Max. Negotiated Rate |
$1,062.00 |
| Rate for Payer: Aetna Commercial |
$1,003.00
|
| Rate for Payer: BCBS Trust/PPO |
$963.23
|
| Rate for Payer: BCN Commercial |
$911.90
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$1,014.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.00
|
| Rate for Payer: Healthscope Commercial |
$1,062.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$885.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,003.00
|
| Rate for Payer: Nomi Health Commercial |
$967.60
|
| Rate for Payer: PHP Commercial |
$1,003.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.00
|
| Rate for Payer: Priority Health HMO/PPO |
$1,026.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$790.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,038.40
|
| Rate for Payer: UHC Core |
$985.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$885.00
|
|
|
PR TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT
|
Professional
|
Both
|
$1,419.00
|
|
|
Service Code
|
HCPCS 26483
|
| Min. Negotiated Rate |
$567.60 |
| Max. Negotiated Rate |
$1,171.71 |
| Rate for Payer: Aetna Commercial |
$1,090.34
|
| Rate for Payer: Aetna Medicare |
$846.24
|
| Rate for Payer: BCBS Complete |
$567.60
|
| Rate for Payer: BCBS MAPPO |
$813.69
|
| Rate for Payer: BCN Medicare Advantage |
$813.69
|
| Rate for Payer: Cash Price |
$1,135.20
|
| Rate for Payer: Cash Price |
$1,135.20
|
| Rate for Payer: Cofinity Commercial |
$1,171.71
|
| Rate for Payer: Cofinity Commercial |
$1,090.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$813.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$854.37
|
| Rate for Payer: Nomi Health Commercial |
$976.43
|
| Rate for Payer: PACE SWMI |
$813.69
|
| Rate for Payer: PHP Medicare Advantage |
$813.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$922.35
|
| Rate for Payer: Priority Health Medicare |
$821.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$813.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$813.69
|
| Rate for Payer: UHC Exchange |
$813.69
|
| Rate for Payer: UHC Medicare Advantage |
$813.69
|
|
|
PR TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,092.00
|
|
|
Service Code
|
HCPCS 24340
|
| Min. Negotiated Rate |
$436.80 |
| Max. Negotiated Rate |
$844.34 |
| Rate for Payer: Aetna Commercial |
$785.71
|
| Rate for Payer: Aetna Medicare |
$609.80
|
| Rate for Payer: BCBS Complete |
$436.80
|
| Rate for Payer: BCBS MAPPO |
$586.35
|
| Rate for Payer: BCN Medicare Advantage |
$586.35
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cash Price |
$873.60
|
| Rate for Payer: Cofinity Commercial |
$844.34
|
| Rate for Payer: Cofinity Commercial |
$785.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$586.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$615.67
|
| Rate for Payer: Nomi Health Commercial |
$703.62
|
| Rate for Payer: PACE SWMI |
$586.35
|
| Rate for Payer: PHP Medicare Advantage |
$586.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$709.80
|
| Rate for Payer: Priority Health Medicare |
$592.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$586.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$586.35
|
| Rate for Payer: UHC Exchange |
$586.35
|
| Rate for Payer: UHC Medicare Advantage |
$586.35
|
|
|
PR TENODESIS DISTAL JOINT EACH
|
Professional
|
Both
|
$1,015.00
|
|
|
Service Code
|
HCPCS 26474
|
| Min. Negotiated Rate |
$406.00 |
| Max. Negotiated Rate |
$874.18 |
| Rate for Payer: Aetna Commercial |
$813.47
|
| Rate for Payer: Aetna Medicare |
$631.35
|
| Rate for Payer: BCBS Complete |
$406.00
|
| Rate for Payer: BCBS MAPPO |
$607.07
|
| Rate for Payer: BCN Medicare Advantage |
$607.07
|
| Rate for Payer: Cash Price |
$812.00
|
| Rate for Payer: Cash Price |
$812.00
|
| Rate for Payer: Cofinity Commercial |
$874.18
|
| Rate for Payer: Cofinity Commercial |
$813.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$637.42
|
| Rate for Payer: Nomi Health Commercial |
$728.48
|
| Rate for Payer: PACE SWMI |
$607.07
|
| Rate for Payer: PHP Medicare Advantage |
$607.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$659.75
|
| Rate for Payer: Priority Health Medicare |
$613.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$607.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$607.07
|
| Rate for Payer: UHC Exchange |
$607.07
|
| Rate for Payer: UHC Medicare Advantage |
$607.07
|
|
|
PR TENODESIS LONG TENDON BICEPS
|
Professional
|
Both
|
$2,357.00
|
|
|
Service Code
|
HCPCS 23430
|
| Min. Negotiated Rate |
$717.63 |
| Max. Negotiated Rate |
$1,532.05 |
| Rate for Payer: Aetna Commercial |
$961.62
|
| Rate for Payer: Aetna Medicare |
$746.34
|
| Rate for Payer: BCBS Complete |
$942.80
|
| Rate for Payer: BCBS MAPPO |
$717.63
|
| Rate for Payer: BCN Medicare Advantage |
$717.63
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Cash Price |
$1,885.60
|
| Rate for Payer: Cofinity Commercial |
$961.62
|
| Rate for Payer: Cofinity Commercial |
$1,033.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$753.51
|
| Rate for Payer: Nomi Health Commercial |
$861.16
|
| Rate for Payer: PACE SWMI |
$717.63
|
| Rate for Payer: PHP Medicare Advantage |
$717.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,532.05
|
| Rate for Payer: Priority Health Medicare |
$724.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$717.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$717.63
|
| Rate for Payer: UHC Exchange |
$717.63
|
| Rate for Payer: UHC Medicare Advantage |
$717.63
|
|
