|
PR ARREST EPIPHYSEAL OPEN DISTAL TIBIA
|
Professional
|
Both
|
$1,430.00
|
|
|
Service Code
|
HCPCS 27730
|
| Min. Negotiated Rate |
$341.28 |
| Max. Negotiated Rate |
$929.50 |
| Rate for Payer: Aetna Commercial |
$763.42
|
| Rate for Payer: Aetna Medicare |
$592.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$763.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$820.40
|
| Rate for Payer: BCBS Complete |
$405.48
|
| Rate for Payer: BCBS MAPPO |
$569.72
|
| Rate for Payer: BCBS Trust/PPO |
$341.28
|
| Rate for Payer: BCN Commercial |
$869.36
|
| Rate for Payer: BCN Medicare Advantage |
$569.72
|
| Rate for Payer: Cash Price |
$1,144.00
|
| Rate for Payer: Cash Price |
$1,144.00
|
| Rate for Payer: Cofinity Commercial |
$763.42
|
| Rate for Payer: Cofinity Commercial |
$820.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$569.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$598.21
|
| Rate for Payer: Meridian Medicaid |
$405.48
|
| Rate for Payer: Nomi Health Commercial |
$683.66
|
| Rate for Payer: PACE SWMI |
$569.72
|
| Rate for Payer: PHP Commercial |
$797.61
|
| Rate for Payer: PHP Medicare Advantage |
$569.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$386.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$929.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$914.93
|
| Rate for Payer: Priority Health Medicare |
$569.72
|
| Rate for Payer: Priority Health Narrow Network |
$914.93
|
| Rate for Payer: Priority Health SBD |
$914.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$569.72
|
| Rate for Payer: UHC Medicare Advantage |
$569.72
|
| Rate for Payer: UHCCP Medicaid |
$386.17
|
| Rate for Payer: UMR Bronson Commercial |
$657.80
|
|
|
PR ARREST EPIPHYSEAL OPEN DISTAL TIBIA&FIBULA
|
Professional
|
Both
|
$2,957.00
|
|
|
Service Code
|
HCPCS 27734
|
| Min. Negotiated Rate |
$237.21 |
| Max. Negotiated Rate |
$1,922.05 |
| Rate for Payer: Aetna Commercial |
$853.71
|
| Rate for Payer: Aetna Medicare |
$662.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$853.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$917.42
|
| Rate for Payer: BCBS Complete |
$452.67
|
| Rate for Payer: BCBS MAPPO |
$637.10
|
| Rate for Payer: BCBS Trust/PPO |
$237.21
|
| Rate for Payer: BCN Commercial |
$971.00
|
| Rate for Payer: BCN Medicare Advantage |
$637.10
|
| Rate for Payer: Cash Price |
$2,365.60
|
| Rate for Payer: Cash Price |
$2,365.60
|
| Rate for Payer: Cofinity Commercial |
$853.71
|
| Rate for Payer: Cofinity Commercial |
$917.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$668.96
|
| Rate for Payer: Meridian Medicaid |
$452.67
|
| Rate for Payer: Nomi Health Commercial |
$764.52
|
| Rate for Payer: PACE SWMI |
$637.10
|
| Rate for Payer: PHP Commercial |
$891.94
|
| Rate for Payer: PHP Medicare Advantage |
$637.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,922.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,020.78
|
| Rate for Payer: Priority Health Medicare |
$637.10
|
| Rate for Payer: Priority Health Narrow Network |
$1,020.78
|
| Rate for Payer: Priority Health SBD |
$1,020.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$637.10
|
| Rate for Payer: UHC Medicare Advantage |
$637.10
|
| Rate for Payer: UHCCP Medicaid |
$431.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,360.22
|
|
|
PR ARRST EPIPHYSL ANY METH TIBFIB&DSTL FEMUR
|
Professional
|
Both
|
$1,353.00
|
|
|
Service Code
|
HCPCS 27742
|
| Min. Negotiated Rate |
$507.79 |
| Max. Negotiated Rate |
$2,852.82 |
| Rate for Payer: Aetna Commercial |
$1,006.90
|
| Rate for Payer: Aetna Medicare |
$781.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,006.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,082.04
|
| Rate for Payer: BCBS Complete |
$533.18
|
| Rate for Payer: BCBS MAPPO |
$751.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,852.82
|
| Rate for Payer: BCN Commercial |
$1,144.48
|
| Rate for Payer: BCN Medicare Advantage |
$751.42
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cofinity Commercial |
$1,006.90
|
| Rate for Payer: Cofinity Commercial |
$1,082.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$751.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$788.99
|
| Rate for Payer: Meridian Medicaid |
$533.18
|
| Rate for Payer: Nomi Health Commercial |
$901.70
|
| Rate for Payer: PACE SWMI |
$751.42
|
| Rate for Payer: PHP Commercial |
$1,051.99
|
| Rate for Payer: PHP Medicare Advantage |
$751.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$507.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$879.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,202.95
|
| Rate for Payer: Priority Health Medicare |
$751.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,202.95
|
| Rate for Payer: Priority Health SBD |
$1,202.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$751.42
|
| Rate for Payer: UHC Medicare Advantage |
$751.42
|
| Rate for Payer: UHCCP Medicaid |
$507.79
|
| Rate for Payer: UMR Bronson Commercial |
$622.38
|
|
|
PR ARRST EPIPHYSL CMBN DSTL FEMUR PROX TIBFIB
|
Professional
|
Both
|
$3,099.00
|
|
|
Service Code
|
HCPCS 27479
|
| Min. Negotiated Rate |
$597.25 |
| Max. Negotiated Rate |
$2,014.35 |
| Rate for Payer: Aetna Commercial |
$1,188.41
|
| Rate for Payer: Aetna Medicare |
$922.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,188.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,277.09
|
| Rate for Payer: BCBS Complete |
$627.11
|
| Rate for Payer: BCBS MAPPO |
$886.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,021.73
|
| Rate for Payer: BCN Commercial |
$1,348.75
|
| Rate for Payer: BCN Medicare Advantage |
$886.87
|
| Rate for Payer: Cash Price |
$2,479.20
|
| Rate for Payer: Cash Price |
$2,479.20
|
| Rate for Payer: Cofinity Commercial |
$1,188.41
|
| Rate for Payer: Cofinity Commercial |
$1,277.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$886.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$931.21
|
| Rate for Payer: Meridian Medicaid |
$627.11
|
| Rate for Payer: Nomi Health Commercial |
$1,064.24
|
| Rate for Payer: PACE SWMI |
$886.87
|
| Rate for Payer: PHP Commercial |
$1,241.62
|
| Rate for Payer: PHP Medicare Advantage |
$886.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,014.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,415.15
|
| Rate for Payer: Priority Health Medicare |
$886.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,415.15
|
| Rate for Payer: Priority Health SBD |
$1,415.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$886.87
|
| Rate for Payer: UHC Medicare Advantage |
$886.87
|
| Rate for Payer: UHCCP Medicaid |
$597.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,425.54
|
|
|
PR ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS 36600
|
| Min. Negotiated Rate |
$9.37 |
| Max. Negotiated Rate |
$789.28 |
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Aetna Commercial |
$18.84
|
| Rate for Payer: Aetna Medicare |
$14.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.25
|
| Rate for Payer: BCBS Complete |
$9.84
|
| Rate for Payer: BCBS MAPPO |
$14.06
|
| Rate for Payer: BCBS Trust/PPO |
$789.28
|
| Rate for Payer: BCN Commercial |
$40.07
|
| Rate for Payer: BCN Medicare Advantage |
$14.06
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cofinity Commercial |
$18.84
|
| Rate for Payer: Cofinity Commercial |
$20.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.76
|
| Rate for Payer: Meridian Medicaid |
$9.84
|
| Rate for Payer: Nomi Health Commercial |
$16.87
|
| Rate for Payer: PACE SWMI |
$14.06
|
| Rate for Payer: PHP Commercial |
$19.68
|
| Rate for Payer: PHP Medicare Advantage |
$14.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.41
|
| Rate for Payer: Priority Health Medicare |
$14.06
|
| Rate for Payer: Priority Health Narrow Network |
$23.41
|
| Rate for Payer: Priority Health SBD |
$23.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.06
|
| Rate for Payer: UHC Medicare Advantage |
$14.06
|
| Rate for Payer: UHCCP Medicaid |
$9.37
|
| Rate for Payer: UMR Bronson Commercial |
$64.40
|
|
|
PR ARTERIOVENOUS ANASTOMOSIS OPEN DIRECT
|
Professional
|
Both
|
$2,238.00
|
|
|
Service Code
|
HCPCS 36821
|
| Min. Negotiated Rate |
$413.43 |
| Max. Negotiated Rate |
$1,454.70 |
| Rate for Payer: Aetna Commercial |
$845.27
|
| Rate for Payer: Aetna Medicare |
$656.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$845.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$908.35
|
| Rate for Payer: BCBS Complete |
$434.10
|
| Rate for Payer: BCBS MAPPO |
$630.80
|
| Rate for Payer: BCBS Trust/PPO |
$869.05
|
| Rate for Payer: BCN Commercial |
$946.08
|
| Rate for Payer: BCN Medicare Advantage |
$630.80
|
| Rate for Payer: Cash Price |
$1,790.40
|
| Rate for Payer: Cash Price |
$1,790.40
|
| Rate for Payer: Cofinity Commercial |
$845.27
|
| Rate for Payer: Cofinity Commercial |
$908.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$630.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$662.34
|
| Rate for Payer: Meridian Medicaid |
$434.10
|
| Rate for Payer: Nomi Health Commercial |
$756.96
|
| Rate for Payer: PACE SWMI |
$630.80
|
| Rate for Payer: PHP Commercial |
$883.12
|
| Rate for Payer: PHP Medicare Advantage |
$630.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,454.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,031.20
|
| Rate for Payer: Priority Health Medicare |
$630.80
|
| Rate for Payer: Priority Health Narrow Network |
$1,031.20
|
| Rate for Payer: Priority Health SBD |
$1,031.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$630.80
|
| Rate for Payer: UHC Medicare Advantage |
$630.80
|
| Rate for Payer: UHCCP Medicaid |
$413.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,029.48
|
|
|
PR ARTERY EXPOS/GRAFT ARTERY PERFUSION ECMO/ECLS
|
Professional
|
Both
|
$442.00
|
|
|
Service Code
|
HCPCS 33987
|
| Min. Negotiated Rate |
$129.08 |
| Max. Negotiated Rate |
$322.28 |
| Rate for Payer: Aetna Commercial |
$265.21
|
| Rate for Payer: Aetna Medicare |
$205.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.00
|
| Rate for Payer: BCBS Complete |
$135.53
|
| Rate for Payer: BCBS MAPPO |
$197.92
|
| Rate for Payer: BCBS Trust/PPO |
$129.43
|
| Rate for Payer: BCN Commercial |
$295.65
|
| Rate for Payer: BCN Medicare Advantage |
$197.92
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Cofinity Commercial |
$265.21
|
| Rate for Payer: Cofinity Commercial |
$285.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.82
|
| Rate for Payer: Meridian Medicaid |
$135.53
|
| Rate for Payer: Nomi Health Commercial |
$237.50
|
| Rate for Payer: PACE SWMI |
$197.92
|
| Rate for Payer: PHP Commercial |
$277.09
|
| Rate for Payer: PHP Medicare Advantage |
$197.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$322.28
|
| Rate for Payer: Priority Health Medicare |
$197.92
|
| Rate for Payer: Priority Health Narrow Network |
$322.28
|
| Rate for Payer: Priority Health SBD |
$322.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.92
|
| Rate for Payer: UHC Medicare Advantage |
$197.92
|
| Rate for Payer: UHCCP Medicaid |
$129.08
|
| Rate for Payer: UMR Bronson Commercial |
$203.32
|
|
|
PR ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2
|
Professional
|
Both
|
$4,416.00
|
|
|
Service Code
|
HCPCS 22551
|
| Min. Negotiated Rate |
$1,102.06 |
| Max. Negotiated Rate |
$12,500.50 |
| Rate for Payer: Aetna Commercial |
$2,232.49
|
| Rate for Payer: Aetna Medicare |
$1,732.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,232.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,399.10
|
| Rate for Payer: BCBS Complete |
$1,157.16
|
| Rate for Payer: BCBS MAPPO |
$1,666.04
|
| Rate for Payer: BCBS Trust/PPO |
$12,500.50
|
| Rate for Payer: BCN Commercial |
$2,498.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,666.04
|
| Rate for Payer: Cash Price |
$3,532.80
|
| Rate for Payer: Cash Price |
$3,532.80
|
| Rate for Payer: Cofinity Commercial |
$2,232.49
|
| Rate for Payer: Cofinity Commercial |
$2,399.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,666.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,749.34
|
| Rate for Payer: Meridian Medicaid |
$1,157.16
|
| Rate for Payer: Nomi Health Commercial |
$1,999.25
|
| Rate for Payer: PACE SWMI |
$1,666.04
|
| Rate for Payer: PHP Commercial |
$2,332.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,666.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,102.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,870.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,620.64
|
| Rate for Payer: Priority Health Medicare |
$1,666.04
|
| Rate for Payer: Priority Health Narrow Network |
$2,620.64
|
| Rate for Payer: Priority Health SBD |
$2,620.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,666.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,666.04
|
| Rate for Payer: UHCCP Medicaid |
$1,102.06
|
| Rate for Payer: UMR Bronson Commercial |
$2,031.36
|
|
|
PR ARTHRD ANT INTERBODY MIN DSC CRV BELOW C2
|
Professional
|
Both
|
$4,916.00
|
|
|
Service Code
|
HCPCS 22554
|
| Min. Negotiated Rate |
$407.75 |
| Max. Negotiated Rate |
$3,195.40 |
| Rate for Payer: Aetna Commercial |
$1,656.15
|
| Rate for Payer: Aetna Medicare |
$1,285.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,656.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,779.74
|
| Rate for Payer: BCBS Complete |
$862.40
|
| Rate for Payer: BCBS MAPPO |
$1,235.93
|
| Rate for Payer: BCBS Trust/PPO |
$407.75
|
| Rate for Payer: BCN Commercial |
$2,043.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,235.93
|
| Rate for Payer: Cash Price |
$3,932.80
|
| Rate for Payer: Cash Price |
$3,932.80
|
| Rate for Payer: Cofinity Commercial |
$1,656.15
|
| Rate for Payer: Cofinity Commercial |
$1,779.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,235.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,297.73
|
| Rate for Payer: Meridian Medicaid |
$862.40
|
| Rate for Payer: Nomi Health Commercial |
$1,483.12
|
| Rate for Payer: PACE SWMI |
$1,235.93
|
| Rate for Payer: PHP Commercial |
$1,730.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,235.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$821.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,195.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,950.97
|
| Rate for Payer: Priority Health Medicare |
$1,235.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,950.97
|
| Rate for Payer: Priority Health SBD |
$1,950.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,235.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,235.93
|
| Rate for Payer: UHCCP Medicaid |
$821.33
|
| Rate for Payer: UMR Bronson Commercial |
$2,261.36
|
|
|
PR ARTHRD ANT INTERBODY MIN DSC LUMBAR
|
Professional
|
Both
|
$3,190.00
|
|
|
Service Code
|
HCPCS 22558
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$2,462.22 |
| Rate for Payer: Aetna Commercial |
$1,992.14
|
| Rate for Payer: Aetna Medicare |
$1,546.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,992.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,140.80
|
| Rate for Payer: BCBS Complete |
$1,035.50
|
| Rate for Payer: BCBS MAPPO |
$1,486.67
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$2,462.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,486.67
|
| Rate for Payer: Cash Price |
$2,552.00
|
| Rate for Payer: Cash Price |
$2,552.00
|
| Rate for Payer: Cofinity Commercial |
$1,992.14
|
| Rate for Payer: Cofinity Commercial |
$2,140.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,486.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,561.00
|
| Rate for Payer: Meridian Medicaid |
$1,035.50
|
| Rate for Payer: Nomi Health Commercial |
$1,784.00
|
| Rate for Payer: PACE SWMI |
$1,486.67
|
| Rate for Payer: PHP Commercial |
$2,081.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,486.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$986.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,073.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,343.30
|
| Rate for Payer: Priority Health Medicare |
$1,486.67
|
| Rate for Payer: Priority Health Narrow Network |
$2,343.30
|
| Rate for Payer: Priority Health SBD |
$2,343.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,486.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,486.67
|
| Rate for Payer: UHCCP Medicaid |
$986.19
|
| Rate for Payer: UMR Bronson Commercial |
$1,467.40
|
|
|
PR ARTHRD ANT INTERBODY MIN DSC THORACIC
|
Professional
|
Both
|
$5,983.00
|
|
|
Service Code
|
HCPCS 22556
|
| Min. Negotiated Rate |
$350.50 |
| Max. Negotiated Rate |
$3,888.95 |
| Rate for Payer: Aetna Commercial |
$2,207.88
|
| Rate for Payer: Aetna Medicare |
$1,713.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,207.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,372.64
|
| Rate for Payer: BCBS Complete |
$1,147.54
|
| Rate for Payer: BCBS MAPPO |
$1,647.67
|
| Rate for Payer: BCBS Trust/PPO |
$350.50
|
| Rate for Payer: BCN Commercial |
$2,700.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,647.67
|
| Rate for Payer: Cash Price |
$4,786.40
|
| Rate for Payer: Cash Price |
$4,786.40
|
| Rate for Payer: Cofinity Commercial |
$2,207.88
|
| Rate for Payer: Cofinity Commercial |
$2,372.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,647.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,730.05
|
| Rate for Payer: Meridian Medicaid |
$1,147.54
|
| Rate for Payer: Nomi Health Commercial |
$1,977.20
|
| Rate for Payer: PACE SWMI |
$1,647.67
|
| Rate for Payer: PHP Commercial |
$2,306.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,647.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,092.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,888.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,597.74
|
| Rate for Payer: Priority Health Medicare |
$1,647.67
|
| Rate for Payer: Priority Health Narrow Network |
$2,597.74
|
| Rate for Payer: Priority Health SBD |
$2,597.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,647.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,647.67
|
| Rate for Payer: UHCCP Medicaid |
$1,092.90
|
| Rate for Payer: UMR Bronson Commercial |
$2,752.18
|
|
|
PR ARTHRD ANT INTERDY CERVCL BELW C2 EA ADDL NTRSPC
|
Professional
|
Both
|
$1,031.00
|
|
|
Service Code
|
HCPCS 22552
|
| Min. Negotiated Rate |
$86.88 |
| Max. Negotiated Rate |
$670.15 |
| Rate for Payer: Aetna Commercial |
$519.44
|
| Rate for Payer: Aetna Medicare |
$403.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$558.20
|
| Rate for Payer: BCBS Complete |
$266.36
|
| Rate for Payer: BCBS MAPPO |
$387.64
|
| Rate for Payer: BCBS Trust/PPO |
$86.88
|
| Rate for Payer: BCN Commercial |
$576.64
|
| Rate for Payer: BCN Medicare Advantage |
$387.64
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cash Price |
$824.80
|
| Rate for Payer: Cofinity Commercial |
$519.44
|
| Rate for Payer: Cofinity Commercial |
$558.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$407.02
|
| Rate for Payer: Meridian Medicaid |
$266.36
|
| Rate for Payer: Nomi Health Commercial |
$465.17
|
| Rate for Payer: PACE SWMI |
$387.64
|
| Rate for Payer: PHP Commercial |
$542.70
|
| Rate for Payer: PHP Medicare Advantage |
$387.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$670.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$603.00
|
| Rate for Payer: Priority Health Medicare |
$387.64
|
| Rate for Payer: Priority Health Narrow Network |
$603.00
|
| Rate for Payer: Priority Health SBD |
$603.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$387.64
|
| Rate for Payer: UHC Medicare Advantage |
$387.64
|
| Rate for Payer: UHCCP Medicaid |
$253.68
|
| Rate for Payer: UMR Bronson Commercial |
$474.26
|
|
|
PR ARTHRD ANT NTRBD MIN DSC EA ADDL INTERSPACE
|
Professional
|
Both
|
$1,667.00
|
|
|
Service Code
|
HCPCS 22585
|
| Min. Negotiated Rate |
$207.04 |
| Max. Negotiated Rate |
$1,083.55 |
| Rate for Payer: Aetna Commercial |
$423.28
|
| Rate for Payer: Aetna Medicare |
$328.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$423.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$454.87
|
| Rate for Payer: BCBS Complete |
$217.39
|
| Rate for Payer: BCBS MAPPO |
$315.88
|
| Rate for Payer: BCBS Trust/PPO |
$233.52
|
| Rate for Payer: BCN Commercial |
$520.86
|
| Rate for Payer: BCN Medicare Advantage |
$315.88
|
| Rate for Payer: Cash Price |
$1,333.60
|
| Rate for Payer: Cash Price |
$1,333.60
|
| Rate for Payer: Cofinity Commercial |
$423.28
|
| Rate for Payer: Cofinity Commercial |
$454.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$315.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$331.67
|
| Rate for Payer: Meridian Medicaid |
$217.39
|
| Rate for Payer: Nomi Health Commercial |
$379.06
|
| Rate for Payer: PACE SWMI |
$315.88
|
| Rate for Payer: PHP Commercial |
$442.23
|
| Rate for Payer: PHP Medicare Advantage |
$315.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$207.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,083.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$493.09
|
| Rate for Payer: Priority Health Medicare |
$315.88
|
| Rate for Payer: Priority Health Narrow Network |
$493.09
|
| Rate for Payer: Priority Health SBD |
$493.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$315.88
|
| Rate for Payer: UHC Medicare Advantage |
$315.88
|
| Rate for Payer: UHCCP Medicaid |
$207.04
|
| Rate for Payer: UMR Bronson Commercial |
$766.82
|
|
|
PR ARTHRD CARP/MTCRPL JT DGT OTHER THAN THUMB EACH
|
Professional
|
Both
|
$3,111.00
|
|
|
Service Code
|
HCPCS 26843
|
| Min. Negotiated Rate |
$230.34 |
| Max. Negotiated Rate |
$2,022.15 |
| Rate for Payer: Aetna Commercial |
$983.91
|
| Rate for Payer: Aetna Medicare |
$763.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,057.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$983.91
|
| Rate for Payer: BCBS Complete |
$530.05
|
| Rate for Payer: BCBS MAPPO |
$734.26
|
| Rate for Payer: BCBS Trust/PPO |
$230.34
|
| Rate for Payer: BCN Commercial |
$1,163.54
|
| Rate for Payer: BCN Medicare Advantage |
$734.26
|
| Rate for Payer: Cash Price |
$2,488.80
|
| Rate for Payer: Cash Price |
$2,488.80
|
| Rate for Payer: Cofinity Commercial |
$1,057.33
|
| Rate for Payer: Cofinity Commercial |
$983.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$734.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$770.97
|
| Rate for Payer: Meridian Medicaid |
$530.05
|
| Rate for Payer: Nomi Health Commercial |
$881.11
|
| Rate for Payer: PACE SWMI |
$734.26
|
| Rate for Payer: PHP Commercial |
$1,027.96
|
| Rate for Payer: PHP Medicare Advantage |
$734.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$504.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,022.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,211.08
|
| Rate for Payer: Priority Health Medicare |
$734.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,211.08
|
| Rate for Payer: Priority Health SBD |
$1,211.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$734.26
|
| Rate for Payer: UHC Medicare Advantage |
$734.26
|
| Rate for Payer: UHCCP Medicaid |
$504.81
|
| Rate for Payer: UMR Bronson Commercial |
$1,431.06
|
|
|
PR ARTHRD CARP/MTCRPL JT DGT OTH/THN THMB W/AGRFT
|
Professional
|
Both
|
$3,348.00
|
|
|
Service Code
|
HCPCS 26844
|
| Min. Negotiated Rate |
$195.47 |
| Max. Negotiated Rate |
$2,176.20 |
| Rate for Payer: Aetna Commercial |
$1,086.14
|
| Rate for Payer: Aetna Medicare |
$842.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,086.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,167.19
|
| Rate for Payer: BCBS Complete |
$583.73
|
| Rate for Payer: BCBS MAPPO |
$810.55
|
| Rate for Payer: BCBS Trust/PPO |
$195.47
|
| Rate for Payer: BCN Commercial |
$1,278.38
|
| Rate for Payer: BCN Medicare Advantage |
$810.55
|
| Rate for Payer: Cash Price |
$2,678.40
|
| Rate for Payer: Cash Price |
$2,678.40
|
| Rate for Payer: Cofinity Commercial |
$1,086.14
|
| Rate for Payer: Cofinity Commercial |
$1,167.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$851.08
|
| Rate for Payer: Meridian Medicaid |
$583.73
|
| Rate for Payer: Nomi Health Commercial |
$972.66
|
| Rate for Payer: PACE SWMI |
$810.55
|
| Rate for Payer: PHP Commercial |
$1,134.77
|
| Rate for Payer: PHP Medicare Advantage |
$810.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$555.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,330.67
|
| Rate for Payer: Priority Health Medicare |
$810.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,330.67
|
| Rate for Payer: Priority Health SBD |
$1,330.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$810.55
|
| Rate for Payer: UHC Medicare Advantage |
$810.55
|
| Rate for Payer: UHCCP Medicaid |
$555.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,540.08
|
|
|
PR ARTHRD CARPO/METACARPAL JT THUMB W/WO INT FIXJ
|
Professional
|
Both
|
$3,111.00
|
|
|
Service Code
|
HCPCS 26841
|
| Min. Negotiated Rate |
$223.47 |
| Max. Negotiated Rate |
$2,022.15 |
| Rate for Payer: Aetna Commercial |
$970.16
|
| Rate for Payer: Aetna Medicare |
$752.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,042.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$970.16
|
| Rate for Payer: BCBS Complete |
$524.23
|
| Rate for Payer: BCBS MAPPO |
$724.00
|
| Rate for Payer: BCBS Trust/PPO |
$223.47
|
| Rate for Payer: BCN Commercial |
$1,148.40
|
| Rate for Payer: BCN Medicare Advantage |
$724.00
|
| Rate for Payer: Cash Price |
$2,488.80
|
| Rate for Payer: Cash Price |
$2,488.80
|
| Rate for Payer: Cofinity Commercial |
$1,042.56
|
| Rate for Payer: Cofinity Commercial |
$970.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$724.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$760.20
|
| Rate for Payer: Meridian Medicaid |
$524.23
|
| Rate for Payer: Nomi Health Commercial |
$868.80
|
| Rate for Payer: PACE SWMI |
$724.00
|
| Rate for Payer: PHP Commercial |
$1,013.60
|
| Rate for Payer: PHP Medicare Advantage |
$724.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,022.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,200.40
|
| Rate for Payer: Priority Health Medicare |
$724.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,200.40
|
| Rate for Payer: Priority Health SBD |
$1,200.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$724.00
|
| Rate for Payer: UHC Medicare Advantage |
$724.00
|
| Rate for Payer: UHCCP Medicaid |
$499.27
|
| Rate for Payer: UMR Bronson Commercial |
$1,431.06
|
|
|
PR ARTHRD CRP/MTACRPL JT THMB W/WO INT FIXJ W/AGRFT
|
Professional
|
Both
|
$3,300.00
|
|
|
Service Code
|
HCPCS 26842
|
| Min. Negotiated Rate |
$161.13 |
| Max. Negotiated Rate |
$2,145.00 |
| Rate for Payer: Aetna Commercial |
$1,049.56
|
| Rate for Payer: Aetna Medicare |
$814.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,049.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,127.88
|
| Rate for Payer: BCBS Complete |
$564.72
|
| Rate for Payer: BCBS MAPPO |
$783.25
|
| Rate for Payer: BCBS Trust/PPO |
$161.13
|
| Rate for Payer: BCN Commercial |
$1,237.34
|
| Rate for Payer: BCN Medicare Advantage |
$783.25
|
| Rate for Payer: Cash Price |
$2,640.00
|
| Rate for Payer: Cash Price |
$2,640.00
|
| Rate for Payer: Cofinity Commercial |
$1,049.56
|
| Rate for Payer: Cofinity Commercial |
$1,127.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$783.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$822.41
|
| Rate for Payer: Meridian Medicaid |
$564.72
|
| Rate for Payer: Nomi Health Commercial |
$939.90
|
| Rate for Payer: PACE SWMI |
$783.25
|
| Rate for Payer: PHP Commercial |
$1,096.55
|
| Rate for Payer: PHP Medicare Advantage |
$783.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$537.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,145.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,287.41
|
| Rate for Payer: Priority Health Medicare |
$783.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,287.41
|
| Rate for Payer: Priority Health SBD |
$1,287.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$783.25
|
| Rate for Payer: UHC Medicare Advantage |
$783.25
|
| Rate for Payer: UHCCP Medicaid |
$537.83
|
| Rate for Payer: UMR Bronson Commercial |
$1,518.00
|
|
|
PR ARTHRD DSTL RAD/ULN JT SGMTL RSCJ ULNA W/WO BONE
|
Professional
|
Both
|
$1,686.00
|
|
|
Service Code
|
HCPCS 25830
|
| Min. Negotiated Rate |
$57.73 |
| Max. Negotiated Rate |
$1,588.67 |
| Rate for Payer: Aetna Commercial |
$1,298.10
|
| Rate for Payer: Aetna Medicare |
$1,007.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,298.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,394.97
|
| Rate for Payer: BCBS Complete |
$697.12
|
| Rate for Payer: BCBS MAPPO |
$968.73
|
| Rate for Payer: BCBS Trust/PPO |
$57.73
|
| Rate for Payer: BCN Commercial |
$1,498.29
|
| Rate for Payer: BCN Medicare Advantage |
$968.73
|
| Rate for Payer: Cash Price |
$1,348.80
|
| Rate for Payer: Cash Price |
$1,348.80
|
| Rate for Payer: Cofinity Commercial |
$1,298.10
|
| Rate for Payer: Cofinity Commercial |
$1,394.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$968.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,017.17
|
| Rate for Payer: Meridian Medicaid |
$697.12
|
| Rate for Payer: Nomi Health Commercial |
$1,162.48
|
| Rate for Payer: PACE SWMI |
$968.73
|
| Rate for Payer: PHP Commercial |
$1,356.22
|
| Rate for Payer: PHP Medicare Advantage |
$968.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$663.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,095.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,588.67
|
| Rate for Payer: Priority Health Medicare |
$968.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,588.67
|
| Rate for Payer: Priority Health SBD |
$1,588.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$968.73
|
| Rate for Payer: UHC Medicare Advantage |
$968.73
|
| Rate for Payer: UHCCP Medicaid |
$663.92
|
| Rate for Payer: UMR Bronson Commercial |
$775.56
|
|
|
PR ARTHRD MIDTARSL/TARS MLT/TRANSVRS W/OSTEOT
|
Professional
|
Both
|
$2,872.00
|
|
|
Service Code
|
HCPCS 28735
|
| Min. Negotiated Rate |
$505.24 |
| Max. Negotiated Rate |
$1,866.80 |
| Rate for Payer: Aetna Commercial |
$1,003.90
|
| Rate for Payer: Aetna Medicare |
$779.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,003.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,078.82
|
| Rate for Payer: BCBS Complete |
$530.50
|
| Rate for Payer: BCBS MAPPO |
$749.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,635.09
|
| Rate for Payer: BCN Commercial |
$1,140.08
|
| Rate for Payer: BCN Medicare Advantage |
$749.18
|
| Rate for Payer: Cash Price |
$2,297.60
|
| Rate for Payer: Cash Price |
$2,297.60
|
| Rate for Payer: Cofinity Commercial |
$1,003.90
|
| Rate for Payer: Cofinity Commercial |
$1,078.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$749.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$786.64
|
| Rate for Payer: Meridian Medicaid |
$530.50
|
| Rate for Payer: Nomi Health Commercial |
$899.02
|
| Rate for Payer: PACE SWMI |
$749.18
|
| Rate for Payer: PHP Commercial |
$1,048.85
|
| Rate for Payer: PHP Medicare Advantage |
$749.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,866.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,192.27
|
| Rate for Payer: Priority Health Medicare |
$749.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,192.27
|
| Rate for Payer: Priority Health SBD |
$1,192.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$749.18
|
| Rate for Payer: UHC Medicare Advantage |
$749.18
|
| Rate for Payer: UHCCP Medicaid |
$505.24
|
| Rate for Payer: UMR Bronson Commercial |
$1,321.12
|
|
|
PR ARTHRD MIDTARSL/TARSOMETATARSAL MULT/TRANSVRS
|
Professional
|
Both
|
$2,783.00
|
|
|
Service Code
|
HCPCS 28730
|
| Min. Negotiated Rate |
$470.30 |
| Max. Negotiated Rate |
$1,808.95 |
| Rate for Payer: Aetna Commercial |
$931.09
|
| Rate for Payer: Aetna Medicare |
$722.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,000.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$931.09
|
| Rate for Payer: BCBS Complete |
$493.82
|
| Rate for Payer: BCBS MAPPO |
$694.84
|
| Rate for Payer: BCBS Trust/PPO |
$872.22
|
| Rate for Payer: BCN Commercial |
$1,065.80
|
| Rate for Payer: BCN Medicare Advantage |
$694.84
|
| Rate for Payer: Cash Price |
$2,226.40
|
| Rate for Payer: Cash Price |
$2,226.40
|
| Rate for Payer: Cofinity Commercial |
$1,000.57
|
| Rate for Payer: Cofinity Commercial |
$931.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$694.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.58
|
| Rate for Payer: Meridian Medicaid |
$493.82
|
| Rate for Payer: Nomi Health Commercial |
$833.81
|
| Rate for Payer: PACE SWMI |
$694.84
|
| Rate for Payer: PHP Commercial |
$972.78
|
| Rate for Payer: PHP Medicare Advantage |
$694.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,808.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,115.92
|
| Rate for Payer: Priority Health Medicare |
$694.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,115.92
|
| Rate for Payer: Priority Health SBD |
$1,115.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$694.84
|
| Rate for Payer: UHC Medicare Advantage |
$694.84
|
| Rate for Payer: UHCCP Medicaid |
$470.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,280.18
|
|
|
PR ARTHRD PST/PSTLAT TQ 1NTRSPC CRV BELW C2 SEGMENT
|
Professional
|
Both
|
$4,367.00
|
|
|
Service Code
|
HCPCS 22600
|
| Min. Negotiated Rate |
$86.88 |
| Max. Negotiated Rate |
$2,838.55 |
| Rate for Payer: Aetna Commercial |
$1,714.11
|
| Rate for Payer: Aetna Medicare |
$1,330.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,714.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,842.03
|
| Rate for Payer: BCBS Complete |
$893.93
|
| Rate for Payer: BCBS MAPPO |
$1,279.19
|
| Rate for Payer: BCBS Trust/PPO |
$86.88
|
| Rate for Payer: BCN Commercial |
$2,113.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,279.19
|
| Rate for Payer: Cash Price |
$3,493.60
|
| Rate for Payer: Cash Price |
$3,493.60
|
| Rate for Payer: Cofinity Commercial |
$1,714.11
|
| Rate for Payer: Cofinity Commercial |
$1,842.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,279.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,343.15
|
| Rate for Payer: Meridian Medicaid |
$893.93
|
| Rate for Payer: Nomi Health Commercial |
$1,535.03
|
| Rate for Payer: PACE SWMI |
$1,279.19
|
| Rate for Payer: PHP Commercial |
$1,790.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,279.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$851.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,838.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,020.17
|
| Rate for Payer: Priority Health Medicare |
$1,279.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,020.17
|
| Rate for Payer: Priority Health SBD |
$2,020.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,279.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,279.19
|
| Rate for Payer: UHCCP Medicaid |
$851.36
|
| Rate for Payer: UMR Bronson Commercial |
$2,008.82
|
|
|
PR ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFOR
|
Professional
|
Both
|
$1,224.00
|
|
|
Service Code
|
HCPCS 28737
|
| Min. Negotiated Rate |
$444.53 |
| Max. Negotiated Rate |
$2,092.60 |
| Rate for Payer: Aetna Commercial |
$882.42
|
| Rate for Payer: Aetna Medicare |
$684.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$882.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$948.27
|
| Rate for Payer: BCBS Complete |
$466.76
|
| Rate for Payer: BCBS MAPPO |
$658.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,092.60
|
| Rate for Payer: BCN Commercial |
$1,001.30
|
| Rate for Payer: BCN Medicare Advantage |
$658.52
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cofinity Commercial |
$882.42
|
| Rate for Payer: Cofinity Commercial |
$948.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$691.45
|
| Rate for Payer: Meridian Medicaid |
$466.76
|
| Rate for Payer: Nomi Health Commercial |
$790.22
|
| Rate for Payer: PACE SWMI |
$658.52
|
| Rate for Payer: PHP Commercial |
$921.93
|
| Rate for Payer: PHP Medicare Advantage |
$658.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$795.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,063.02
|
| Rate for Payer: Priority Health Medicare |
$658.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,063.02
|
| Rate for Payer: Priority Health SBD |
$1,063.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$658.52
|
| Rate for Payer: UHC Medicare Advantage |
$658.52
|
| Rate for Payer: UHCCP Medicaid |
$444.53
|
| Rate for Payer: UMR Bronson Commercial |
$563.04
|
|
|
PR ARTHRD W/XTNSR HALLUCIS LONGUS TR 1ST METAR NCK
|
Professional
|
Both
|
$1,472.00
|
|
|
Service Code
|
HCPCS 28760
|
| Min. Negotiated Rate |
$369.77 |
| Max. Negotiated Rate |
$1,105.87 |
| Rate for Payer: Aetna Commercial |
$732.22
|
| Rate for Payer: Aetna Medicare |
$568.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$732.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$786.86
|
| Rate for Payer: BCBS Complete |
$388.26
|
| Rate for Payer: BCBS MAPPO |
$546.43
|
| Rate for Payer: BCBS Trust/PPO |
$579.02
|
| Rate for Payer: BCN Commercial |
$1,105.87
|
| Rate for Payer: BCN Medicare Advantage |
$546.43
|
| Rate for Payer: Cash Price |
$1,177.60
|
| Rate for Payer: Cash Price |
$1,177.60
|
| Rate for Payer: Cofinity Commercial |
$732.22
|
| Rate for Payer: Cofinity Commercial |
$786.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$573.75
|
| Rate for Payer: Meridian Medicaid |
$388.26
|
| Rate for Payer: Nomi Health Commercial |
$655.72
|
| Rate for Payer: PACE SWMI |
$546.43
|
| Rate for Payer: PHP Commercial |
$765.00
|
| Rate for Payer: PHP Medicare Advantage |
$546.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$956.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$880.84
|
| Rate for Payer: Priority Health Medicare |
$546.43
|
| Rate for Payer: Priority Health Narrow Network |
$880.84
|
| Rate for Payer: Priority Health SBD |
$880.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$546.43
|
| Rate for Payer: UHC Medicare Advantage |
$546.43
|
| Rate for Payer: UHCCP Medicaid |
$369.77
|
| Rate for Payer: UMR Bronson Commercial |
$677.12
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US
|
Professional
|
Both
|
$124.00
|
|
|
Service Code
|
HCPCS 20605
|
| Min. Negotiated Rate |
$23.43 |
| Max. Negotiated Rate |
$80.60 |
| Rate for Payer: Aetna Commercial |
$46.97
|
| Rate for Payer: Aetna Medicare |
$36.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.47
|
| Rate for Payer: BCBS Complete |
$24.60
|
| Rate for Payer: BCBS MAPPO |
$35.05
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$64.79
|
| Rate for Payer: BCN Medicare Advantage |
$35.05
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Commercial |
$46.97
|
| Rate for Payer: Cofinity Commercial |
$50.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.80
|
| Rate for Payer: Meridian Medicaid |
$24.60
|
| Rate for Payer: Nomi Health Commercial |
$42.06
|
| Rate for Payer: PACE SWMI |
$35.05
|
| Rate for Payer: PHP Commercial |
$49.07
|
| Rate for Payer: PHP Medicare Advantage |
$35.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.98
|
| Rate for Payer: Priority Health Medicare |
$35.05
|
| Rate for Payer: Priority Health Narrow Network |
$55.98
|
| Rate for Payer: Priority Health SBD |
$55.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.05
|
| Rate for Payer: UHC Medicare Advantage |
$35.05
|
| Rate for Payer: UHCCP Medicaid |
$23.43
|
| Rate for Payer: UMR Bronson Commercial |
$57.04
|
|
|
PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 20606
|
| Min. Negotiated Rate |
$33.23 |
| Max. Negotiated Rate |
$262.93 |
| Rate for Payer: Aetna Commercial |
$66.93
|
| Rate for Payer: Aetna Medicare |
$51.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.93
|
| Rate for Payer: BCBS Complete |
$34.89
|
| Rate for Payer: BCBS MAPPO |
$49.95
|
| Rate for Payer: BCBS Trust/PPO |
$262.93
|
| Rate for Payer: BCN Commercial |
$104.84
|
| Rate for Payer: BCN Medicare Advantage |
$49.95
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cofinity Commercial |
$66.93
|
| Rate for Payer: Cofinity Commercial |
$71.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.45
|
| Rate for Payer: Meridian Medicaid |
$34.89
|
| Rate for Payer: Nomi Health Commercial |
$59.94
|
| Rate for Payer: PACE SWMI |
$49.95
|
| Rate for Payer: PHP Commercial |
$69.93
|
| Rate for Payer: PHP Medicare Advantage |
$49.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.88
|
| Rate for Payer: Priority Health Medicare |
$49.95
|
| Rate for Payer: Priority Health Narrow Network |
$78.88
|
| Rate for Payer: Priority Health SBD |
$78.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.95
|
| Rate for Payer: UHC Medicare Advantage |
$49.95
|
| Rate for Payer: UHCCP Medicaid |
$33.23
|
| Rate for Payer: UMR Bronson Commercial |
$67.62
|
|
