|
PR AORTIC SUSPENSION TRACHEAL DECOMPRESSION SPX
|
Professional
|
Both
|
$1,920.00
|
|
|
Service Code
|
HCPCS 33800
|
| Min. Negotiated Rate |
$597.04 |
| Max. Negotiated Rate |
$1,753.45 |
| Rate for Payer: Aetna Commercial |
$1,252.00
|
| Rate for Payer: Aetna Medicare |
$971.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,252.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,345.44
|
| Rate for Payer: BCBS Complete |
$626.89
|
| Rate for Payer: BCBS MAPPO |
$934.33
|
| Rate for Payer: BCN Commercial |
$1,458.09
|
| Rate for Payer: BCN Medicare Advantage |
$934.33
|
| Rate for Payer: Cash Price |
$1,536.00
|
| Rate for Payer: Cash Price |
$1,536.00
|
| Rate for Payer: Cofinity Commercial |
$1,252.00
|
| Rate for Payer: Cofinity Commercial |
$1,345.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$934.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$981.05
|
| Rate for Payer: Meridian Medicaid |
$626.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,027.76
|
| Rate for Payer: Nomi Health Commercial |
$1,121.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,440.00
|
| Rate for Payer: PACE SWMI |
$934.33
|
| Rate for Payer: PHP Commercial |
$1,308.06
|
| Rate for Payer: PHP Medicare Advantage |
$934.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,568.00
|
| Rate for Payer: Priority Health Medicare |
$934.33
|
| Rate for Payer: Priority Health SBD |
$1,568.00
|
| Rate for Payer: Priority Health Tiered Network |
$1,568.00
|
| Rate for Payer: Railroad Medicare Medicare |
$934.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,753.45
|
| Rate for Payer: UHC Core |
$1,753.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$934.33
|
| Rate for Payer: UHC Exchange |
$1,753.45
|
| Rate for Payer: UHC Medicaid |
$597.04
|
| Rate for Payer: UHCCP Medicaid |
$597.04
|
| Rate for Payer: UMR Bronson Commercial |
$883.20
|
|
|
PR AORTOPLASTY SUPRAVALVULAR STENOSIS
|
Professional
|
Both
|
$9,659.00
|
|
|
Service Code
|
HCPCS 33417
|
| Min. Negotiated Rate |
$1,007.70 |
| Max. Negotiated Rate |
$7,244.25 |
| Rate for Payer: Aetna Commercial |
$2,114.41
|
| Rate for Payer: Aetna Medicare |
$1,641.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,114.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,272.20
|
| Rate for Payer: BCBS Complete |
$1,058.09
|
| Rate for Payer: BCBS MAPPO |
$1,577.92
|
| Rate for Payer: BCN Commercial |
$2,464.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,577.92
|
| Rate for Payer: Cash Price |
$7,727.20
|
| Rate for Payer: Cash Price |
$7,727.20
|
| Rate for Payer: Cofinity Commercial |
$2,114.41
|
| Rate for Payer: Cofinity Commercial |
$2,272.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,577.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,656.82
|
| Rate for Payer: Meridian Medicaid |
$1,058.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,735.71
|
| Rate for Payer: Nomi Health Commercial |
$1,893.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,244.25
|
| Rate for Payer: PACE SWMI |
$1,577.92
|
| Rate for Payer: PHP Commercial |
$2,209.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,577.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,007.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,649.72
|
| Rate for Payer: Priority Health Medicare |
$1,577.92
|
| Rate for Payer: Priority Health SBD |
$2,649.72
|
| Rate for Payer: Priority Health Tiered Network |
$2,649.72
|
| Rate for Payer: Railroad Medicare Medicare |
$1,577.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,963.05
|
| Rate for Payer: UHC Core |
$2,963.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,577.92
|
| Rate for Payer: UHC Exchange |
$2,963.05
|
| Rate for Payer: UHC Medicaid |
$1,007.70
|
| Rate for Payer: UHCCP Medicaid |
$1,007.70
|
| Rate for Payer: UMR Bronson Commercial |
$4,443.14
|
|
|
PR APNEALINK
|
Professional
|
Both
|
$10.00
|
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: Aetna Medicare |
$5.00
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.50
|
| Rate for Payer: UMR Bronson Commercial |
$4.60
|
|
|
PR APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX
|
Professional
|
Both
|
$891.00
|
|
|
Service Code
|
HCPCS 44955
|
| Min. Negotiated Rate |
$47.71 |
| Max. Negotiated Rate |
$668.25 |
| Rate for Payer: Aetna Commercial |
$100.82
|
| Rate for Payer: Aetna Medicare |
$78.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.35
|
| Rate for Payer: BCBS Complete |
$50.10
|
| Rate for Payer: BCBS MAPPO |
$75.24
|
| Rate for Payer: BCN Commercial |
$124.00
|
| Rate for Payer: BCN Medicare Advantage |
$75.24
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cofinity Commercial |
$108.35
|
| Rate for Payer: Cofinity Commercial |
$100.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.00
|
| Rate for Payer: Meridian Medicaid |
$50.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$82.76
|
| Rate for Payer: Nomi Health Commercial |
$90.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$668.25
|
| Rate for Payer: PACE SWMI |
$75.24
|
| Rate for Payer: PHP Commercial |
$105.34
|
| Rate for Payer: PHP Medicare Advantage |
$75.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$151.08
|
| Rate for Payer: Priority Health Medicare |
$75.24
|
| Rate for Payer: Priority Health SBD |
$151.08
|
| Rate for Payer: Priority Health Tiered Network |
$151.08
|
| Rate for Payer: Railroad Medicare Medicare |
$75.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.48
|
| Rate for Payer: UHC Core |
$149.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$75.24
|
| Rate for Payer: UHC Exchange |
$149.48
|
| Rate for Payer: UHC Medicaid |
$47.71
|
| Rate for Payer: UHCCP Medicaid |
$47.71
|
| Rate for Payer: UMR Bronson Commercial |
$409.86
|
|
|
PR APPENDEC RPTD APPENDIX ABSC/PRITONITIS
|
Professional
|
Both
|
$2,201.00
|
|
|
Service Code
|
HCPCS 44960
|
| Min. Negotiated Rate |
$526.11 |
| Max. Negotiated Rate |
$1,650.75 |
| Rate for Payer: Aetna Commercial |
$1,099.97
|
| Rate for Payer: Aetna Medicare |
$853.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,099.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,182.05
|
| Rate for Payer: BCBS Complete |
$552.42
|
| Rate for Payer: BCBS MAPPO |
$820.87
|
| Rate for Payer: BCN Commercial |
$1,319.65
|
| Rate for Payer: BCN Medicare Advantage |
$820.87
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cash Price |
$1,760.80
|
| Rate for Payer: Cofinity Commercial |
$1,099.97
|
| Rate for Payer: Cofinity Commercial |
$1,182.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$820.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$861.91
|
| Rate for Payer: Meridian Medicaid |
$552.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$902.96
|
| Rate for Payer: Nomi Health Commercial |
$985.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,650.75
|
| Rate for Payer: PACE SWMI |
$820.87
|
| Rate for Payer: PHP Commercial |
$1,149.22
|
| Rate for Payer: PHP Medicare Advantage |
$820.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$526.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,607.90
|
| Rate for Payer: Priority Health Medicare |
$820.87
|
| Rate for Payer: Priority Health SBD |
$1,607.90
|
| Rate for Payer: Priority Health Tiered Network |
$1,607.90
|
| Rate for Payer: Railroad Medicare Medicare |
$820.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,564.17
|
| Rate for Payer: UHC Core |
$1,564.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$820.87
|
| Rate for Payer: UHC Exchange |
$1,564.17
|
| Rate for Payer: UHC Medicaid |
$526.11
|
| Rate for Payer: UHCCP Medicaid |
$526.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,012.46
|
|
|
PR APPENDECTOMY
|
Professional
|
Both
|
$1,790.00
|
|
|
Service Code
|
HCPCS 44950
|
| Min. Negotiated Rate |
$386.17 |
| Max. Negotiated Rate |
$1,342.50 |
| Rate for Payer: Aetna Commercial |
$806.35
|
| Rate for Payer: Aetna Medicare |
$625.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$806.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$866.52
|
| Rate for Payer: BCBS Complete |
$405.48
|
| Rate for Payer: BCBS MAPPO |
$601.75
|
| Rate for Payer: BCN Commercial |
$967.08
|
| Rate for Payer: BCN Medicare Advantage |
$601.75
|
| Rate for Payer: Cash Price |
$1,432.00
|
| Rate for Payer: Cash Price |
$1,432.00
|
| Rate for Payer: Cofinity Commercial |
$806.35
|
| Rate for Payer: Cofinity Commercial |
$866.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$601.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$631.84
|
| Rate for Payer: Meridian Medicaid |
$405.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$661.92
|
| Rate for Payer: Nomi Health Commercial |
$722.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,342.50
|
| Rate for Payer: PACE SWMI |
$601.75
|
| Rate for Payer: PHP Commercial |
$842.45
|
| Rate for Payer: PHP Medicare Advantage |
$601.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$386.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,178.32
|
| Rate for Payer: Priority Health Medicare |
$601.75
|
| Rate for Payer: Priority Health SBD |
$1,178.32
|
| Rate for Payer: Priority Health Tiered Network |
$1,178.32
|
| Rate for Payer: Railroad Medicare Medicare |
$601.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,145.86
|
| Rate for Payer: UHC Core |
$1,145.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$601.75
|
| Rate for Payer: UHC Exchange |
$1,145.86
|
| Rate for Payer: UHC Medicaid |
$386.17
|
| Rate for Payer: UHCCP Medicaid |
$386.17
|
| Rate for Payer: UMR Bronson Commercial |
$823.40
|
|
|
PR APPL CRANIAL TONG/STRTCTC FRAME W/REMOVAL SPX
|
Professional
|
Both
|
$890.00
|
|
|
Service Code
|
HCPCS 20660
|
| Min. Negotiated Rate |
$136.96 |
| Max. Negotiated Rate |
$667.50 |
| Rate for Payer: Aetna Commercial |
$290.12
|
| Rate for Payer: Aetna Medicare |
$225.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.77
|
| Rate for Payer: BCBS Complete |
$143.81
|
| Rate for Payer: BCBS MAPPO |
$216.51
|
| Rate for Payer: BCN Commercial |
$362.03
|
| Rate for Payer: BCN Medicare Advantage |
$216.51
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Commercial |
$290.12
|
| Rate for Payer: Cofinity Commercial |
$311.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.34
|
| Rate for Payer: Meridian Medicaid |
$143.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$238.16
|
| Rate for Payer: Nomi Health Commercial |
$259.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$667.50
|
| Rate for Payer: PACE SWMI |
$216.51
|
| Rate for Payer: PHP Commercial |
$303.11
|
| Rate for Payer: PHP Medicare Advantage |
$216.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$387.00
|
| Rate for Payer: Priority Health Medicare |
$216.51
|
| Rate for Payer: Priority Health SBD |
$387.00
|
| Rate for Payer: Priority Health Tiered Network |
$387.00
|
| Rate for Payer: Railroad Medicare Medicare |
$216.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.62
|
| Rate for Payer: UHC Core |
$429.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$216.51
|
| Rate for Payer: UHC Exchange |
$429.62
|
| Rate for Payer: UHC Medicaid |
$136.96
|
| Rate for Payer: UHCCP Medicaid |
$136.96
|
| Rate for Payer: UMR Bronson Commercial |
$409.40
|
|
|
PR APPL HIP SPICA CAST ONE&ONE-HALF SPICA/BOTH LEGS
|
Professional
|
Both
|
$680.00
|
|
|
Service Code
|
HCPCS 29325
|
| Min. Negotiated Rate |
$107.35 |
| Max. Negotiated Rate |
$510.00 |
| Rate for Payer: Aetna Commercial |
$219.29
|
| Rate for Payer: Aetna Medicare |
$170.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.66
|
| Rate for Payer: BCBS Complete |
$112.72
|
| Rate for Payer: BCBS MAPPO |
$163.65
|
| Rate for Payer: BCN Commercial |
$271.40
|
| Rate for Payer: BCN Medicare Advantage |
$163.65
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cash Price |
$544.00
|
| Rate for Payer: Cofinity Commercial |
$219.29
|
| Rate for Payer: Cofinity Commercial |
$235.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$171.83
|
| Rate for Payer: Meridian Medicaid |
$112.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$180.01
|
| Rate for Payer: Nomi Health Commercial |
$196.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$510.00
|
| Rate for Payer: PACE SWMI |
$163.65
|
| Rate for Payer: PHP Commercial |
$229.11
|
| Rate for Payer: PHP Medicare Advantage |
$163.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$290.12
|
| Rate for Payer: Priority Health Medicare |
$163.65
|
| Rate for Payer: Priority Health SBD |
$290.12
|
| Rate for Payer: Priority Health Tiered Network |
$290.12
|
| Rate for Payer: Railroad Medicare Medicare |
$163.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.32
|
| Rate for Payer: UHC Core |
$307.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$163.65
|
| Rate for Payer: UHC Exchange |
$307.32
|
| Rate for Payer: UHC Medicaid |
$107.35
|
| Rate for Payer: UHCCP Medicaid |
$107.35
|
| Rate for Payer: UMR Bronson Commercial |
$312.80
|
|
|
PR APPLICATION CAST ELBOW TO FINGER SHORT ARM
|
Professional
|
Both
|
$207.00
|
|
|
Service Code
|
HCPCS 29075
|
| Min. Negotiated Rate |
$37.49 |
| Max. Negotiated Rate |
$155.25 |
| Rate for Payer: Aetna Commercial |
$76.19
|
| Rate for Payer: Aetna Medicare |
$59.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.88
|
| Rate for Payer: BCBS Complete |
$39.36
|
| Rate for Payer: BCBS MAPPO |
$56.86
|
| Rate for Payer: BCN Commercial |
$75.79
|
| Rate for Payer: BCN Medicare Advantage |
$56.86
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cofinity Commercial |
$76.19
|
| Rate for Payer: Cofinity Commercial |
$81.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.70
|
| Rate for Payer: Meridian Medicaid |
$39.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.55
|
| Rate for Payer: Nomi Health Commercial |
$68.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$155.25
|
| Rate for Payer: PACE SWMI |
$56.86
|
| Rate for Payer: PHP Commercial |
$79.60
|
| Rate for Payer: PHP Medicare Advantage |
$56.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$102.74
|
| Rate for Payer: Priority Health Medicare |
$56.86
|
| Rate for Payer: Priority Health SBD |
$102.74
|
| Rate for Payer: Priority Health Tiered Network |
$102.74
|
| Rate for Payer: Railroad Medicare Medicare |
$56.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.91
|
| Rate for Payer: UHC Core |
$105.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$56.86
|
| Rate for Payer: UHC Exchange |
$105.91
|
| Rate for Payer: UHC Medicaid |
$37.49
|
| Rate for Payer: UHCCP Medicaid |
$37.49
|
| Rate for Payer: UMR Bronson Commercial |
$95.22
|
|
|
PR APPLICATION CAST FIGURE-OF-EIGHT
|
Professional
|
Both
|
$246.00
|
|
|
Service Code
|
HCPCS 29049
|
| Min. Negotiated Rate |
$42.81 |
| Max. Negotiated Rate |
$184.50 |
| Rate for Payer: Aetna Commercial |
$87.35
|
| Rate for Payer: Aetna Medicare |
$67.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.87
|
| Rate for Payer: BCBS Complete |
$44.95
|
| Rate for Payer: BCBS MAPPO |
$65.19
|
| Rate for Payer: BCN Commercial |
$106.57
|
| Rate for Payer: BCN Medicare Advantage |
$65.19
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cofinity Commercial |
$87.35
|
| Rate for Payer: Cofinity Commercial |
$93.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.45
|
| Rate for Payer: Meridian Medicaid |
$44.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.71
|
| Rate for Payer: Nomi Health Commercial |
$78.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$184.50
|
| Rate for Payer: PACE SWMI |
$65.19
|
| Rate for Payer: PHP Commercial |
$91.27
|
| Rate for Payer: PHP Medicare Advantage |
$65.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$113.92
|
| Rate for Payer: Priority Health Medicare |
$65.19
|
| Rate for Payer: Priority Health SBD |
$113.92
|
| Rate for Payer: Priority Health Tiered Network |
$113.92
|
| Rate for Payer: Railroad Medicare Medicare |
$65.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.62
|
| Rate for Payer: UHC Core |
$120.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.19
|
| Rate for Payer: UHC Exchange |
$120.62
|
| Rate for Payer: UHC Medicaid |
$42.81
|
| Rate for Payer: UHCCP Medicaid |
$42.81
|
| Rate for Payer: UMR Bronson Commercial |
$113.16
|
|
|
PR APPLICATION CAST FINGER
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 29086
|
| Min. Negotiated Rate |
$29.39 |
| Max. Negotiated Rate |
$101.25 |
| Rate for Payer: Aetna Commercial |
$59.21
|
| Rate for Payer: Aetna Medicare |
$45.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.63
|
| Rate for Payer: BCBS Complete |
$30.86
|
| Rate for Payer: BCBS MAPPO |
$44.19
|
| Rate for Payer: BCN Commercial |
$74.70
|
| Rate for Payer: BCN Medicare Advantage |
$44.19
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cofinity Commercial |
$59.21
|
| Rate for Payer: Cofinity Commercial |
$63.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.40
|
| Rate for Payer: Meridian Medicaid |
$30.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.61
|
| Rate for Payer: Nomi Health Commercial |
$53.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.25
|
| Rate for Payer: PACE SWMI |
$44.19
|
| Rate for Payer: PHP Commercial |
$61.87
|
| Rate for Payer: PHP Medicare Advantage |
$44.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$79.85
|
| Rate for Payer: Priority Health Medicare |
$44.19
|
| Rate for Payer: Priority Health SBD |
$79.85
|
| Rate for Payer: Priority Health Tiered Network |
$79.85
|
| Rate for Payer: Railroad Medicare Medicare |
$44.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.25
|
| Rate for Payer: UHC Core |
$88.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.19
|
| Rate for Payer: UHC Exchange |
$88.25
|
| Rate for Payer: UHC Medicaid |
$29.39
|
| Rate for Payer: UHCCP Medicaid |
$29.39
|
| Rate for Payer: UMR Bronson Commercial |
$62.10
|
|
|
PR APPLICATION CAST HAND & LOWER FOREARM GAUNTLET
|
Professional
|
Both
|
$195.00
|
|
|
Service Code
|
HCPCS 29085
|
| Min. Negotiated Rate |
$40.47 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Aetna Commercial |
$82.49
|
| Rate for Payer: Aetna Medicare |
$64.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.65
|
| Rate for Payer: BCBS Complete |
$42.49
|
| Rate for Payer: BCBS MAPPO |
$61.56
|
| Rate for Payer: BCN Commercial |
$81.29
|
| Rate for Payer: BCN Medicare Advantage |
$61.56
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cofinity Commercial |
$82.49
|
| Rate for Payer: Cofinity Commercial |
$88.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.64
|
| Rate for Payer: Meridian Medicaid |
$42.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.72
|
| Rate for Payer: Nomi Health Commercial |
$73.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$146.25
|
| Rate for Payer: PACE SWMI |
$61.56
|
| Rate for Payer: PHP Commercial |
$86.18
|
| Rate for Payer: PHP Medicare Advantage |
$61.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$110.20
|
| Rate for Payer: Priority Health Medicare |
$61.56
|
| Rate for Payer: Priority Health SBD |
$110.20
|
| Rate for Payer: Priority Health Tiered Network |
$110.20
|
| Rate for Payer: Railroad Medicare Medicare |
$61.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.76
|
| Rate for Payer: UHC Core |
$115.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$61.56
|
| Rate for Payer: UHC Exchange |
$115.76
|
| Rate for Payer: UHC Medicaid |
$40.47
|
| Rate for Payer: UHCCP Medicaid |
$40.47
|
| Rate for Payer: UMR Bronson Commercial |
$89.70
|
|
|
PR APPLICATION CAST SHOULDER TO HAND LONG ARM
|
Professional
|
Both
|
$267.00
|
|
|
Service Code
|
HCPCS 29065
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$200.25 |
| Rate for Payer: Aetna Commercial |
$83.82
|
| Rate for Payer: Aetna Medicare |
$65.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.07
|
| Rate for Payer: BCBS Complete |
$43.17
|
| Rate for Payer: BCBS MAPPO |
$62.55
|
| Rate for Payer: BCN Commercial |
$81.68
|
| Rate for Payer: BCN Medicare Advantage |
$62.55
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cofinity Commercial |
$83.82
|
| Rate for Payer: Cofinity Commercial |
$90.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.68
|
| Rate for Payer: Meridian Medicaid |
$43.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.81
|
| Rate for Payer: Nomi Health Commercial |
$75.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.25
|
| Rate for Payer: PACE SWMI |
$62.55
|
| Rate for Payer: PHP Commercial |
$87.57
|
| Rate for Payer: PHP Medicare Advantage |
$62.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$110.72
|
| Rate for Payer: Priority Health Medicare |
$62.55
|
| Rate for Payer: Priority Health SBD |
$110.72
|
| Rate for Payer: Priority Health Tiered Network |
$110.72
|
| Rate for Payer: Railroad Medicare Medicare |
$62.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.54
|
| Rate for Payer: UHC Core |
$117.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.55
|
| Rate for Payer: UHC Exchange |
$117.54
|
| Rate for Payer: UHC Medicaid |
$41.11
|
| Rate for Payer: UHCCP Medicaid |
$41.11
|
| Rate for Payer: UMR Bronson Commercial |
$122.82
|
|
|
PR APPLICATION CYLINDER CAST THIGH TO ANKLE
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
HCPCS 29365
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$107.23
|
| Rate for Payer: Aetna Medicare |
$83.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.23
|
| Rate for Payer: BCBS Complete |
$55.02
|
| Rate for Payer: BCBS MAPPO |
$80.02
|
| Rate for Payer: BCN Commercial |
$132.46
|
| Rate for Payer: BCN Medicare Advantage |
$80.02
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Commercial |
$107.23
|
| Rate for Payer: Cofinity Commercial |
$115.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.02
|
| Rate for Payer: Meridian Medicaid |
$55.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.02
|
| Rate for Payer: Nomi Health Commercial |
$96.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.00
|
| Rate for Payer: PACE SWMI |
$80.02
|
| Rate for Payer: PHP Commercial |
$112.03
|
| Rate for Payer: PHP Medicare Advantage |
$80.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$141.60
|
| Rate for Payer: Priority Health Medicare |
$80.02
|
| Rate for Payer: Priority Health SBD |
$141.60
|
| Rate for Payer: Priority Health Tiered Network |
$141.60
|
| Rate for Payer: Railroad Medicare Medicare |
$80.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.15
|
| Rate for Payer: UHC Core |
$151.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.02
|
| Rate for Payer: UHC Exchange |
$151.15
|
| Rate for Payer: UHC Medicaid |
$52.40
|
| Rate for Payer: UHCCP Medicaid |
$52.40
|
| Rate for Payer: UMR Bronson Commercial |
$119.60
|
|
|
PR APPLICATION FINGER SPLINT DYNAMIC
|
Professional
|
Both
|
$108.00
|
|
|
Service Code
|
HCPCS 29131
|
| Min. Negotiated Rate |
$19.81 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Aetna Commercial |
$40.88
|
| Rate for Payer: Aetna Medicare |
$31.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.93
|
| Rate for Payer: BCBS Complete |
$20.80
|
| Rate for Payer: BCBS MAPPO |
$30.51
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: BCN Medicare Advantage |
$30.51
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cofinity Commercial |
$40.88
|
| Rate for Payer: Cofinity Commercial |
$43.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.04
|
| Rate for Payer: Meridian Medicaid |
$20.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.56
|
| Rate for Payer: Nomi Health Commercial |
$36.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.00
|
| Rate for Payer: PACE SWMI |
$30.51
|
| Rate for Payer: PHP Commercial |
$42.71
|
| Rate for Payer: PHP Medicare Advantage |
$30.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$55.89
|
| Rate for Payer: Priority Health Medicare |
$30.51
|
| Rate for Payer: Priority Health SBD |
$55.89
|
| Rate for Payer: Priority Health Tiered Network |
$55.89
|
| Rate for Payer: Railroad Medicare Medicare |
$30.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.72
|
| Rate for Payer: UHC Core |
$59.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.51
|
| Rate for Payer: UHC Exchange |
$59.72
|
| Rate for Payer: UHC Medicaid |
$19.81
|
| Rate for Payer: UHCCP Medicaid |
$19.81
|
| Rate for Payer: UMR Bronson Commercial |
$49.68
|
|
|
PR APPLICATION FINGER SPLINT STATIC
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS 29130
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$72.75 |
| Rate for Payer: Aetna Commercial |
$34.14
|
| Rate for Payer: Aetna Medicare |
$26.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.69
|
| Rate for Payer: BCBS Complete |
$17.22
|
| Rate for Payer: BCBS MAPPO |
$25.48
|
| Rate for Payer: BCN Commercial |
$43.33
|
| Rate for Payer: BCN Medicare Advantage |
$25.48
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cofinity Commercial |
$34.14
|
| Rate for Payer: Cofinity Commercial |
$36.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.75
|
| Rate for Payer: Meridian Medicaid |
$17.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.03
|
| Rate for Payer: Nomi Health Commercial |
$30.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.75
|
| Rate for Payer: PACE SWMI |
$25.48
|
| Rate for Payer: PHP Commercial |
$35.67
|
| Rate for Payer: PHP Medicare Advantage |
$25.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$46.31
|
| Rate for Payer: Priority Health Medicare |
$25.48
|
| Rate for Payer: Priority Health SBD |
$46.31
|
| Rate for Payer: Priority Health Tiered Network |
$46.31
|
| Rate for Payer: Railroad Medicare Medicare |
$25.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.99
|
| Rate for Payer: UHC Core |
$51.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.48
|
| Rate for Payer: UHC Exchange |
$51.99
|
| Rate for Payer: UHC Medicaid |
$16.40
|
| Rate for Payer: UHCCP Medicaid |
$16.40
|
| Rate for Payer: UMR Bronson Commercial |
$44.62
|
|
|
PR APPLICATION HALO CRANIAL INCLUDING REMOVAL
|
Professional
|
Both
|
$1,132.00
|
|
|
Service Code
|
HCPCS 20661
|
| Min. Negotiated Rate |
$352.94 |
| Max. Negotiated Rate |
$870.93 |
| Rate for Payer: Aetna Commercial |
$714.10
|
| Rate for Payer: Aetna Medicare |
$554.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$714.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.39
|
| Rate for Payer: BCBS Complete |
$370.59
|
| Rate for Payer: BCBS MAPPO |
$532.91
|
| Rate for Payer: BCN Commercial |
$870.93
|
| Rate for Payer: BCN Medicare Advantage |
$532.91
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Cofinity Commercial |
$714.10
|
| Rate for Payer: Cofinity Commercial |
$767.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$532.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$559.56
|
| Rate for Payer: Meridian Medicaid |
$370.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$586.20
|
| Rate for Payer: Nomi Health Commercial |
$639.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$849.00
|
| Rate for Payer: PACE SWMI |
$532.91
|
| Rate for Payer: PHP Commercial |
$746.07
|
| Rate for Payer: PHP Medicare Advantage |
$532.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$847.47
|
| Rate for Payer: Priority Health Medicare |
$532.91
|
| Rate for Payer: Priority Health SBD |
$847.47
|
| Rate for Payer: Priority Health Tiered Network |
$847.47
|
| Rate for Payer: Railroad Medicare Medicare |
$532.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$865.89
|
| Rate for Payer: UHC Core |
$865.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$532.91
|
| Rate for Payer: UHC Exchange |
$865.89
|
| Rate for Payer: UHC Medicaid |
$352.94
|
| Rate for Payer: UHCCP Medicaid |
$352.94
|
| Rate for Payer: UMR Bronson Commercial |
$520.72
|
|
|
PR APPLICATION HIP SPICA CAST 1 LEG
|
Professional
|
Both
|
$505.00
|
|
|
Service Code
|
HCPCS 29305
|
| Min. Negotiated Rate |
$96.70 |
| Max. Negotiated Rate |
$378.75 |
| Rate for Payer: Aetna Commercial |
$197.29
|
| Rate for Payer: Aetna Medicare |
$153.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.01
|
| Rate for Payer: BCBS Complete |
$101.53
|
| Rate for Payer: BCBS MAPPO |
$147.23
|
| Rate for Payer: BCN Commercial |
$242.02
|
| Rate for Payer: BCN Medicare Advantage |
$147.23
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Cofinity Commercial |
$197.29
|
| Rate for Payer: Cofinity Commercial |
$212.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.59
|
| Rate for Payer: Meridian Medicaid |
$101.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$161.95
|
| Rate for Payer: Nomi Health Commercial |
$176.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.75
|
| Rate for Payer: PACE SWMI |
$147.23
|
| Rate for Payer: PHP Commercial |
$206.12
|
| Rate for Payer: PHP Medicare Advantage |
$147.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$258.70
|
| Rate for Payer: Priority Health Medicare |
$147.23
|
| Rate for Payer: Priority Health SBD |
$258.70
|
| Rate for Payer: Priority Health Tiered Network |
$258.70
|
| Rate for Payer: Railroad Medicare Medicare |
$147.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.28
|
| Rate for Payer: UHC Core |
$273.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$147.23
|
| Rate for Payer: UHC Exchange |
$273.28
|
| Rate for Payer: UHC Medicaid |
$96.70
|
| Rate for Payer: UHCCP Medicaid |
$96.70
|
| Rate for Payer: UMR Bronson Commercial |
$232.30
|
|
|
PR APPLICATION INTERVERTEBRAL BIOMECHANICAL DEVICE
|
Professional
|
Both
|
$2,145.00
|
|
|
Service Code
|
HCPCS 22851
|
| Min. Negotiated Rate |
$858.00 |
| Max. Negotiated Rate |
$1,608.75 |
| Rate for Payer: Aetna Medicare |
$1,072.50
|
| Rate for Payer: BCBS Complete |
$858.00
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,608.75
|
| Rate for Payer: UMR Bronson Commercial |
$986.70
|
|
|
PR APPLICATION LONG ARM SPLINT SHOULDER TO HAND
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 29105
|
| Min. Negotiated Rate |
$24.07 |
| Max. Negotiated Rate |
$127.50 |
| Rate for Payer: Aetna Commercial |
$50.85
|
| Rate for Payer: Aetna Medicare |
$39.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.65
|
| Rate for Payer: BCBS Complete |
$25.27
|
| Rate for Payer: BCBS MAPPO |
$37.95
|
| Rate for Payer: BCN Commercial |
$62.25
|
| Rate for Payer: BCN Medicare Advantage |
$37.95
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cofinity Commercial |
$54.65
|
| Rate for Payer: Cofinity Commercial |
$50.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.85
|
| Rate for Payer: Meridian Medicaid |
$25.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.74
|
| Rate for Payer: Nomi Health Commercial |
$45.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.50
|
| Rate for Payer: PACE SWMI |
$37.95
|
| Rate for Payer: PHP Commercial |
$53.13
|
| Rate for Payer: PHP Medicare Advantage |
$37.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$66.54
|
| Rate for Payer: Priority Health Medicare |
$37.95
|
| Rate for Payer: Priority Health SBD |
$66.54
|
| Rate for Payer: Priority Health Tiered Network |
$66.54
|
| Rate for Payer: Railroad Medicare Medicare |
$37.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.47
|
| Rate for Payer: UHC Core |
$74.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.95
|
| Rate for Payer: UHC Exchange |
$74.47
|
| Rate for Payer: UHC Medicaid |
$24.07
|
| Rate for Payer: UHCCP Medicaid |
$24.07
|
| Rate for Payer: UMR Bronson Commercial |
$78.20
|
|
|
PR APPLICATION LONG LEG CAST BRACE
|
Professional
|
Both
|
$285.00
|
|
|
Service Code
|
HCPCS 29358
|
| Min. Negotiated Rate |
$61.13 |
| Max. Negotiated Rate |
$213.75 |
| Rate for Payer: Aetna Commercial |
$125.49
|
| Rate for Payer: Aetna Medicare |
$97.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.86
|
| Rate for Payer: BCBS Complete |
$64.19
|
| Rate for Payer: BCBS MAPPO |
$93.65
|
| Rate for Payer: BCN Commercial |
$156.37
|
| Rate for Payer: BCN Medicare Advantage |
$93.65
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$125.49
|
| Rate for Payer: Cofinity Commercial |
$134.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.33
|
| Rate for Payer: Meridian Medicaid |
$64.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$103.02
|
| Rate for Payer: Nomi Health Commercial |
$112.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.75
|
| Rate for Payer: PACE SWMI |
$93.65
|
| Rate for Payer: PHP Commercial |
$131.11
|
| Rate for Payer: PHP Medicare Advantage |
$93.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$167.15
|
| Rate for Payer: Priority Health Medicare |
$93.65
|
| Rate for Payer: Priority Health SBD |
$167.15
|
| Rate for Payer: Priority Health Tiered Network |
$167.15
|
| Rate for Payer: Railroad Medicare Medicare |
$93.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.19
|
| Rate for Payer: UHC Core |
$179.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$93.65
|
| Rate for Payer: UHC Exchange |
$179.19
|
| Rate for Payer: UHC Medicaid |
$61.13
|
| Rate for Payer: UHCCP Medicaid |
$61.13
|
| Rate for Payer: UMR Bronson Commercial |
$131.10
|
|
|
PR APPLICATION LONG LEG CAST THIGH-TOE
|
Professional
|
Both
|
$290.00
|
|
|
Service Code
|
HCPCS 29345
|
| Min. Negotiated Rate |
$58.36 |
| Max. Negotiated Rate |
$217.50 |
| Rate for Payer: Aetna Commercial |
$119.81
|
| Rate for Payer: Aetna Medicare |
$92.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.75
|
| Rate for Payer: BCBS Complete |
$61.28
|
| Rate for Payer: BCBS MAPPO |
$89.41
|
| Rate for Payer: BCN Commercial |
$150.39
|
| Rate for Payer: BCN Medicare Advantage |
$89.41
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cofinity Commercial |
$119.81
|
| Rate for Payer: Cofinity Commercial |
$128.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.88
|
| Rate for Payer: Meridian Medicaid |
$61.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.35
|
| Rate for Payer: Nomi Health Commercial |
$107.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$217.50
|
| Rate for Payer: PACE SWMI |
$89.41
|
| Rate for Payer: PHP Commercial |
$125.17
|
| Rate for Payer: PHP Medicare Advantage |
$89.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$160.77
|
| Rate for Payer: Priority Health Medicare |
$89.41
|
| Rate for Payer: Priority Health SBD |
$160.77
|
| Rate for Payer: Priority Health Tiered Network |
$160.77
|
| Rate for Payer: Railroad Medicare Medicare |
$89.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.81
|
| Rate for Payer: UHC Core |
$173.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$89.41
|
| Rate for Payer: UHC Exchange |
$173.81
|
| Rate for Payer: UHC Medicaid |
$58.36
|
| Rate for Payer: UHCCP Medicaid |
$58.36
|
| Rate for Payer: UMR Bronson Commercial |
$133.40
|
|
|
PR APPLICATION LONG LEG CAST WALKER/AMBULATORY TYPE
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
HCPCS 29355
|
| Min. Negotiated Rate |
$61.77 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$127.02
|
| Rate for Payer: Aetna Medicare |
$98.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.50
|
| Rate for Payer: BCBS Complete |
$64.86
|
| Rate for Payer: BCBS MAPPO |
$94.79
|
| Rate for Payer: BCN Commercial |
$159.85
|
| Rate for Payer: BCN Medicare Advantage |
$94.79
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Commercial |
$127.02
|
| Rate for Payer: Cofinity Commercial |
$136.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.53
|
| Rate for Payer: Meridian Medicaid |
$64.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.27
|
| Rate for Payer: Nomi Health Commercial |
$113.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.00
|
| Rate for Payer: PACE SWMI |
$94.79
|
| Rate for Payer: PHP Commercial |
$132.71
|
| Rate for Payer: PHP Medicare Advantage |
$94.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$170.87
|
| Rate for Payer: Priority Health Medicare |
$94.79
|
| Rate for Payer: Priority Health SBD |
$170.87
|
| Rate for Payer: Priority Health Tiered Network |
$170.87
|
| Rate for Payer: Railroad Medicare Medicare |
$94.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.04
|
| Rate for Payer: UHC Core |
$186.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$94.79
|
| Rate for Payer: UHC Exchange |
$186.04
|
| Rate for Payer: UHC Medicaid |
$61.77
|
| Rate for Payer: UHCCP Medicaid |
$61.77
|
| Rate for Payer: UMR Bronson Commercial |
$119.60
|
|
|
PR APPLICATION LONG LEG SPLINT THIGH TO ANKLE/TOES
|
Professional
|
Both
|
$141.00
|
|
|
Service Code
|
HCPCS 29505
|
| Min. Negotiated Rate |
$34.93 |
| Max. Negotiated Rate |
$105.75 |
| Rate for Payer: Aetna Commercial |
$70.89
|
| Rate for Payer: Aetna Medicare |
$55.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.18
|
| Rate for Payer: BCBS Complete |
$36.68
|
| Rate for Payer: BCBS MAPPO |
$52.90
|
| Rate for Payer: BCN Commercial |
$80.18
|
| Rate for Payer: BCN Medicare Advantage |
$52.90
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cofinity Commercial |
$70.89
|
| Rate for Payer: Cofinity Commercial |
$76.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.55
|
| Rate for Payer: Meridian Medicaid |
$36.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.19
|
| Rate for Payer: Nomi Health Commercial |
$63.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.75
|
| Rate for Payer: PACE SWMI |
$52.90
|
| Rate for Payer: PHP Commercial |
$74.06
|
| Rate for Payer: PHP Medicare Advantage |
$52.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$85.71
|
| Rate for Payer: Priority Health Medicare |
$52.90
|
| Rate for Payer: Priority Health SBD |
$85.71
|
| Rate for Payer: Priority Health Tiered Network |
$85.71
|
| Rate for Payer: Railroad Medicare Medicare |
$52.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.57
|
| Rate for Payer: UHC Core |
$87.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.90
|
| Rate for Payer: UHC Exchange |
$87.57
|
| Rate for Payer: UHC Medicaid |
$34.93
|
| Rate for Payer: UHCCP Medicaid |
$34.93
|
| Rate for Payer: UMR Bronson Commercial |
$64.86
|
|
|
PR APPLICATION MODALITY 1/> AREAS HOT/COLD PACKS
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS 97010
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$89.48 |
| Rate for Payer: Aetna Commercial |
$4.45
|
| Rate for Payer: Aetna Medicare |
$4.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.45
|
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: BCN Commercial |
$6.68
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$89.48
|
| Rate for Payer: Priority Health SBD |
$89.48
|
| Rate for Payer: Priority Health Tiered Network |
$89.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.54
|
| Rate for Payer: UHC Core |
$5.54
|
| Rate for Payer: UHC Exchange |
$5.54
|
| Rate for Payer: UMR Bronson Commercial |
$3.68
|
|
